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File: //soft/newreobd.sql
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Недавно посетив вашу замечательную страну Украина, хотели выразить свое почтение и уважение. Однако для себя и для нашей страны как Казахстан мы увидели много возможностей для совместного партнерство и взаимовыгодного сотрудничество между нашими Странами и компаниями. Мы заинтересованы в продвижении всей линейки вашей продукции на всей территории Казахстан включая 14 областей и17 городов республиканского значения с общейчисленностью в 20 млн. человек. С учетом изложенного будем рады в дальнейшем сотрудничеству и ответа на данное сообщения. С наилучшими пожеланиями и уважением директор по коммерции и логистики. Турегазин Айбек + 7 777 760 06 80.\r\nТоварищество с ограниченной ответственностью\r\n«BAIGELMAN»Республика Казахстан, 010000, г. 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replaced with core/cover -->\n		<gutenberg-block type=\"core/cover-image\" translate=\"1\">\n			<xpath>//div/p</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/subhead\" translate=\"1\">\n			<xpath>//p</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/verse\" translate=\"1\">\n			<xpath>//pre</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/table\" translate=\"1\">\n			<xpath>//th</xpath>\n			<xpath>//td</xpath>\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/preformatted\" translate=\"1\">\n			<xpath>//pre</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/pullquote\" translate=\"1\">\n			<xpath>//blockquote/p</xpath>\n			<xpath>//blockquote/cite</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/navigation-link\" translate=\"1\">\n			<key name=\"label\" />\n			<key name=\"url\" />\n		</gutenberg-block>\n		<gutenberg-block type=\"core/navigation-submenu\" translate=\"1\">\n			<key name=\"label\" />\n			<key name=\"url\" />\n		</gutenberg-block>\n		<gutenberg-block type=\"core/column\" translate=\"0\" />\n		<gutenberg-block type=\"core/columns\" translate=\"0\" />\n		<gutenberg-block type=\"core/code\" translate=\"0\" />\n		<gutenberg-block type=\"core/more\" translate=\"0\" />\n		<gutenberg-block type=\"core/nextpage\" translate=\"0\" />\n		<gutenberg-block type=\"core/separator\" translate=\"0\" />\n		<gutenberg-block type=\"core/spacer\" translate=\"0\" />\n		<gutenberg-block type=\"core/shortcode\" translate=\"0\" />\n		<gutenberg-block type=\"core-embed/twitter\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/youtube\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/facebook\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/instagram\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/vimeo\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/soundcloud\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/spotify\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/flickr\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/animoto\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/collegehumor\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/dailymotion\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/funnyordie\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/hulu\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/imgur\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/issuu\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/kickstarter\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/meetup-com\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/mixcloud\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/photobucket\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/photobucket\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/polldaddy\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/reddit\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/reverbnation\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/screencast\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/scribd\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/slideshare\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/smugmug\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/speaker\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/ted\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/tumblr\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/videopress\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/wordpress\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core-embed/wordpress-tv\" translate=\"1\">\n			<xpath>//figure/figcaption</xpath>\n		</gutenberg-block>\n		<gutenberg-block type=\"core/html\" translate=\"1\">\n			<xpath>/*</xpath>\n		</gutenberg-block>\n	</gutenberg-blocks>\n</wpml-config>\n\";s:9:\"Yoast SEO\";s:2142:\"<wpml-config>\n    <custom-fields>\n        <custom-field action=\"translate\">_yoast_wpseo_title</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_bctitle</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_metadesc</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_metakeywords</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_focuskw</custom-field>\n        <custom-field action=\"copy\">_yoast_wpseo_meta-robots-noindex</custom-field>\n        <custom-field action=\"copy\">_yoast_wpseo_meta-robots-nofollow</custom-field>\n        <custom-field action=\"copy\">_yoast_wpseo_meta-robots-adv</custom-field>\n        <custom-field action=\"ignore\">_yoast_wpseo_canonical</custom-field>\n        <custom-field action=\"ignore\">_yoast_wpseo_redirect</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_opengraph-description</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_google-plus-description</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_twitter-title</custom-field>\n        <custom-field action=\"translate\">_yoast_wpseo_twitter-description</custom-field>\n    </custom-fields>\n    <admin-texts>\n        <key name=\"wpseo_titles\">\n            <key name=\"title-*\" />\n            <key name=\"metadesc-*\" />\n            <key name=\"metakey-*\" />\n            <key name=\"company_name\" />\n        </key>\n        <key name=\"wpseo_internallinks\">\n            <key name=\"breadcrumbs-sep\" />\n            <key name=\"breadcrumbs-home\" />\n            <key name=\"breadcrumbs-prefix\" />\n            <key name=\"breadcrumbs-archiveprefix\" />\n            <key name=\"breadcrumbs-searchprefix\" />\n            <key name=\"breadcrumbs-404crumb\" />\n        </key>\n        <key name=\"wpseo_rss\">\n            <key name=\"rssbefore\" />\n            <key name=\"rssafter\" />\n        </key>\n         <key name=\"wpseo_social\">\n            <key name=\"og_default_image\" />\n            <key name=\"og_frontpage_title\" />\n            <key name=\"og_frontpage_desc\" />\n            <key name=\"og_frontpage_image\" />\n        </key>\n    </admin-texts>\n</wpml-config>\";}}','no'),(269,'icl_admin_messages','a:2:{s:8:\"messages\";a:0:{}s:16:\"instant_messages\";a:0:{}}','yes'),(270,'wp_installer_settings','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href=\"%link%\" class=\"%type%\" bcn-aria-current><span property=\"name\">%htitle%</span></a><meta property=\"position\" content=\"%position%\"></span>\";s:29:\"Hpost_page_template_no_anchor\";s:195:\"<span property=\"itemListElement\" typeof=\"ListItem\"><span property=\"name\" class=\"%type%\">%htitle%</span><meta property=\"url\" content=\"%link%\"><meta property=\"position\" content=\"%position%\"></span>\";s:15:\"apost_page_root\";s:1:\"8\";s:15:\"Hpaged_template\";s:53:\"<span class=\"%type%\">Страница %htitle%</span>\";s:14:\"bpaged_display\";b:0;s:19:\"Hpost_post_template\";s:263:\"<span property=\"itemListElement\" typeof=\"ListItem\"><a property=\"item\" typeof=\"WebPage\" title=\"Перейти к %title%.\" href=\"%link%\" class=\"%type%\" bcn-aria-current><span property=\"name\">%htitle%</span></a><meta property=\"position\" content=\"%position%\"></span>\";s:29:\"Hpost_post_template_no_anchor\";s:195:\"<span property=\"itemListElement\" typeof=\"ListItem\"><span property=\"name\" 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Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(731,8,'_s4-notes','field_60bf7ca31f58d'),(732,8,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(13001,1315,'slider','8'),(13002,1315,'_slider','field_60bf767ef46ea'),(733,8,'_s5-video','field_60bf7ccfa01a5'),(734,8,'s6-ttl','Коли звичайної води замало!'),(735,8,'_s6-ttl','field_60bf7cfb10d31'),(736,8,'s6-list','6'),(737,8,'_s6-list','field_60bf7d0410d32'),(738,91,'slider','8'),(739,91,'_slider','field_60bf767ef46ea'),(740,91,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(741,91,'_s2-ttl','field_60bf76d1f46ed'),(742,91,'s2-list','6'),(743,91,'_s2-list','field_60bf76e0f46ee'),(744,91,'slider_0_slide','50'),(745,91,'_slider_0_slide','field_60bf7688f46eb'),(746,91,'slider_1_slide','51'),(747,91,'_slider_1_slide','field_60bf7688f46eb'),(748,91,'slider_2_slide','52'),(749,91,'_slider_2_slide','field_60bf7688f46eb'),(750,91,'slider_3_slide','53'),(751,91,'_slider_3_slide','field_60bf7688f46eb'),(752,91,'slider_4_slide','54'),(753,91,'_slider_4_slide','field_60bf7688f46eb'),(754,91,'slider_5_slide','55'),(755,91,'_slider_5_slide','field_60bf7688f46eb'),(756,91,'slider_6_slide','56'),(757,91,'_slider_6_slide','field_60bf7688f46eb'),(758,91,'slider_7_slide','57'),(759,91,'_slider_7_slide','field_60bf7688f46eb'),(760,91,'s2-list_0_icon','61'),(761,91,'_s2-list_0_icon','field_60bf76ecf46ef'),(762,91,'s2-list_0_icon-hover','62'),(763,91,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(764,91,'s2-list_0_text','Лихоманка'),(765,91,'_s2-list_0_text','field_60bf7712f46f1'),(766,91,'s2-list_1_icon','63'),(767,91,'_s2-list_1_icon','field_60bf76ecf46ef'),(768,91,'s2-list_1_icon-hover','64'),(769,91,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(770,91,'s2-list_1_text','Похмільний синдром'),(771,91,'_s2-list_1_text','field_60bf7712f46f1'),(772,91,'s2-list_2_icon','65'),(773,91,'_s2-list_2_icon','field_60bf76ecf46ef'),(774,91,'s2-list_2_icon-hover','66'),(775,91,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(776,91,'s2-list_2_text','Діарея'),(777,91,'_s2-list_2_text','field_60bf7712f46f1'),(778,91,'s2-list_3_icon','67'),(779,91,'_s2-list_3_icon','field_60bf76ecf46ef'),(780,91,'s2-list_3_icon-hover','68'),(781,91,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(782,91,'s2-list_3_text','Блювота'),(783,91,'_s2-list_3_text','field_60bf7712f46f1'),(784,91,'s2-list_4_icon','69'),(785,91,'_s2-list_4_icon','field_60bf76ecf46ef'),(786,91,'s2-list_4_icon-hover','70'),(787,91,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(788,91,'s2-list_4_text','Інтенсивні фізичні навантаження'),(789,91,'_s2-list_4_text','field_60bf7712f46f1'),(790,91,'s2-list_5_icon','71'),(791,91,'_s2-list_5_icon','field_60bf76ecf46ef'),(792,91,'s2-list_5_icon-hover','72'),(793,91,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(794,91,'s2-list_5_text','Перегрівання в спекотну погоду'),(795,91,'_s2-list_5_text','field_60bf7712f46f1'),(796,91,'s1-slogan','Коли звичайної води замало!'),(797,91,'_s1-slogan','field_60bf7ab4d9ba9'),(798,91,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. 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А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(997,99,'_s3-text','field_60bf7bb5a7e2b'),(998,99,'s4-ttl','РеО – вода для медичних цілей'),(999,99,'_s4-ttl','field_60bf7c831f58c'),(1000,99,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(1001,99,'_s4-notes','field_60bf7ca31f58d'),(1002,99,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(1003,99,'_s5-video','field_60bf7ccfa01a5'),(1004,99,'s6-ttl','Коли звичайної води замало!'),(1005,99,'_s6-ttl','field_60bf7cfb10d31'),(1006,99,'s6-list','6'),(1007,99,'_s6-list','field_60bf7d0410d32'),(1008,99,'s6-list_0_icon','92'),(1009,99,'_s6-list_0_icon','field_60bf7d1810d33'),(1010,99,'s6-list_0_text','При підвищеній температурі'),(1011,99,'_s6-list_0_text','field_60bf7d2710d34'),(1012,99,'s6-list_1_icon','93'),(1013,99,'_s6-list_1_icon','field_60bf7d1810d33'),(1014,99,'s6-list_1_text','При харчових отруєннях'),(1015,99,'_s6-list_1_text','field_60bf7d2710d34'),(1016,99,'s6-list_2_icon','94'),(1017,99,'_s6-list_2_icon','field_60bf7d1810d33'),(1018,99,'s6-list_2_text','При кишкових інфекціях'),(1019,99,'_s6-list_2_text','field_60bf7d2710d34'),(1020,99,'s6-list_3_icon','95'),(1021,99,'_s6-list_3_icon','field_60bf7d1810d33'),(1022,99,'s6-list_3_text','Під час вагітності'),(1023,99,'_s6-list_3_text','field_60bf7d2710d34'),(1024,99,'s6-list_4_icon','96'),(1025,99,'_s6-list_4_icon','field_60bf7d1810d33'),(1026,99,'s6-list_4_text','Під час заняття спортом'),(1027,99,'_s6-list_4_text','field_60bf7d2710d34'),(1028,99,'s6-list_5_icon','97'),(1029,99,'_s6-list_5_icon','field_60bf7d1810d33'),(1030,99,'s6-list_5_text','При похмільному синдромі'),(1031,99,'_s6-list_5_text','field_60bf7d2710d34'),(1032,8,'s4-list_0_ttl','Натрій'),(1033,8,'_s4-list_0_ttl','field_60bf7fa95a92c'),(1034,8,'s4-list_0_formula','Na<sup>+</sup>'),(1035,8,'_s4-list_0_formula','field_60bf7fc65a92d'),(1036,8,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(1037,8,'_s4-list_0_text','field_60bf7fd35a92e'),(1038,8,'s4-list_1_ttl','Вода'),(1039,8,'_s4-list_1_ttl','field_60bf7fa95a92c'),(1040,8,'s4-list_1_formula','H<sub>2</sub>O'),(1041,8,'_s4-list_1_formula','field_60bf7fc65a92d'),(1042,8,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(1043,8,'_s4-list_1_text','field_60bf7fd35a92e'),(1044,8,'s4-list','9'),(1045,8,'_s4-list','field_60bf7f985a92b'),(1046,104,'slider','8'),(1047,104,'_slider','field_60bf767ef46ea'),(1048,104,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(1049,104,'_s2-ttl','field_60bf76d1f46ed'),(1050,104,'s2-list','6'),(1051,104,'_s2-list','field_60bf76e0f46ee'),(1052,104,'slider_0_slide','50'),(1053,104,'_slider_0_slide','field_60bf7688f46eb'),(1054,104,'slider_1_slide','51'),(1055,104,'_slider_1_slide','field_60bf7688f46eb'),(1056,104,'slider_2_slide','52'),(1057,104,'_slider_2_slide','field_60bf7688f46eb'),(1058,104,'slider_3_slide','53'),(1059,104,'_slider_3_slide','field_60bf7688f46eb'),(1060,104,'slider_4_slide','54'),(1061,104,'_slider_4_slide','field_60bf7688f46eb'),(1062,104,'slider_5_slide','55'),(1063,104,'_slider_5_slide','field_60bf7688f46eb'),(1064,104,'slider_6_slide','56'),(1065,104,'_slider_6_slide','field_60bf7688f46eb'),(1066,104,'slider_7_slide','57'),(1067,104,'_slider_7_slide','field_60bf7688f46eb'),(1068,104,'s2-list_0_icon','61'),(1069,104,'_s2-list_0_icon','field_60bf76ecf46ef'),(1070,104,'s2-list_0_icon-hover','62'),(1071,104,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(1072,104,'s2-list_0_text','Лихоманка'),(1073,104,'_s2-list_0_text','field_60bf7712f46f1'),(1074,104,'s2-list_1_icon','63'),(1075,104,'_s2-list_1_icon','field_60bf76ecf46ef'),(1076,104,'s2-list_1_icon-hover','64'),(1077,104,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(1078,104,'s2-list_1_text','Похмільний синдром'),(1079,104,'_s2-list_1_text','field_60bf7712f46f1'),(1080,104,'s2-list_2_icon','65'),(1081,104,'_s2-list_2_icon','field_60bf76ecf46ef'),(1082,104,'s2-list_2_icon-hover','66'),(1083,104,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(1084,104,'s2-list_2_text','Діарея'),(1085,104,'_s2-list_2_text','field_60bf7712f46f1'),(1086,104,'s2-list_3_icon','67'),(1087,104,'_s2-list_3_icon','field_60bf76ecf46ef'),(1088,104,'s2-list_3_icon-hover','68'),(1089,104,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(1090,104,'s2-list_3_text','Блювота'),(1091,104,'_s2-list_3_text','field_60bf7712f46f1'),(1092,104,'s2-list_4_icon','69'),(1093,104,'_s2-list_4_icon','field_60bf76ecf46ef'),(1094,104,'s2-list_4_icon-hover','70'),(1095,104,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(1096,104,'s2-list_4_text','Інтенсивні фізичні навантаження'),(1097,104,'_s2-list_4_text','field_60bf7712f46f1'),(1098,104,'s2-list_5_icon','71'),(1099,104,'_s2-list_5_icon','field_60bf76ecf46ef'),(1100,104,'s2-list_5_icon-hover','72'),(1101,104,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(1102,104,'s2-list_5_text','Перегрівання в спекотну погоду'),(1103,104,'_s2-list_5_text','field_60bf7712f46f1'),(1104,104,'s1-slogan','Коли звичайної води замало!'),(1105,104,'_s1-slogan','field_60bf7ab4d9ba9'),(1106,104,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(1107,104,'_s3-text','field_60bf7bb5a7e2b'),(1108,104,'s4-ttl','РеО – вода для медичних цілей'),(1109,104,'_s4-ttl','field_60bf7c831f58c'),(1110,104,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(1111,104,'_s4-notes','field_60bf7ca31f58d'),(1112,104,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(1113,104,'_s5-video','field_60bf7ccfa01a5'),(1114,104,'s6-ttl','Коли звичайної води замало!'),(1115,104,'_s6-ttl','field_60bf7cfb10d31'),(1116,104,'s6-list','6'),(1117,104,'_s6-list','field_60bf7d0410d32'),(1118,104,'s6-list_0_icon','92'),(1119,104,'_s6-list_0_icon','field_60bf7d1810d33'),(1120,104,'s6-list_0_text','При підвищеній температурі'),(1121,104,'_s6-list_0_text','field_60bf7d2710d34'),(1122,104,'s6-list_1_icon','93'),(1123,104,'_s6-list_1_icon','field_60bf7d1810d33'),(1124,104,'s6-list_1_text','При харчових отруєннях'),(1125,104,'_s6-list_1_text','field_60bf7d2710d34'),(1126,104,'s6-list_2_icon','94'),(1127,104,'_s6-list_2_icon','field_60bf7d1810d33'),(1128,104,'s6-list_2_text','При кишкових інфекціях'),(1129,104,'_s6-list_2_text','field_60bf7d2710d34'),(1130,104,'s6-list_3_icon','95'),(1131,104,'_s6-list_3_icon','field_60bf7d1810d33'),(1132,104,'s6-list_3_text','Під час вагітності'),(1133,104,'_s6-list_3_text','field_60bf7d2710d34'),(1134,104,'s6-list_4_icon','96'),(1135,104,'_s6-list_4_icon','field_60bf7d1810d33'),(1136,104,'s6-list_4_text','Під час заняття спортом'),(1137,104,'_s6-list_4_text','field_60bf7d2710d34'),(1138,104,'s6-list_5_icon','97'),(1139,104,'_s6-list_5_icon','field_60bf7d1810d33'),(1140,104,'s6-list_5_text','При похмільному синдромі'),(1141,104,'_s6-list_5_text','field_60bf7d2710d34'),(1142,104,'s4-list_0_ttl','Натрій'),(1143,104,'_s4-list_0_ttl','field_60bf7fa95a92c'),(1144,104,'s4-list_0_formula','Na<sup>+</sup>'),(1145,104,'_s4-list_0_formula','field_60bf7fc65a92d'),(1146,104,'s4-list_0_text',''),(1147,104,'_s4-list_0_text','field_60bf7fd35a92e'),(1148,104,'s4-list_1_ttl',''),(1149,104,'_s4-list_1_ttl','field_60bf7fa95a92c'),(1150,104,'s4-list_1_formula',''),(1151,104,'_s4-list_1_formula','field_60bf7fc65a92d'),(1152,104,'s4-list_1_text',''),(1153,104,'_s4-list_1_text','field_60bf7fd35a92e'),(1154,104,'s4-list','2'),(1155,104,'_s4-list','field_60bf7f985a92b'),(1156,8,'s4-list_2_ttl','Калій'),(1157,8,'_s4-list_2_ttl','field_60bf7fa95a92c'),(1158,8,'s4-list_2_formula','K<sup>+</sup>'),(1159,8,'_s4-list_2_formula','field_60bf7fc65a92d'),(1160,8,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(1161,8,'_s4-list_2_text','field_60bf7fd35a92e'),(1162,8,'s4-list_3_ttl','Гідрокарбонати'),(1163,8,'_s4-list_3_ttl','field_60bf7fa95a92c'),(1164,8,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(1165,8,'_s4-list_3_formula','field_60bf7fc65a92d'),(1166,8,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(1167,8,'_s4-list_3_text','field_60bf7fd35a92e'),(1168,8,'s4-list_4_ttl','Магній'),(1169,8,'_s4-list_4_ttl','field_60bf7fa95a92c'),(1170,8,'s4-list_4_formula','Mg<sup>2+</sup>'),(1171,8,'_s4-list_4_formula','field_60bf7fc65a92d'),(1172,8,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(1173,8,'_s4-list_4_text','field_60bf7fd35a92e'),(1174,8,'s4-list_5_ttl','Вуглекислий газ'),(1175,8,'_s4-list_5_ttl','field_60bf7fa95a92c'),(1176,8,'s4-list_5_formula','CO<sup>2+</sup>'),(1177,8,'_s4-list_5_formula','field_60bf7fc65a92d'),(1178,8,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(1179,8,'_s4-list_5_text','field_60bf7fd35a92e'),(1180,8,'s4-list_6_ttl','Кальцій'),(1181,8,'_s4-list_6_ttl','field_60bf7fa95a92c'),(1182,8,'s4-list_6_formula','Ca<sup>2+</sup>'),(1183,8,'_s4-list_6_formula','field_60bf7fc65a92d'),(1184,8,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(1185,8,'_s4-list_6_text','field_60bf7fd35a92e'),(1186,8,'s4-list_7_ttl','Сорбіт'),(1187,8,'_s4-list_7_ttl','field_60bf7fa95a92c'),(1188,8,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(1189,8,'_s4-list_7_formula','field_60bf7fc65a92d'),(1190,8,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(1191,8,'_s4-list_7_text','field_60bf7fd35a92e'),(1192,8,'s4-list_8_ttl','Хлор'),(1193,8,'_s4-list_8_ttl','field_60bf7fa95a92c'),(1194,8,'s4-list_8_formula','Cl<sup>-</sup>'),(1195,8,'_s4-list_8_formula','field_60bf7fc65a92d'),(1196,8,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(1197,8,'_s4-list_8_text','field_60bf7fd35a92e'),(1198,105,'slider','8'),(1199,105,'_slider','field_60bf767ef46ea'),(1200,105,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(1201,105,'_s2-ttl','field_60bf76d1f46ed'),(1202,105,'s2-list','6'),(1203,105,'_s2-list','field_60bf76e0f46ee'),(1204,105,'slider_0_slide','50'),(1205,105,'_slider_0_slide','field_60bf7688f46eb'),(1206,105,'slider_1_slide','51'),(1207,105,'_slider_1_slide','field_60bf7688f46eb'),(1208,105,'slider_2_slide','52'),(1209,105,'_slider_2_slide','field_60bf7688f46eb'),(1210,105,'slider_3_slide','53'),(1211,105,'_slider_3_slide','field_60bf7688f46eb'),(1212,105,'slider_4_slide','54'),(1213,105,'_slider_4_slide','field_60bf7688f46eb'),(1214,105,'slider_5_slide','55'),(1215,105,'_slider_5_slide','field_60bf7688f46eb'),(1216,105,'slider_6_slide','56'),(1217,105,'_slider_6_slide','field_60bf7688f46eb'),(1218,105,'slider_7_slide','57'),(1219,105,'_slider_7_slide','field_60bf7688f46eb'),(1220,105,'s2-list_0_icon','61'),(1221,105,'_s2-list_0_icon','field_60bf76ecf46ef'),(1222,105,'s2-list_0_icon-hover','62'),(1223,105,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(1224,105,'s2-list_0_text','Лихоманка'),(1225,105,'_s2-list_0_text','field_60bf7712f46f1'),(1226,105,'s2-list_1_icon','63'),(1227,105,'_s2-list_1_icon','field_60bf76ecf46ef'),(1228,105,'s2-list_1_icon-hover','64'),(1229,105,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(1230,105,'s2-list_1_text','Похмільний синдром'),(1231,105,'_s2-list_1_text','field_60bf7712f46f1'),(1232,105,'s2-list_2_icon','65'),(1233,105,'_s2-list_2_icon','field_60bf76ecf46ef'),(1234,105,'s2-list_2_icon-hover','66'),(1235,105,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(1236,105,'s2-list_2_text','Діарея'),(1237,105,'_s2-list_2_text','field_60bf7712f46f1'),(1238,105,'s2-list_3_icon','67'),(1239,105,'_s2-list_3_icon','field_60bf76ecf46ef'),(1240,105,'s2-list_3_icon-hover','68'),(1241,105,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(1242,105,'s2-list_3_text','Блювота'),(1243,105,'_s2-list_3_text','field_60bf7712f46f1'),(1244,105,'s2-list_4_icon','69'),(1245,105,'_s2-list_4_icon','field_60bf76ecf46ef'),(1246,105,'s2-list_4_icon-hover','70'),(1247,105,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(1248,105,'s2-list_4_text','Інтенсивні фізичні навантаження'),(1249,105,'_s2-list_4_text','field_60bf7712f46f1'),(1250,105,'s2-list_5_icon','71'),(1251,105,'_s2-list_5_icon','field_60bf76ecf46ef'),(1252,105,'s2-list_5_icon-hover','72'),(1253,105,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(1254,105,'s2-list_5_text','Перегрівання в спекотну погоду'),(1255,105,'_s2-list_5_text','field_60bf7712f46f1'),(1256,105,'s1-slogan','Коли звичайної води замало!'),(1257,105,'_s1-slogan','field_60bf7ab4d9ba9'),(1258,105,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(1259,105,'_s3-text','field_60bf7bb5a7e2b'),(1260,105,'s4-ttl','РеО – вода для медичних цілей'),(1261,105,'_s4-ttl','field_60bf7c831f58c'),(1262,105,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(1263,105,'_s4-notes','field_60bf7ca31f58d'),(1264,105,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(1265,105,'_s5-video','field_60bf7ccfa01a5'),(1266,105,'s6-ttl','Коли звичайної води замало!'),(1267,105,'_s6-ttl','field_60bf7cfb10d31'),(1268,105,'s6-list','6'),(1269,105,'_s6-list','field_60bf7d0410d32'),(1270,105,'s6-list_0_icon','92'),(1271,105,'_s6-list_0_icon','field_60bf7d1810d33'),(1272,105,'s6-list_0_text','При підвищеній температурі'),(1273,105,'_s6-list_0_text','field_60bf7d2710d34'),(1274,105,'s6-list_1_icon','93'),(1275,105,'_s6-list_1_icon','field_60bf7d1810d33'),(1276,105,'s6-list_1_text','При харчових отруєннях'),(1277,105,'_s6-list_1_text','field_60bf7d2710d34'),(1278,105,'s6-list_2_icon','94'),(1279,105,'_s6-list_2_icon','field_60bf7d1810d33'),(1280,105,'s6-list_2_text','При кишкових інфекціях'),(1281,105,'_s6-list_2_text','field_60bf7d2710d34'),(1282,105,'s6-list_3_icon','95'),(1283,105,'_s6-list_3_icon','field_60bf7d1810d33'),(1284,105,'s6-list_3_text','Під час вагітності'),(1285,105,'_s6-list_3_text','field_60bf7d2710d34'),(1286,105,'s6-list_4_icon','96'),(1287,105,'_s6-list_4_icon','field_60bf7d1810d33'),(1288,105,'s6-list_4_text','Під час заняття спортом'),(1289,105,'_s6-list_4_text','field_60bf7d2710d34'),(1290,105,'s6-list_5_icon','97'),(1291,105,'_s6-list_5_icon','field_60bf7d1810d33'),(1292,105,'s6-list_5_text','При похмільному синдромі'),(1293,105,'_s6-list_5_text','field_60bf7d2710d34'),(1294,105,'s4-list_0_ttl','Натрій'),(1295,105,'_s4-list_0_ttl','field_60bf7fa95a92c'),(1296,105,'s4-list_0_formula','Na<sup>+</sup>'),(1297,105,'_s4-list_0_formula','field_60bf7fc65a92d'),(1298,105,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(1299,105,'_s4-list_0_text','field_60bf7fd35a92e'),(1300,105,'s4-list_1_ttl','Вода'),(1301,105,'_s4-list_1_ttl','field_60bf7fa95a92c'),(1302,105,'s4-list_1_formula','H<sub>2</sub>O'),(1303,105,'_s4-list_1_formula','field_60bf7fc65a92d'),(1304,105,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(1305,105,'_s4-list_1_text','field_60bf7fd35a92e'),(1306,105,'s4-list','9'),(1307,105,'_s4-list','field_60bf7f985a92b'),(1308,105,'s4-list_2_ttl','Калій'),(1309,105,'_s4-list_2_ttl','field_60bf7fa95a92c'),(1310,105,'s4-list_2_formula','K<sup>+</sup>'),(1311,105,'_s4-list_2_formula','field_60bf7fc65a92d'),(1312,105,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(1313,105,'_s4-list_2_text','field_60bf7fd35a92e'),(1314,105,'s4-list_3_ttl','Гідрокарбонати'),(1315,105,'_s4-list_3_ttl','field_60bf7fa95a92c'),(1316,105,'s4-list_3_formula','HCO<sup>3+</sup>'),(1317,105,'_s4-list_3_formula','field_60bf7fc65a92d'),(1318,105,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(1319,105,'_s4-list_3_text','field_60bf7fd35a92e'),(1320,105,'s4-list_4_ttl','Магній'),(1321,105,'_s4-list_4_ttl','field_60bf7fa95a92c'),(1322,105,'s4-list_4_formula','Mg<sup>2+</sup>'),(1323,105,'_s4-list_4_formula','field_60bf7fc65a92d'),(1324,105,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(1325,105,'_s4-list_4_text','field_60bf7fd35a92e'),(1326,105,'s4-list_5_ttl','Вуглекислий газ'),(1327,105,'_s4-list_5_ttl','field_60bf7fa95a92c'),(1328,105,'s4-list_5_formula','CO<sup>2</sup>+'),(1329,105,'_s4-list_5_formula','field_60bf7fc65a92d'),(1330,105,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(1331,105,'_s4-list_5_text','field_60bf7fd35a92e'),(1332,105,'s4-list_6_ttl','Кальцій'),(1333,105,'_s4-list_6_ttl','field_60bf7fa95a92c'),(1334,105,'s4-list_6_formula','Ca<sup>2+</sup>'),(1335,105,'_s4-list_6_formula','field_60bf7fc65a92d'),(1336,105,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(1337,105,'_s4-list_6_text','field_60bf7fd35a92e'),(1338,105,'s4-list_7_ttl','Сорбіт'),(1339,105,'_s4-list_7_ttl','field_60bf7fa95a92c'),(1340,105,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(1341,105,'_s4-list_7_formula','field_60bf7fc65a92d'),(1342,105,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(1343,105,'_s4-list_7_text','field_60bf7fd35a92e'),(1344,105,'s4-list_8_ttl','Хлор'),(1345,105,'_s4-list_8_ttl','field_60bf7fa95a92c'),(1346,105,'s4-list_8_formula','Cl'),(1347,105,'_s4-list_8_formula','field_60bf7fc65a92d'),(1348,105,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(1349,105,'_s4-list_8_text','field_60bf7fd35a92e'),(1350,8,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(1351,8,'_s4-feature1','field_60bf80ca480ea'),(1352,8,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(1353,8,'_s4-feature2','field_60bf80de480eb'),(1354,8,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(1355,8,'_s4-feature3','field_60bf80e2480ec'),(1356,8,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(1357,8,'_s4-feature4','field_60bf80e5480ed'),(1358,110,'slider','8'),(1359,110,'_slider','field_60bf767ef46ea'),(1360,110,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(1361,110,'_s2-ttl','field_60bf76d1f46ed'),(1362,110,'s2-list','6'),(1363,110,'_s2-list','field_60bf76e0f46ee'),(1364,110,'slider_0_slide','50'),(1365,110,'_slider_0_slide','field_60bf7688f46eb'),(1366,110,'slider_1_slide','51'),(1367,110,'_slider_1_slide','field_60bf7688f46eb'),(1368,110,'slider_2_slide','52'),(1369,110,'_slider_2_slide','field_60bf7688f46eb'),(1370,110,'slider_3_slide','53'),(1371,110,'_slider_3_slide','field_60bf7688f46eb'),(1372,110,'slider_4_slide','54'),(1373,110,'_slider_4_slide','field_60bf7688f46eb'),(1374,110,'slider_5_slide','55'),(1375,110,'_slider_5_slide','field_60bf7688f46eb'),(1376,110,'slider_6_slide','56'),(1377,110,'_slider_6_slide','field_60bf7688f46eb'),(1378,110,'slider_7_slide','57'),(1379,110,'_slider_7_slide','field_60bf7688f46eb'),(1380,110,'s2-list_0_icon','61'),(1381,110,'_s2-list_0_icon','field_60bf76ecf46ef'),(1382,110,'s2-list_0_icon-hover','62'),(1383,110,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(1384,110,'s2-list_0_text','Лихоманка'),(1385,110,'_s2-list_0_text','field_60bf7712f46f1'),(1386,110,'s2-list_1_icon','63'),(1387,110,'_s2-list_1_icon','field_60bf76ecf46ef'),(1388,110,'s2-list_1_icon-hover','64'),(1389,110,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(1390,110,'s2-list_1_text','Похмільний синдром'),(1391,110,'_s2-list_1_text','field_60bf7712f46f1'),(1392,110,'s2-list_2_icon','65'),(1393,110,'_s2-list_2_icon','field_60bf76ecf46ef'),(1394,110,'s2-list_2_icon-hover','66'),(1395,110,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(1396,110,'s2-list_2_text','Діарея'),(1397,110,'_s2-list_2_text','field_60bf7712f46f1'),(1398,110,'s2-list_3_icon','67'),(1399,110,'_s2-list_3_icon','field_60bf76ecf46ef'),(1400,110,'s2-list_3_icon-hover','68'),(1401,110,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(1402,110,'s2-list_3_text','Блювота'),(1403,110,'_s2-list_3_text','field_60bf7712f46f1'),(1404,110,'s2-list_4_icon','69'),(1405,110,'_s2-list_4_icon','field_60bf76ecf46ef'),(1406,110,'s2-list_4_icon-hover','70'),(1407,110,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(1408,110,'s2-list_4_text','Інтенсивні фізичні навантаження'),(1409,110,'_s2-list_4_text','field_60bf7712f46f1'),(1410,110,'s2-list_5_icon','71'),(1411,110,'_s2-list_5_icon','field_60bf76ecf46ef'),(1412,110,'s2-list_5_icon-hover','72'),(1413,110,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(1414,110,'s2-list_5_text','Перегрівання в спекотну погоду'),(1415,110,'_s2-list_5_text','field_60bf7712f46f1'),(1416,110,'s1-slogan','Коли звичайної води замало!'),(1417,110,'_s1-slogan','field_60bf7ab4d9ba9'),(1418,110,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(1419,110,'_s3-text','field_60bf7bb5a7e2b'),(1420,110,'s4-ttl','РеО – вода для медичних цілей'),(1421,110,'_s4-ttl','field_60bf7c831f58c'),(1422,110,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(1423,110,'_s4-notes','field_60bf7ca31f58d'),(1424,110,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(1425,110,'_s5-video','field_60bf7ccfa01a5'),(1426,110,'s6-ttl','Коли звичайної води замало!'),(1427,110,'_s6-ttl','field_60bf7cfb10d31'),(1428,110,'s6-list','6'),(1429,110,'_s6-list','field_60bf7d0410d32'),(1430,110,'s6-list_0_icon','92'),(1431,110,'_s6-list_0_icon','field_60bf7d1810d33'),(1432,110,'s6-list_0_text','При підвищеній температурі'),(1433,110,'_s6-list_0_text','field_60bf7d2710d34'),(1434,110,'s6-list_1_icon','93'),(1435,110,'_s6-list_1_icon','field_60bf7d1810d33'),(1436,110,'s6-list_1_text','При харчових отруєннях'),(1437,110,'_s6-list_1_text','field_60bf7d2710d34'),(1438,110,'s6-list_2_icon','94'),(1439,110,'_s6-list_2_icon','field_60bf7d1810d33'),(1440,110,'s6-list_2_text','При кишкових інфекціях'),(1441,110,'_s6-list_2_text','field_60bf7d2710d34'),(1442,110,'s6-list_3_icon','95'),(1443,110,'_s6-list_3_icon','field_60bf7d1810d33'),(1444,110,'s6-list_3_text','Під час вагітності'),(1445,110,'_s6-list_3_text','field_60bf7d2710d34'),(1446,110,'s6-list_4_icon','96'),(1447,110,'_s6-list_4_icon','field_60bf7d1810d33'),(1448,110,'s6-list_4_text','Під час заняття спортом'),(1449,110,'_s6-list_4_text','field_60bf7d2710d34'),(1450,110,'s6-list_5_icon','97'),(1451,110,'_s6-list_5_icon','field_60bf7d1810d33'),(1452,110,'s6-list_5_text','При похмільному синдромі'),(1453,110,'_s6-list_5_text','field_60bf7d2710d34'),(1454,110,'s4-list_0_ttl','Натрій'),(1455,110,'_s4-list_0_ttl','field_60bf7fa95a92c'),(1456,110,'s4-list_0_formula','Na<sup>+</sup>'),(1457,110,'_s4-list_0_formula','field_60bf7fc65a92d'),(1458,110,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(1459,110,'_s4-list_0_text','field_60bf7fd35a92e'),(1460,110,'s4-list_1_ttl','Вода'),(1461,110,'_s4-list_1_ttl','field_60bf7fa95a92c'),(1462,110,'s4-list_1_formula','H<sub>2</sub>O'),(1463,110,'_s4-list_1_formula','field_60bf7fc65a92d'),(1464,110,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(1465,110,'_s4-list_1_text','field_60bf7fd35a92e'),(1466,110,'s4-list','9'),(1467,110,'_s4-list','field_60bf7f985a92b'),(1468,110,'s4-list_2_ttl','Калій'),(1469,110,'_s4-list_2_ttl','field_60bf7fa95a92c'),(1470,110,'s4-list_2_formula','K<sup>+</sup>'),(1471,110,'_s4-list_2_formula','field_60bf7fc65a92d'),(1472,110,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(1473,110,'_s4-list_2_text','field_60bf7fd35a92e'),(1474,110,'s4-list_3_ttl','Гідрокарбонати'),(1475,110,'_s4-list_3_ttl','field_60bf7fa95a92c'),(1476,110,'s4-list_3_formula','HCO<sup>3+</sup>'),(1477,110,'_s4-list_3_formula','field_60bf7fc65a92d'),(1478,110,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(1479,110,'_s4-list_3_text','field_60bf7fd35a92e'),(1480,110,'s4-list_4_ttl','Магній'),(1481,110,'_s4-list_4_ttl','field_60bf7fa95a92c'),(1482,110,'s4-list_4_formula','Mg<sup>2+</sup>'),(1483,110,'_s4-list_4_formula','field_60bf7fc65a92d'),(1484,110,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(1485,110,'_s4-list_4_text','field_60bf7fd35a92e'),(1486,110,'s4-list_5_ttl','Вуглекислий газ'),(1487,110,'_s4-list_5_ttl','field_60bf7fa95a92c'),(1488,110,'s4-list_5_formula','CO<sup>2</sup>+'),(1489,110,'_s4-list_5_formula','field_60bf7fc65a92d'),(1490,110,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(1491,110,'_s4-list_5_text','field_60bf7fd35a92e'),(1492,110,'s4-list_6_ttl','Кальцій'),(1493,110,'_s4-list_6_ttl','field_60bf7fa95a92c'),(1494,110,'s4-list_6_formula','Ca<sup>2+</sup>'),(1495,110,'_s4-list_6_formula','field_60bf7fc65a92d'),(1496,110,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(1497,110,'_s4-list_6_text','field_60bf7fd35a92e'),(1498,110,'s4-list_7_ttl','Сорбіт'),(1499,110,'_s4-list_7_ttl','field_60bf7fa95a92c'),(1500,110,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(1501,110,'_s4-list_7_formula','field_60bf7fc65a92d'),(1502,110,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(1503,110,'_s4-list_7_text','field_60bf7fd35a92e'),(1504,110,'s4-list_8_ttl','Хлор'),(1505,110,'_s4-list_8_ttl','field_60bf7fa95a92c'),(1506,110,'s4-list_8_formula','Cl'),(1507,110,'_s4-list_8_formula','field_60bf7fc65a92d'),(1508,110,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(1509,110,'_s4-list_8_text','field_60bf7fd35a92e'),(1510,110,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(1511,110,'_s4-feature1','field_60bf80ca480ea'),(1512,110,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(1513,110,'_s4-feature2','field_60bf80de480eb'),(1514,110,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(1515,110,'_s4-feature3','field_60bf80e2480ec'),(1516,110,'s4-feature4','Приємна на смак та легко п’єтьсянавіть при відчутті нудоти<sup>1,3</sup>'),(1517,110,'_s4-feature4','field_60bf80e5480ed'),(1518,111,'_edit_last','1'),(1519,111,'_edit_lock','1623227174:1'),(1520,11,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1521,11,'_s1-text','field_60c069d69838b'),(1522,11,'s3-list','5'),(1523,11,'_s3-list','field_60c06d9298394'),(1524,11,'s3-list2','3'),(1525,11,'_s3-list2','field_60c06dd498396'),(1526,11,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1527,11,'_s4-ttl','field_60c06ba39838e'),(1528,11,'s4-list','7'),(1529,11,'_s4-list','field_60c06bb39838f'),(1530,11,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1531,11,'_s4-slogan','field_60c06d6d98392'),(1532,126,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1533,126,'_s1-text','field_60c069d69838b'),(1534,126,'s3-list',''),(1535,126,'_s3-list','field_60c06d9298394'),(1536,126,'s3-list2',''),(1537,126,'_s3-list2','field_60c06dd498396'),(1538,126,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1539,126,'_s4-ttl','field_60c06ba39838e'),(1540,126,'s4-list',''),(1541,126,'_s4-list','field_60c06bb39838f'),(1542,126,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1543,126,'_s4-slogan','field_60c06d6d98392'),(1544,127,'_wp_attached_file','2021/06/symptoms-icon-1.svg'),(1545,128,'_wp_attached_file','2021/06/symptoms-icon-2.svg'),(1546,129,'_wp_attached_file','2021/06/symptoms-icon-5.svg'),(1547,130,'_wp_attached_file','2021/06/symptoms-icon-6.svg'),(1548,131,'_wp_attached_file','2021/06/symptoms-icon-7.svg'),(1549,11,'s4-list_0_icon','127'),(1550,11,'_s4-list_0_icon','field_60c06bc298390'),(1551,11,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1552,11,'_s4-list_0_text','field_60c06bce98391'),(1553,11,'s4-list_1_icon','128'),(1554,11,'_s4-list_1_icon','field_60c06bc298390'),(1555,11,'s4-list_1_text','<strong>головокружiння</strong>'),(1556,11,'_s4-list_1_text','field_60c06bce98391'),(1557,11,'s4-list_2_icon','68'),(1558,11,'_s4-list_2_icon','field_60c06bc298390'),(1559,11,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1560,11,'_s4-list_2_text','field_60c06bce98391'),(1561,11,'s4-list_3_icon','64'),(1562,11,'_s4-list_3_icon','field_60c06bc298390'),(1563,11,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1564,11,'_s4-list_3_text','field_60c06bce98391'),(1565,11,'s4-list_4_icon','129'),(1566,11,'_s4-list_4_icon','field_60c06bc298390'),(1567,11,'s4-list_4_text','<strong>дiарея</strong>'),(1568,11,'_s4-list_4_text','field_60c06bce98391'),(1569,11,'s4-list_5_icon','130'),(1570,11,'_s4-list_5_icon','field_60c06bc298390'),(1571,11,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1572,11,'_s4-list_5_text','field_60c06bce98391'),(1573,11,'s4-list_6_icon','131'),(1574,11,'_s4-list_6_icon','field_60c06bc298390'),(1575,11,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1576,11,'_s4-list_6_text','field_60c06bce98391'),(1577,132,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1578,132,'_s1-text','field_60c069d69838b'),(1579,132,'s3-list',''),(1580,132,'_s3-list','field_60c06d9298394'),(1581,132,'s3-list2',''),(1582,132,'_s3-list2','field_60c06dd498396'),(1583,132,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1584,132,'_s4-ttl','field_60c06ba39838e'),(1585,132,'s4-list','7'),(1586,132,'_s4-list','field_60c06bb39838f'),(1587,132,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1588,132,'_s4-slogan','field_60c06d6d98392'),(1589,132,'s4-list_0_icon','127'),(1590,132,'_s4-list_0_icon','field_60c06bc298390'),(1591,132,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1592,132,'_s4-list_0_text','field_60c06bce98391'),(1593,132,'s4-list_1_icon','128'),(1594,132,'_s4-list_1_icon','field_60c06bc298390'),(1595,132,'s4-list_1_text','<strong>головокружiння</strong>'),(1596,132,'_s4-list_1_text','field_60c06bce98391'),(1597,132,'s4-list_2_icon','68'),(1598,132,'_s4-list_2_icon','field_60c06bc298390'),(1599,132,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1600,132,'_s4-list_2_text','field_60c06bce98391'),(1601,132,'s4-list_3_icon','64'),(1602,132,'_s4-list_3_icon','field_60c06bc298390'),(1603,132,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1604,132,'_s4-list_3_text','field_60c06bce98391'),(1605,132,'s4-list_4_icon','129'),(1606,132,'_s4-list_4_icon','field_60c06bc298390'),(1607,132,'s4-list_4_text','<strong>дiарея</strong>'),(1608,132,'_s4-list_4_text','field_60c06bce98391'),(1609,132,'s4-list_5_icon','130'),(1610,132,'_s4-list_5_icon','field_60c06bc298390'),(1611,132,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1612,132,'_s4-list_5_text','field_60c06bce98391'),(1613,132,'s4-list_6_icon','131'),(1614,132,'_s4-list_6_icon','field_60c06bc298390'),(1615,132,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1616,132,'_s4-list_6_text','field_60c06bce98391'),(1617,11,'s3-list_0_li','має збалансований<br /> склад'),(1618,11,'_s3-list_0_li','field_60c06db098395'),(1619,11,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(1620,11,'_s3-list_1_li','field_60c06db098395'),(1621,133,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1622,133,'_s1-text','field_60c069d69838b'),(1623,133,'s3-list','2'),(1624,133,'_s3-list','field_60c06d9298394'),(1625,133,'s3-list2',''),(1626,133,'_s3-list2','field_60c06dd498396'),(1627,133,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1628,133,'_s4-ttl','field_60c06ba39838e'),(1629,133,'s4-list','7'),(1630,133,'_s4-list','field_60c06bb39838f'),(1631,133,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1632,133,'_s4-slogan','field_60c06d6d98392'),(1633,133,'s4-list_0_icon','127'),(1634,133,'_s4-list_0_icon','field_60c06bc298390'),(1635,133,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1636,133,'_s4-list_0_text','field_60c06bce98391'),(1637,133,'s4-list_1_icon','128'),(1638,133,'_s4-list_1_icon','field_60c06bc298390'),(1639,133,'s4-list_1_text','<strong>головокружiння</strong>'),(1640,133,'_s4-list_1_text','field_60c06bce98391'),(1641,133,'s4-list_2_icon','68'),(1642,133,'_s4-list_2_icon','field_60c06bc298390'),(1643,133,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1644,133,'_s4-list_2_text','field_60c06bce98391'),(1645,133,'s4-list_3_icon','64'),(1646,133,'_s4-list_3_icon','field_60c06bc298390'),(1647,133,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1648,133,'_s4-list_3_text','field_60c06bce98391'),(1649,133,'s4-list_4_icon','129'),(1650,133,'_s4-list_4_icon','field_60c06bc298390'),(1651,133,'s4-list_4_text','<strong>дiарея</strong>'),(1652,133,'_s4-list_4_text','field_60c06bce98391'),(1653,133,'s4-list_5_icon','130'),(1654,133,'_s4-list_5_icon','field_60c06bc298390'),(1655,133,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1656,133,'_s4-list_5_text','field_60c06bce98391'),(1657,133,'s4-list_6_icon','131'),(1658,133,'_s4-list_6_icon','field_60c06bc298390'),(1659,133,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1660,133,'_s4-list_6_text','field_60c06bce98391'),(1661,133,'s3-list_0_li','має збалансований\r\nсклад'),(1662,133,'_s3-list_0_li','field_60c06db098395'),(1663,133,'s3-list_1_li',''),(1664,133,'_s3-list_1_li','field_60c06db098395'),(1665,11,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(1666,11,'_s3-list_2_li','field_60c06db098395'),(1667,11,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(1668,11,'_s3-list_3_li','field_60c06db098395'),(1669,11,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(1670,11,'_s3-list_4_li','field_60c06db098395'),(1671,11,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(1672,11,'_s3-list2_0_li','field_60c06dd498397'),(1673,11,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(1674,11,'_s3-list2_1_li','field_60c06dd498397'),(1675,11,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(1676,11,'_s3-list2_2_li','field_60c06dd498397'),(1677,134,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1678,134,'_s1-text','field_60c069d69838b'),(1679,134,'s3-list','5'),(1680,134,'_s3-list','field_60c06d9298394'),(1681,134,'s3-list2','3'),(1682,134,'_s3-list2','field_60c06dd498396'),(1683,134,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1684,134,'_s4-ttl','field_60c06ba39838e'),(1685,134,'s4-list','7'),(1686,134,'_s4-list','field_60c06bb39838f'),(1687,134,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1688,134,'_s4-slogan','field_60c06d6d98392'),(1689,134,'s4-list_0_icon','127'),(1690,134,'_s4-list_0_icon','field_60c06bc298390'),(1691,134,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1692,134,'_s4-list_0_text','field_60c06bce98391'),(1693,134,'s4-list_1_icon','128'),(1694,134,'_s4-list_1_icon','field_60c06bc298390'),(1695,134,'s4-list_1_text','<strong>головокружiння</strong>'),(1696,134,'_s4-list_1_text','field_60c06bce98391'),(1697,134,'s4-list_2_icon','68'),(1698,134,'_s4-list_2_icon','field_60c06bc298390'),(1699,134,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1700,134,'_s4-list_2_text','field_60c06bce98391'),(1701,134,'s4-list_3_icon','64'),(1702,134,'_s4-list_3_icon','field_60c06bc298390'),(1703,134,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1704,134,'_s4-list_3_text','field_60c06bce98391'),(1705,134,'s4-list_4_icon','129'),(1706,134,'_s4-list_4_icon','field_60c06bc298390'),(1707,134,'s4-list_4_text','<strong>дiарея</strong>'),(1708,134,'_s4-list_4_text','field_60c06bce98391'),(1709,134,'s4-list_5_icon','130'),(1710,134,'_s4-list_5_icon','field_60c06bc298390'),(1711,134,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1712,134,'_s4-list_5_text','field_60c06bce98391'),(1713,134,'s4-list_6_icon','131'),(1714,134,'_s4-list_6_icon','field_60c06bc298390'),(1715,134,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1716,134,'_s4-list_6_text','field_60c06bce98391'),(1717,134,'s3-list_0_li','має збалансований<br /> склад'),(1718,134,'_s3-list_0_li','field_60c06db098395'),(1719,134,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(1720,134,'_s3-list_1_li','field_60c06db098395'),(1721,134,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(1722,134,'_s3-list_2_li','field_60c06db098395'),(1723,134,'s3-list_3_li','має приємний смак та легко п’ється навіть при відчутті нудоти'),(1724,134,'_s3-list_3_li','field_60c06db098395'),(1725,134,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(1726,134,'_s3-list_4_li','field_60c06db098395'),(1727,134,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(1728,134,'_s3-list2_0_li','field_60c06dd498397'),(1729,134,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(1730,134,'_s3-list2_1_li','field_60c06dd498397'),(1731,134,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс в стаціонарі та після виписки на дому'),(1732,134,'_s3-list2_2_li','field_60c06dd498397'),(1888,11,'_s2-list_3_text','field_60c0749d53147'),(1887,11,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(1886,11,'_s2-list_3_size','field_60c0749553146'),(1884,11,'_s2-list_3_formula','field_60c0747253145'),(1885,11,'s2-list_3_size','- 1300 мг/л'),(1883,11,'s2-list_3_formula','Na<sup>+</sup>'),(1881,11,'s2-list_3_ttl','Натрій'),(1882,11,'_s2-list_3_ttl','field_60c0745253144'),(1880,11,'_s2-list_2_text','field_60c0749d53147'),(1879,11,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(1878,11,'_s2-list_2_size','field_60c0749553146'),(1877,11,'s2-list_2_size','до 90 мг/л'),(1876,11,'_s2-list_2_formula','field_60c0747253145'),(1875,11,'s2-list_2_formula','Сорбітол'),(1874,11,'_s2-list_2_ttl','field_60c0745253144'),(1873,11,'s2-list_2_ttl','Сорбітол'),(1872,11,'_s2-list_1_text','field_60c0749d53147'),(1871,11,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(1870,11,'_s2-list_1_size','field_60c0749553146'),(1869,11,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(1868,11,'_s2-list_1_formula','field_60c0747253145'),(1867,11,'s2-list_1_formula','Мiнералiзацiя'),(1865,11,'s2-list_1_ttl','Мiнералiзацiя'),(1866,11,'_s2-list_1_ttl','field_60c0745253144'),(1789,11,'s2-list_0_ttl','Вуглекислота'),(1790,11,'_s2-list_0_ttl','field_60c0745253144'),(1791,11,'s2-list_0_formula','Вуглекислота'),(1792,11,'_s2-list_0_formula','field_60c0747253145'),(1793,11,'s2-list_0_size','- 0,05-0,3%'),(1794,11,'_s2-list_0_size','field_60c0749553146'),(1795,11,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(1796,11,'_s2-list_0_text','field_60c0749d53147'),(1797,11,'s2-list','9'),(1798,11,'_s2-list','field_60c0743a53143'),(1799,141,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1800,141,'_s1-text','field_60c069d69838b'),(1801,141,'s3-list','5'),(1802,141,'_s3-list','field_60c06d9298394'),(1803,141,'s3-list2','3'),(1804,141,'_s3-list2','field_60c06dd498396'),(1805,141,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1806,141,'_s4-ttl','field_60c06ba39838e'),(1807,141,'s4-list','7'),(1808,141,'_s4-list','field_60c06bb39838f'),(1809,141,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1810,141,'_s4-slogan','field_60c06d6d98392'),(1811,141,'s4-list_0_icon','127'),(1812,141,'_s4-list_0_icon','field_60c06bc298390'),(1813,141,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1814,141,'_s4-list_0_text','field_60c06bce98391'),(1815,141,'s4-list_1_icon','128'),(1816,141,'_s4-list_1_icon','field_60c06bc298390'),(1817,141,'s4-list_1_text','<strong>головокружiння</strong>'),(1818,141,'_s4-list_1_text','field_60c06bce98391'),(1819,141,'s4-list_2_icon','68'),(1820,141,'_s4-list_2_icon','field_60c06bc298390'),(1821,141,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1822,141,'_s4-list_2_text','field_60c06bce98391'),(1823,141,'s4-list_3_icon','64'),(1824,141,'_s4-list_3_icon','field_60c06bc298390'),(1825,141,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1826,141,'_s4-list_3_text','field_60c06bce98391'),(1827,141,'s4-list_4_icon','129'),(1828,141,'_s4-list_4_icon','field_60c06bc298390'),(1829,141,'s4-list_4_text','<strong>дiарея</strong>'),(1830,141,'_s4-list_4_text','field_60c06bce98391'),(1831,141,'s4-list_5_icon','130'),(1832,141,'_s4-list_5_icon','field_60c06bc298390'),(1833,141,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1834,141,'_s4-list_5_text','field_60c06bce98391'),(1835,141,'s4-list_6_icon','131'),(1836,141,'_s4-list_6_icon','field_60c06bc298390'),(1837,141,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1838,141,'_s4-list_6_text','field_60c06bce98391'),(1839,141,'s3-list_0_li','має збалансований<br /> склад'),(1840,141,'_s3-list_0_li','field_60c06db098395'),(1841,141,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(1842,141,'_s3-list_1_li','field_60c06db098395'),(1843,141,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(1844,141,'_s3-list_2_li','field_60c06db098395'),(1845,141,'s3-list_3_li','має приємний смак та легко п’ється навіть при відчутті нудоти'),(1846,141,'_s3-list_3_li','field_60c06db098395'),(1847,141,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(1848,141,'_s3-list_4_li','field_60c06db098395'),(1849,141,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(1850,141,'_s3-list2_0_li','field_60c06dd498397'),(1851,141,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(1852,141,'_s3-list2_1_li','field_60c06dd498397'),(1853,141,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс в стаціонарі та після виписки на дому'),(1854,141,'_s3-list2_2_li','field_60c06dd498397'),(1855,141,'s2-list_0_ttl',''),(1856,141,'_s2-list_0_ttl','field_60c0745253144'),(1857,141,'s2-list_0_formula',''),(1858,141,'_s2-list_0_formula','field_60c0747253145'),(1859,141,'s2-list_0_size',''),(1860,141,'_s2-list_0_size','field_60c0749553146'),(1861,141,'s2-list_0_text',''),(1862,141,'_s2-list_0_text','field_60c0749d53147'),(1863,141,'s2-list','1'),(1864,141,'_s2-list','field_60c0743a53143'),(1889,11,'s2-list_4_ttl','Магній'),(1890,11,'_s2-list_4_ttl','field_60c0745253144'),(1891,11,'s2-list_4_formula','Mg<sup>2+</sup>'),(1892,11,'_s2-list_4_formula','field_60c0747253145'),(1893,11,'s2-list_4_size','- 80 мг/л'),(1894,11,'_s2-list_4_size','field_60c0749553146'),(1895,11,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(1896,11,'_s2-list_4_text','field_60c0749d53147'),(1897,11,'s2-list_5_ttl','Хлор'),(1898,11,'_s2-list_5_ttl','field_60c0745253144'),(1899,11,'s2-list_5_formula','Cl<sup>-</sup>'),(1900,11,'_s2-list_5_formula','field_60c0747253145'),(1901,11,'s2-list_5_size','- 2000 мг/л'),(1902,11,'_s2-list_5_size','field_60c0749553146'),(1903,11,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(1904,11,'_s2-list_5_text','field_60c0749d53147'),(1905,11,'s2-list_6_ttl','Калій'),(1906,11,'_s2-list_6_ttl','field_60c0745253144'),(1907,11,'s2-list_6_formula','K<sup>+</sup>'),(1908,11,'_s2-list_6_formula','field_60c0747253145'),(1909,11,'s2-list_6_size','- 220 мг/л'),(1910,11,'_s2-list_6_size','field_60c0749553146'),(1911,11,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(1912,11,'_s2-list_6_text','field_60c0749d53147'),(1913,11,'s2-list_7_ttl','Кальцій'),(1914,11,'_s2-list_7_ttl','field_60c0745253144'),(1915,11,'s2-list_7_formula','Ca<sup>2+</sup>'),(1916,11,'_s2-list_7_formula','field_60c0747253145'),(1917,11,'s2-list_7_size','- 80 мг/л'),(1918,11,'_s2-list_7_size','field_60c0749553146'),(1919,11,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(1920,11,'_s2-list_7_text','field_60c0749d53147'),(1921,11,'s2-list_8_ttl','Гідрокарбонати'),(1922,11,'_s2-list_8_ttl','field_60c0745253144'),(1923,11,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(1924,11,'_s2-list_8_formula','field_60c0747253145'),(1925,11,'s2-list_8_size','- 200-400 мг/л'),(1926,11,'_s2-list_8_size','field_60c0749553146'),(1927,11,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(1928,11,'_s2-list_8_text','field_60c0749d53147'),(1929,142,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(1930,142,'_s1-text','field_60c069d69838b'),(1931,142,'s3-list','5'),(1932,142,'_s3-list','field_60c06d9298394'),(1933,142,'s3-list2','3'),(1934,142,'_s3-list2','field_60c06dd498396'),(1935,142,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(1936,142,'_s4-ttl','field_60c06ba39838e'),(1937,142,'s4-list','7'),(1938,142,'_s4-list','field_60c06bb39838f'),(1939,142,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(1940,142,'_s4-slogan','field_60c06d6d98392'),(1941,142,'s4-list_0_icon','127'),(1942,142,'_s4-list_0_icon','field_60c06bc298390'),(1943,142,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(1944,142,'_s4-list_0_text','field_60c06bce98391'),(1945,142,'s4-list_1_icon','128'),(1946,142,'_s4-list_1_icon','field_60c06bc298390'),(1947,142,'s4-list_1_text','<strong>головокружiння</strong>'),(1948,142,'_s4-list_1_text','field_60c06bce98391'),(1949,142,'s4-list_2_icon','68'),(1950,142,'_s4-list_2_icon','field_60c06bc298390'),(1951,142,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(1952,142,'_s4-list_2_text','field_60c06bce98391'),(1953,142,'s4-list_3_icon','64'),(1954,142,'_s4-list_3_icon','field_60c06bc298390'),(1955,142,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(1956,142,'_s4-list_3_text','field_60c06bce98391'),(1957,142,'s4-list_4_icon','129'),(1958,142,'_s4-list_4_icon','field_60c06bc298390'),(1959,142,'s4-list_4_text','<strong>дiарея</strong>'),(1960,142,'_s4-list_4_text','field_60c06bce98391'),(1961,142,'s4-list_5_icon','130'),(1962,142,'_s4-list_5_icon','field_60c06bc298390'),(1963,142,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(1964,142,'_s4-list_5_text','field_60c06bce98391'),(1965,142,'s4-list_6_icon','131'),(1966,142,'_s4-list_6_icon','field_60c06bc298390'),(1967,142,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(1968,142,'_s4-list_6_text','field_60c06bce98391'),(1969,142,'s3-list_0_li','має збалансований<br /> склад'),(1970,142,'_s3-list_0_li','field_60c06db098395'),(1971,142,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(1972,142,'_s3-list_1_li','field_60c06db098395'),(1973,142,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(1974,142,'_s3-list_2_li','field_60c06db098395'),(1975,142,'s3-list_3_li','має приємний смак та легко п’ється навіть при відчутті нудоти'),(1976,142,'_s3-list_3_li','field_60c06db098395'),(1977,142,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(1978,142,'_s3-list_4_li','field_60c06db098395'),(1979,142,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(1980,142,'_s3-list2_0_li','field_60c06dd498397'),(1981,142,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(1982,142,'_s3-list2_1_li','field_60c06dd498397'),(1983,142,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс в стаціонарі та після виписки на дому'),(1984,142,'_s3-list2_2_li','field_60c06dd498397'),(1985,142,'s2-list_0_ttl','Вуглекислота'),(1986,142,'_s2-list_0_ttl','field_60c0745253144'),(1987,142,'s2-list_0_formula','Вуглекислота'),(1988,142,'_s2-list_0_formula','field_60c0747253145'),(1989,142,'s2-list_0_size','0,05-0,3%'),(1990,142,'_s2-list_0_size','field_60c0749553146'),(1991,142,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(1992,142,'_s2-list_0_text','field_60c0749d53147'),(1993,142,'s2-list','9'),(1994,142,'_s2-list','field_60c0743a53143'),(1995,142,'s2-list_1_ttl','Мiнералiзацiя'),(1996,142,'_s2-list_1_ttl','field_60c0745253144'),(1997,142,'s2-list_1_formula','Мiнералiзацiя'),(1998,142,'_s2-list_1_formula','field_60c0747253145'),(1999,142,'s2-list_1_size','2500-3000 (мг/дм<sup>3</sup>'),(2000,142,'_s2-list_1_size','field_60c0749553146'),(2001,142,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(2002,142,'_s2-list_1_text','field_60c0749d53147'),(2003,142,'s2-list_2_ttl','Сорбітол'),(2004,142,'_s2-list_2_ttl','field_60c0745253144'),(2005,142,'s2-list_2_formula','Сорбітол'),(2006,142,'_s2-list_2_formula','field_60c0747253145'),(2007,142,'s2-list_2_size','до 900 мл/г'),(2008,142,'_s2-list_2_size','field_60c0749553146'),(2009,142,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(2010,142,'_s2-list_2_text','field_60c0749d53147'),(2011,142,'s2-list_3_ttl','Натрій'),(2012,142,'_s2-list_3_ttl','field_60c0745253144'),(2013,142,'s2-list_3_formula','Na<sup>+</sup>'),(2014,142,'_s2-list_3_formula','field_60c0747253145'),(2015,142,'s2-list_3_size','900 мл/г'),(2016,142,'_s2-list_3_size','field_60c0749553146'),(2017,142,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(2018,142,'_s2-list_3_text','field_60c0749d53147'),(2019,142,'s2-list_4_ttl','Магній'),(2020,142,'_s2-list_4_ttl','field_60c0745253144'),(2021,142,'s2-list_4_formula','Mg<sup>2+</sup>'),(2022,142,'_s2-list_4_formula','field_60c0747253145'),(2023,142,'s2-list_4_size','50 мл/г'),(2024,142,'_s2-list_4_size','field_60c0749553146'),(2025,142,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(2026,142,'_s2-list_4_text','field_60c0749d53147'),(2027,142,'s2-list_5_ttl','Хлор'),(2028,142,'_s2-list_5_ttl','field_60c0745253144'),(2029,142,'s2-list_5_formula','Cl<sup>-</sup>'),(2030,142,'_s2-list_5_formula','field_60c0747253145'),(2031,142,'s2-list_5_size','600 мл/г'),(2032,142,'_s2-list_5_size','field_60c0749553146'),(2033,142,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(2034,142,'_s2-list_5_text','field_60c0749d53147'),(2035,142,'s2-list_6_ttl','Калій'),(2036,142,'_s2-list_6_ttl','field_60c0745253144'),(2037,142,'s2-list_6_formula','K<sup>+</sup>'),(2038,142,'_s2-list_6_formula','field_60c0747253145'),(2039,142,'s2-list_6_size','160 мл/г'),(2040,142,'_s2-list_6_size','field_60c0749553146'),(2041,142,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(2042,142,'_s2-list_6_text','field_60c0749d53147'),(2043,142,'s2-list_7_ttl','Кальцій'),(2044,142,'_s2-list_7_ttl','field_60c0745253144'),(2045,142,'s2-list_7_formula','Ca<sup>2+</sup>'),(2046,142,'_s2-list_7_formula','field_60c0747253145'),(2047,142,'s2-list_7_size','50 мл/г<'),(2048,142,'_s2-list_7_size','field_60c0749553146'),(2049,142,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(2050,142,'_s2-list_7_text','field_60c0749d53147'),(2051,142,'s2-list_8_ttl','Гідрокарбонати'),(2052,142,'_s2-list_8_ttl','field_60c0745253144'),(2053,142,'s2-list_8_formula','HCO<sup>3+</sup>'),(2054,142,'_s2-list_8_formula','field_60c0747253145'),(2055,142,'s2-list_8_size','300 мл/г'),(2056,142,'_s2-list_8_size','field_60c0749553146'),(2057,142,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(2058,142,'_s2-list_8_text','field_60c0749d53147'),(2059,143,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(2060,143,'_s1-text','field_60c069d69838b'),(2061,143,'s3-list','5'),(2062,143,'_s3-list','field_60c06d9298394'),(2063,143,'s3-list2','3'),(2064,143,'_s3-list2','field_60c06dd498396'),(2065,143,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(2066,143,'_s4-ttl','field_60c06ba39838e'),(2067,143,'s4-list','7'),(2068,143,'_s4-list','field_60c06bb39838f'),(2069,143,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(2070,143,'_s4-slogan','field_60c06d6d98392'),(2071,143,'s4-list_0_icon','127'),(2072,143,'_s4-list_0_icon','field_60c06bc298390'),(2073,143,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(2074,143,'_s4-list_0_text','field_60c06bce98391'),(2075,143,'s4-list_1_icon','128'),(2076,143,'_s4-list_1_icon','field_60c06bc298390'),(2077,143,'s4-list_1_text','<strong>головокружiння</strong>'),(2078,143,'_s4-list_1_text','field_60c06bce98391'),(2079,143,'s4-list_2_icon','68'),(2080,143,'_s4-list_2_icon','field_60c06bc298390'),(2081,143,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(2082,143,'_s4-list_2_text','field_60c06bce98391'),(2083,143,'s4-list_3_icon','64'),(2084,143,'_s4-list_3_icon','field_60c06bc298390'),(2085,143,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(2086,143,'_s4-list_3_text','field_60c06bce98391'),(2087,143,'s4-list_4_icon','129'),(2088,143,'_s4-list_4_icon','field_60c06bc298390'),(2089,143,'s4-list_4_text','<strong>дiарея</strong>'),(2090,143,'_s4-list_4_text','field_60c06bce98391'),(2091,143,'s4-list_5_icon','130'),(2092,143,'_s4-list_5_icon','field_60c06bc298390'),(2093,143,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(2094,143,'_s4-list_5_text','field_60c06bce98391'),(2095,143,'s4-list_6_icon','131'),(2096,143,'_s4-list_6_icon','field_60c06bc298390'),(2097,143,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(2098,143,'_s4-list_6_text','field_60c06bce98391'),(2099,143,'s3-list_0_li','має збалансований<br /> склад'),(2100,143,'_s3-list_0_li','field_60c06db098395'),(2101,143,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(2102,143,'_s3-list_1_li','field_60c06db098395'),(2103,143,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(2104,143,'_s3-list_2_li','field_60c06db098395'),(2105,143,'s3-list_3_li','має приємний смак та легко п’ється навіть при відчутті нудоти'),(2106,143,'_s3-list_3_li','field_60c06db098395'),(2107,143,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(2108,143,'_s3-list_4_li','field_60c06db098395'),(2109,143,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(2110,143,'_s3-list2_0_li','field_60c06dd498397'),(2111,143,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(2112,143,'_s3-list2_1_li','field_60c06dd498397'),(2113,143,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс в стаціонарі та після виписки на дому'),(2114,143,'_s3-list2_2_li','field_60c06dd498397'),(2115,143,'s2-list_0_ttl','Вуглекислота'),(2116,143,'_s2-list_0_ttl','field_60c0745253144'),(2117,143,'s2-list_0_formula','Вуглекислота'),(2118,143,'_s2-list_0_formula','field_60c0747253145'),(2119,143,'s2-list_0_size','- 0,05-0,3%'),(2120,143,'_s2-list_0_size','field_60c0749553146'),(2121,143,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(2122,143,'_s2-list_0_text','field_60c0749d53147'),(2123,143,'s2-list','9'),(2124,143,'_s2-list','field_60c0743a53143'),(2125,143,'s2-list_1_ttl','Мiнералiзацiя'),(2126,143,'_s2-list_1_ttl','field_60c0745253144'),(2127,143,'s2-list_1_formula','Мiнералiзацiя'),(2128,143,'_s2-list_1_formula','field_60c0747253145'),(2129,143,'s2-list_1_size','- 2500-3000 (мг/дм<sup>3</sup>'),(2130,143,'_s2-list_1_size','field_60c0749553146'),(2131,143,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(2132,143,'_s2-list_1_text','field_60c0749d53147'),(2133,143,'s2-list_2_ttl','Сорбітол'),(2134,143,'_s2-list_2_ttl','field_60c0745253144'),(2135,143,'s2-list_2_formula','Сорбітол'),(2136,143,'_s2-list_2_formula','field_60c0747253145'),(2137,143,'s2-list_2_size','до 900 мл/г'),(2138,143,'_s2-list_2_size','field_60c0749553146'),(2139,143,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(2140,143,'_s2-list_2_text','field_60c0749d53147'),(2141,143,'s2-list_3_ttl','Натрій'),(2142,143,'_s2-list_3_ttl','field_60c0745253144'),(2143,143,'s2-list_3_formula','Na<sup>+</sup>'),(2144,143,'_s2-list_3_formula','field_60c0747253145'),(2145,143,'s2-list_3_size','- 900 мл/г'),(2146,143,'_s2-list_3_size','field_60c0749553146'),(2147,143,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(2148,143,'_s2-list_3_text','field_60c0749d53147'),(2149,143,'s2-list_4_ttl','Магній'),(2150,143,'_s2-list_4_ttl','field_60c0745253144'),(2151,143,'s2-list_4_formula','Mg<sup>2+</sup>'),(2152,143,'_s2-list_4_formula','field_60c0747253145'),(2153,143,'s2-list_4_size','- 50 мл/г'),(2154,143,'_s2-list_4_size','field_60c0749553146'),(2155,143,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(2156,143,'_s2-list_4_text','field_60c0749d53147'),(2157,143,'s2-list_5_ttl','Хлор'),(2158,143,'_s2-list_5_ttl','field_60c0745253144'),(2159,143,'s2-list_5_formula','Cl<sup>-</sup>'),(2160,143,'_s2-list_5_formula','field_60c0747253145'),(2161,143,'s2-list_5_size','- 600 мл/г'),(2162,143,'_s2-list_5_size','field_60c0749553146'),(2163,143,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(2164,143,'_s2-list_5_text','field_60c0749d53147'),(2165,143,'s2-list_6_ttl','Калій'),(2166,143,'_s2-list_6_ttl','field_60c0745253144'),(2167,143,'s2-list_6_formula','K<sup>+</sup>'),(2168,143,'_s2-list_6_formula','field_60c0747253145'),(2169,143,'s2-list_6_size','- 160 мл/г'),(2170,143,'_s2-list_6_size','field_60c0749553146'),(2171,143,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(2172,143,'_s2-list_6_text','field_60c0749d53147'),(2173,143,'s2-list_7_ttl','Кальцій'),(2174,143,'_s2-list_7_ttl','field_60c0745253144'),(2175,143,'s2-list_7_formula','Ca<sup>2+</sup>'),(2176,143,'_s2-list_7_formula','field_60c0747253145'),(2177,143,'s2-list_7_size','- 50 мл/г'),(2178,143,'_s2-list_7_size','field_60c0749553146'),(2179,143,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(2180,143,'_s2-list_7_text','field_60c0749d53147'),(2181,143,'s2-list_8_ttl','Гідрокарбонати'),(2182,143,'_s2-list_8_ttl','field_60c0745253144'),(2183,143,'s2-list_8_formula','HCO<sup>3+</sup>'),(2184,143,'_s2-list_8_formula','field_60c0747253145'),(2185,143,'s2-list_8_size','- 300 мл/г'),(2186,143,'_s2-list_8_size','field_60c0749553146'),(2187,143,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(2188,143,'_s2-list_8_text','field_60c0749d53147'),(2189,144,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(2190,144,'_s1-text','field_60c069d69838b'),(2191,144,'s3-list','5'),(2192,144,'_s3-list','field_60c06d9298394'),(2193,144,'s3-list2','3'),(2194,144,'_s3-list2','field_60c06dd498396'),(2195,144,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(2196,144,'_s4-ttl','field_60c06ba39838e'),(2197,144,'s4-list','7'),(2198,144,'_s4-list','field_60c06bb39838f'),(2199,144,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(2200,144,'_s4-slogan','field_60c06d6d98392'),(2201,144,'s4-list_0_icon','127'),(2202,144,'_s4-list_0_icon','field_60c06bc298390'),(2203,144,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(2204,144,'_s4-list_0_text','field_60c06bce98391'),(2205,144,'s4-list_1_icon','128'),(2206,144,'_s4-list_1_icon','field_60c06bc298390'),(2207,144,'s4-list_1_text','<strong>головокружiння</strong>'),(2208,144,'_s4-list_1_text','field_60c06bce98391'),(2209,144,'s4-list_2_icon','68'),(2210,144,'_s4-list_2_icon','field_60c06bc298390'),(2211,144,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(2212,144,'_s4-list_2_text','field_60c06bce98391'),(2213,144,'s4-list_3_icon','64'),(2214,144,'_s4-list_3_icon','field_60c06bc298390'),(2215,144,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(2216,144,'_s4-list_3_text','field_60c06bce98391'),(2217,144,'s4-list_4_icon','129'),(2218,144,'_s4-list_4_icon','field_60c06bc298390'),(2219,144,'s4-list_4_text','<strong>дiарея</strong>'),(2220,144,'_s4-list_4_text','field_60c06bce98391'),(2221,144,'s4-list_5_icon','130'),(2222,144,'_s4-list_5_icon','field_60c06bc298390'),(2223,144,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(2224,144,'_s4-list_5_text','field_60c06bce98391'),(2225,144,'s4-list_6_icon','131'),(2226,144,'_s4-list_6_icon','field_60c06bc298390'),(2227,144,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(2228,144,'_s4-list_6_text','field_60c06bce98391'),(2229,144,'s3-list_0_li','має збалансований<br /> склад'),(2230,144,'_s3-list_0_li','field_60c06db098395'),(2231,144,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(2232,144,'_s3-list_1_li','field_60c06db098395'),(2233,144,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(2234,144,'_s3-list_2_li','field_60c06db098395'),(2235,144,'s3-list_3_li','має приємний смак та легко п’ється навіть при відчутті нудоти'),(2236,144,'_s3-list_3_li','field_60c06db098395'),(2237,144,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(2238,144,'_s3-list_4_li','field_60c06db098395'),(2239,144,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(2240,144,'_s3-list2_0_li','field_60c06dd498397'),(2241,144,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(2242,144,'_s3-list2_1_li','field_60c06dd498397'),(2243,144,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс в стаціонарі та після виписки на дому'),(2244,144,'_s3-list2_2_li','field_60c06dd498397'),(2245,144,'s2-list_0_ttl','Вуглекислота'),(2246,144,'_s2-list_0_ttl','field_60c0745253144'),(2247,144,'s2-list_0_formula','Вуглекислота'),(2248,144,'_s2-list_0_formula','field_60c0747253145'),(2249,144,'s2-list_0_size','- 0,05-0,3%'),(2250,144,'_s2-list_0_size','field_60c0749553146'),(2251,144,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(2252,144,'_s2-list_0_text','field_60c0749d53147'),(2253,144,'s2-list','9'),(2254,144,'_s2-list','field_60c0743a53143'),(2255,144,'s2-list_1_ttl','Мiнералiзацiя'),(2256,144,'_s2-list_1_ttl','field_60c0745253144'),(2257,144,'s2-list_1_formula','Мiнералiзацiя'),(2258,144,'_s2-list_1_formula','field_60c0747253145'),(2259,144,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(2260,144,'_s2-list_1_size','field_60c0749553146'),(2261,144,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(2262,144,'_s2-list_1_text','field_60c0749d53147'),(2263,144,'s2-list_2_ttl','Сорбітол'),(2264,144,'_s2-list_2_ttl','field_60c0745253144'),(2265,144,'s2-list_2_formula','Сорбітол'),(2266,144,'_s2-list_2_formula','field_60c0747253145'),(2267,144,'s2-list_2_size','до 900 мл/г'),(2268,144,'_s2-list_2_size','field_60c0749553146'),(2269,144,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(2270,144,'_s2-list_2_text','field_60c0749d53147'),(2271,144,'s2-list_3_ttl','Натрій'),(2272,144,'_s2-list_3_ttl','field_60c0745253144'),(2273,144,'s2-list_3_formula','Na<sup>+</sup>'),(2274,144,'_s2-list_3_formula','field_60c0747253145'),(2275,144,'s2-list_3_size','- 900 мл/г'),(2276,144,'_s2-list_3_size','field_60c0749553146'),(2277,144,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(2278,144,'_s2-list_3_text','field_60c0749d53147'),(2279,144,'s2-list_4_ttl','Магній'),(2280,144,'_s2-list_4_ttl','field_60c0745253144'),(2281,144,'s2-list_4_formula','Mg<sup>2+</sup>'),(2282,144,'_s2-list_4_formula','field_60c0747253145'),(2283,144,'s2-list_4_size','- 50 мл/г'),(2284,144,'_s2-list_4_size','field_60c0749553146'),(2285,144,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(2286,144,'_s2-list_4_text','field_60c0749d53147'),(2287,144,'s2-list_5_ttl','Хлор'),(2288,144,'_s2-list_5_ttl','field_60c0745253144'),(2289,144,'s2-list_5_formula','Cl<sup>-</sup>'),(2290,144,'_s2-list_5_formula','field_60c0747253145'),(2291,144,'s2-list_5_size','- 600 мл/г'),(2292,144,'_s2-list_5_size','field_60c0749553146'),(2293,144,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(2294,144,'_s2-list_5_text','field_60c0749d53147'),(2295,144,'s2-list_6_ttl','Калій'),(2296,144,'_s2-list_6_ttl','field_60c0745253144'),(2297,144,'s2-list_6_formula','K<sup>+</sup>'),(2298,144,'_s2-list_6_formula','field_60c0747253145'),(2299,144,'s2-list_6_size','- 160 мл/г'),(2300,144,'_s2-list_6_size','field_60c0749553146'),(2301,144,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(2302,144,'_s2-list_6_text','field_60c0749d53147'),(2303,144,'s2-list_7_ttl','Кальцій'),(2304,144,'_s2-list_7_ttl','field_60c0745253144'),(2305,144,'s2-list_7_formula','Ca<sup>2+</sup>'),(2306,144,'_s2-list_7_formula','field_60c0747253145'),(2307,144,'s2-list_7_size','- 50 мл/г'),(2308,144,'_s2-list_7_size','field_60c0749553146'),(2309,144,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(2310,144,'_s2-list_7_text','field_60c0749d53147'),(2311,144,'s2-list_8_ttl','Гідрокарбонати'),(2312,144,'_s2-list_8_ttl','field_60c0745253144'),(2313,144,'s2-list_8_formula','HCO<sup>3+</sup>'),(2314,144,'_s2-list_8_formula','field_60c0747253145'),(2315,144,'s2-list_8_size','- 300 мл/г'),(2316,144,'_s2-list_8_size','field_60c0749553146'),(2317,144,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. 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синдром'),(2488,176,'_s2-list_1_text','field_60bf7712f46f1'),(2489,176,'s2-list_2_icon','65'),(2490,176,'_s2-list_2_icon','field_60bf76ecf46ef'),(2491,176,'s2-list_2_icon-hover','66'),(2492,176,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(2493,176,'s2-list_2_text','Диарея'),(2494,176,'_s2-list_2_text','field_60bf7712f46f1'),(2495,176,'s2-list_3_icon','67'),(2496,176,'_s2-list_3_icon','field_60bf76ecf46ef'),(2497,176,'s2-list_3_icon-hover','68'),(2498,176,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(2499,176,'s2-list_3_text','Рвота'),(2500,176,'_s2-list_3_text','field_60bf7712f46f1'),(2501,176,'s2-list_4_icon','69'),(2502,176,'_s2-list_4_icon','field_60bf76ecf46ef'),(2503,176,'s2-list_4_icon-hover','70'),(2504,176,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(2505,176,'s2-list_4_text','Интенсивные физические нагрузки'),(2506,176,'_s2-list_4_text','field_60bf7712f46f1'),(2507,176,'s2-list_5_icon','71'),(2508,176,'_s2-list_5_icon','field_60bf76ecf46ef'),(2509,176,'s2-list_5_icon-hover','72'),(2510,176,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(2511,176,'s2-list_5_text','Перегрев в жаркую погоду'),(2512,176,'_s2-list_5_text','field_60bf7712f46f1'),(2513,176,'s1-slogan','Когда обычной воды недостаточно!'),(2514,176,'_s1-slogan','field_60bf7ab4d9ba9'),(2515,176,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(2516,176,'_s3-text','field_60bf7bb5a7e2b'),(2517,176,'s4-ttl','РеО – вода для медицинских целей!'),(2518,176,'_s4-ttl','field_60bf7c831f58c'),(2519,176,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(2520,176,'_s4-notes','field_60bf7ca31f58d'),(2521,176,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(13418,1320,'s2-list','6'),(13419,1320,'_s2-list','field_60bf76e0f46ee'),(2522,176,'_s5-video','field_60bf7ccfa01a5'),(2523,176,'s6-ttl','Когда обычной воды недостаточно!'),(2524,176,'_s6-ttl','field_60bf7cfb10d31'),(2525,176,'s6-list','6'),(2526,176,'_s6-list','field_60bf7d0410d32'),(2527,176,'s6-list_0_icon','92'),(2528,176,'_s6-list_0_icon','field_60bf7d1810d33'),(2529,176,'s6-list_0_text','При повышенной температуре'),(2530,176,'_s6-list_0_text','field_60bf7d2710d34'),(2531,176,'s6-list_1_icon','93'),(2532,176,'_s6-list_1_icon','field_60bf7d1810d33'),(2533,176,'s6-list_1_text','При пищевых отравлениях'),(2534,176,'_s6-list_1_text','field_60bf7d2710d34'),(2535,176,'s6-list_2_icon','94'),(2536,176,'_s6-list_2_icon','field_60bf7d1810d33'),(2537,176,'s6-list_2_text','При кишечных инфекциях'),(2538,176,'_s6-list_2_text','field_60bf7d2710d34'),(2539,176,'s6-list_3_icon','95'),(2540,176,'_s6-list_3_icon','field_60bf7d1810d33'),(2541,176,'s6-list_3_text','Во время беременности'),(2542,176,'_s6-list_3_text','field_60bf7d2710d34'),(2543,176,'s6-list_4_icon','96'),(2544,176,'_s6-list_4_icon','field_60bf7d1810d33'),(2545,176,'s6-list_4_text','Во время занятий спортом'),(2546,176,'_s6-list_4_text','field_60bf7d2710d34'),(2547,176,'s6-list_5_icon','97'),(2548,176,'_s6-list_5_icon','field_60bf7d1810d33'),(2549,176,'s6-list_5_text','При похмельном синдроме'),(2550,176,'_s6-list_5_text','field_60bf7d2710d34'),(2551,176,'s4-list_0_ttl','Натрий'),(2552,176,'_s4-list_0_ttl','field_60bf7fa95a92c'),(2553,176,'s4-list_0_formula','Na<sup>+</sup>'),(2554,176,'_s4-list_0_formula','field_60bf7fc65a92d'),(2555,176,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(2556,176,'_s4-list_0_text','field_60bf7fd35a92e'),(2557,176,'s4-list_1_ttl','Вода'),(2558,176,'_s4-list_1_ttl','field_60bf7fa95a92c'),(2559,176,'s4-list_1_formula','H<sub>2</sub>O'),(2560,176,'_s4-list_1_formula','field_60bf7fc65a92d'),(2561,176,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(2562,176,'_s4-list_1_text','field_60bf7fd35a92e'),(2563,176,'s4-list','9'),(2564,176,'_s4-list','field_60bf7f985a92b'),(2565,176,'s4-list_2_ttl','Калий'),(2566,176,'_s4-list_2_ttl','field_60bf7fa95a92c'),(2567,176,'s4-list_2_formula','K<sup>+</sup>'),(2568,176,'_s4-list_2_formula','field_60bf7fc65a92d'),(2569,176,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(8659,921,'s2-list','6'),(2570,176,'_s4-list_2_text','field_60bf7fd35a92e'),(2571,176,'s4-list_3_ttl','Гидрокарбонаты'),(2572,176,'_s4-list_3_ttl','field_60bf7fa95a92c'),(2573,176,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(2574,176,'_s4-list_3_formula','field_60bf7fc65a92d'),(2575,176,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(2576,176,'_s4-list_3_text','field_60bf7fd35a92e'),(2577,176,'s4-list_4_ttl','Магний'),(2578,176,'_s4-list_4_ttl','field_60bf7fa95a92c'),(2579,176,'s4-list_4_formula','Mg<sup>2+</sup>'),(2580,176,'_s4-list_4_formula','field_60bf7fc65a92d'),(2581,176,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(2582,176,'_s4-list_4_text','field_60bf7fd35a92e'),(2583,176,'s4-list_5_ttl','Углекислый газ'),(2584,176,'_s4-list_5_ttl','field_60bf7fa95a92c'),(2585,176,'s4-list_5_formula','CO<sup>2+</sup>'),(2586,176,'_s4-list_5_formula','field_60bf7fc65a92d'),(2587,176,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(2588,176,'_s4-list_5_text','field_60bf7fd35a92e'),(2589,176,'s4-list_6_ttl','Кальций'),(2590,176,'_s4-list_6_ttl','field_60bf7fa95a92c'),(2591,176,'s4-list_6_formula','Ca<sup>2+</sup>'),(2592,176,'_s4-list_6_formula','field_60bf7fc65a92d'),(2593,176,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(2594,176,'_s4-list_6_text','field_60bf7fd35a92e'),(2595,176,'s4-list_7_ttl','Сорбит'),(2596,176,'_s4-list_7_ttl','field_60bf7fa95a92c'),(2597,176,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(2598,176,'_s4-list_7_formula','field_60bf7fc65a92d'),(2599,176,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(2600,176,'_s4-list_7_text','field_60bf7fd35a92e'),(2601,176,'s4-list_8_ttl','Хлор'),(2602,176,'_s4-list_8_ttl','field_60bf7fa95a92c'),(2603,176,'s4-list_8_formula','Cl<sup>-</sup>'),(2604,176,'_s4-list_8_formula','field_60bf7fc65a92d'),(2605,176,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(2606,176,'_s4-list_8_text','field_60bf7fd35a92e'),(2607,176,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(2608,176,'_s4-feature1','field_60bf80ca480ea'),(2609,176,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(2610,176,'_s4-feature2','field_60bf80de480eb'),(2611,176,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(2612,176,'_s4-feature3','field_60bf80e2480ec'),(2613,176,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(2614,176,'_s4-feature4','field_60bf80e5480ed'),(2615,176,'_wpml_media_featured','1'),(2616,176,'_wpml_media_duplicate','1'),(2763,177,'_edit_lock','1640082618:1'),(2621,177,'_yoast_wpseo_estimated-reading-time-minutes',''),(2620,177,'_wp_page_template','page-about.php'),(2622,177,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(2623,177,'_s1-text','field_60c069d69838b'),(2624,177,'s3-list','5'),(2625,177,'_s3-list','field_60c06d9298394'),(2626,177,'s3-list2','3'),(2627,177,'_s3-list2','field_60c06dd498396'),(2628,177,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(2629,177,'_s4-ttl','field_60c06ba39838e'),(2630,177,'s4-list','7'),(2631,177,'_s4-list','field_60c06bb39838f'),(2632,177,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(2633,177,'_s4-slogan','field_60c06d6d98392'),(2634,177,'s4-list_0_icon','127'),(2635,177,'_s4-list_0_icon','field_60c06bc298390'),(2636,177,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(2637,177,'_s4-list_0_text','field_60c06bce98391'),(2638,177,'s4-list_1_icon','128'),(2639,177,'_s4-list_1_icon','field_60c06bc298390'),(2640,177,'s4-list_1_text','<strong>головокружение</strong>'),(2641,177,'_s4-list_1_text','field_60c06bce98391'),(2642,177,'s4-list_2_icon','68'),(2643,177,'_s4-list_2_icon','field_60c06bc298390'),(2644,177,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(2645,177,'_s4-list_2_text','field_60c06bce98391'),(2646,177,'s4-list_3_icon','64'),(2647,177,'_s4-list_3_icon','field_60c06bc298390'),(2648,177,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(2649,177,'_s4-list_3_text','field_60c06bce98391'),(2650,177,'s4-list_4_icon','129'),(2651,177,'_s4-list_4_icon','field_60c06bc298390'),(2652,177,'s4-list_4_text','<strong>диарея</strong>'),(2653,177,'_s4-list_4_text','field_60c06bce98391'),(2654,177,'s4-list_5_icon','130'),(2655,177,'_s4-list_5_icon','field_60c06bc298390'),(2656,177,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(2657,177,'_s4-list_5_text','field_60c06bce98391'),(2658,177,'s4-list_6_icon','131'),(2659,177,'_s4-list_6_icon','field_60c06bc298390'),(2660,177,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(2661,177,'_s4-list_6_text','field_60c06bce98391'),(2662,177,'s3-list_0_li','имеет сбалансированный<br /> состав'),(2663,177,'_s3-list_0_li','field_60c06db098395'),(2664,177,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(2665,177,'_s3-list_1_li','field_60c06db098395'),(2666,177,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(2667,177,'_s3-list_2_li','field_60c06db098395'),(2668,177,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(2669,177,'_s3-list_3_li','field_60c06db098395'),(2670,177,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(2671,177,'_s3-list_4_li','field_60c06db098395'),(2672,177,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(2673,177,'_s3-list2_0_li','field_60c06dd498397'),(2674,177,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(2675,177,'_s3-list2_1_li','field_60c06dd498397'),(2676,177,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(2677,177,'_s3-list2_2_li','field_60c06dd498397'),(2678,177,'_s2-list_3_text','field_60c0749d53147'),(2679,177,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(2680,177,'_s2-list_3_size','field_60c0749553146'),(2681,177,'_s2-list_3_formula','field_60c0747253145'),(2682,177,'s2-list_3_size','- 1300 мг/л'),(2683,177,'s2-list_3_formula','Na<sup>+</sup>'),(2684,177,'s2-list_3_ttl','Натрий'),(2685,177,'_s2-list_3_ttl','field_60c0745253144'),(2686,177,'_s2-list_2_text','field_60c0749d53147'),(2687,177,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(2688,177,'_s2-list_2_size','field_60c0749553146'),(2689,177,'s2-list_2_size','до 90 мг/л'),(2690,177,'_s2-list_2_formula','field_60c0747253145'),(2691,177,'s2-list_2_formula','Сорбитол'),(2692,177,'_s2-list_2_ttl','field_60c0745253144'),(2693,177,'s2-list_2_ttl','Сорбитол'),(2694,177,'_s2-list_1_text','field_60c0749d53147'),(2695,177,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(2696,177,'_s2-list_1_size','field_60c0749553146'),(2697,177,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(2698,177,'_s2-list_1_formula','field_60c0747253145'),(2699,177,'s2-list_1_formula','Минерализация'),(2700,177,'s2-list_1_ttl','Минерализация'),(2701,177,'_s2-list_1_ttl','field_60c0745253144'),(2702,177,'s2-list_0_ttl','Углекислота'),(2703,177,'_s2-list_0_ttl','field_60c0745253144'),(2704,177,'s2-list_0_formula','Углекислота'),(2705,177,'_s2-list_0_formula','field_60c0747253145'),(2706,177,'s2-list_0_size','- 0,05-0,3%'),(2707,177,'_s2-list_0_size','field_60c0749553146'),(2708,177,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(2709,177,'_s2-list_0_text','field_60c0749d53147'),(2710,177,'s2-list','9'),(2711,177,'_s2-list','field_60c0743a53143'),(2712,177,'s2-list_4_ttl','Магний'),(2713,177,'_s2-list_4_ttl','field_60c0745253144'),(2714,177,'s2-list_4_formula','Mg<sup>2+</sup>'),(2715,177,'_s2-list_4_formula','field_60c0747253145'),(2716,177,'s2-list_4_size','- 80 мг/л'),(2717,177,'_s2-list_4_size','field_60c0749553146'),(2718,177,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(2719,177,'_s2-list_4_text','field_60c0749d53147'),(2720,177,'s2-list_5_ttl','Хлор'),(2721,177,'_s2-list_5_ttl','field_60c0745253144'),(2722,177,'s2-list_5_formula','Cl<sup>-</sup>'),(2723,177,'_s2-list_5_formula','field_60c0747253145'),(2724,177,'s2-list_5_size','- 2000 мг/л'),(2725,177,'_s2-list_5_size','field_60c0749553146'),(2726,177,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(2727,177,'_s2-list_5_text','field_60c0749d53147'),(2728,177,'s2-list_6_ttl','Калий'),(2729,177,'_s2-list_6_ttl','field_60c0745253144'),(2730,177,'s2-list_6_formula','K<sup>+</sup>'),(2731,177,'_s2-list_6_formula','field_60c0747253145'),(2732,177,'s2-list_6_size','- 220 мг/л'),(2733,177,'_s2-list_6_size','field_60c0749553146'),(2734,177,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(8819,922,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(2735,177,'_s2-list_6_text','field_60c0749d53147'),(2736,177,'s2-list_7_ttl','Кальций'),(2737,177,'_s2-list_7_ttl','field_60c0745253144'),(2738,177,'s2-list_7_formula','Ca<sup>2+</sup>'),(2739,177,'_s2-list_7_formula','field_60c0747253145'),(2740,177,'s2-list_7_size','- 80 мг/л'),(2741,177,'_s2-list_7_size','field_60c0749553146'),(2742,177,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(2743,177,'_s2-list_7_text','field_60c0749d53147'),(2744,177,'s2-list_8_ttl','Гидрокарбонаты'),(2745,177,'_s2-list_8_ttl','field_60c0745253144'),(2746,177,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(2747,177,'_s2-list_8_formula','field_60c0747253145'),(2748,177,'s2-list_8_size','- 200-400 мг/л'),(2749,177,'_s2-list_8_size','field_60c0749553146'),(2750,177,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(2751,177,'_s2-list_8_text','field_60c0749d53147'),(2752,177,'_wpml_media_featured','1'),(2753,177,'_wpml_media_duplicate','1'),(2764,178,'_edit_lock','1630153833:1'),(2758,178,'_yoast_wpseo_estimated-reading-time-minutes',''),(2757,178,'_wp_page_template','page-manufacturer.php'),(2759,178,'_wpml_media_featured','1'),(2760,178,'_wpml_media_duplicate','1'),(2765,176,'_edit_last','1'),(2762,176,'_edit_lock','1640082601:1'),(2766,180,'s2-list','6'),(2767,180,'_s2-list','field_60bf76e0f46ee'),(2768,180,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(2769,180,'_s2-ttl','field_60bf76d1f46ed'),(2770,180,'slider','8'),(2771,180,'_slider','field_60bf767ef46ea'),(2772,180,'slider_0_slide','50'),(2773,180,'_slider_0_slide','field_60bf7688f46eb'),(2774,180,'slider_1_slide','51'),(2775,180,'_slider_1_slide','field_60bf7688f46eb'),(2776,180,'slider_2_slide','52'),(2777,180,'_slider_2_slide','field_60bf7688f46eb'),(2778,180,'slider_3_slide','53'),(2779,180,'_slider_3_slide','field_60bf7688f46eb'),(2780,180,'slider_4_slide','54'),(2781,180,'_slider_4_slide','field_60bf7688f46eb'),(2782,180,'slider_5_slide','55'),(2783,180,'_slider_5_slide','field_60bf7688f46eb'),(2784,180,'slider_6_slide','56'),(2785,180,'_slider_6_slide','field_60bf7688f46eb'),(2786,180,'slider_7_slide','57'),(2787,180,'_slider_7_slide','field_60bf7688f46eb'),(2788,180,'s2-list_0_icon','61'),(2789,180,'_s2-list_0_icon','field_60bf76ecf46ef'),(2790,180,'s2-list_0_icon-hover','62'),(2791,180,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(2792,180,'s2-list_0_text','Лихоманка'),(2793,180,'_s2-list_0_text','field_60bf7712f46f1'),(2794,180,'s2-list_1_icon','63'),(2795,180,'_s2-list_1_icon','field_60bf76ecf46ef'),(2796,180,'s2-list_1_icon-hover','64'),(2797,180,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(2798,180,'s2-list_1_text','Похмільний синдром'),(2799,180,'_s2-list_1_text','field_60bf7712f46f1'),(2800,180,'s2-list_2_icon','65'),(2801,180,'_s2-list_2_icon','field_60bf76ecf46ef'),(2802,180,'s2-list_2_icon-hover','66'),(2803,180,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(2804,180,'s2-list_2_text','Діарея'),(2805,180,'_s2-list_2_text','field_60bf7712f46f1'),(2806,180,'s2-list_3_icon','67'),(2807,180,'_s2-list_3_icon','field_60bf76ecf46ef'),(2808,180,'s2-list_3_icon-hover','68'),(2809,180,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(2810,180,'s2-list_3_text','Блювота'),(2811,180,'_s2-list_3_text','field_60bf7712f46f1'),(2812,180,'s2-list_4_icon','69'),(2813,180,'_s2-list_4_icon','field_60bf76ecf46ef'),(2814,180,'s2-list_4_icon-hover','70'),(2815,180,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(2816,180,'s2-list_4_text','Інтенсивні фізичні навантаження'),(2817,180,'_s2-list_4_text','field_60bf7712f46f1'),(2818,180,'s2-list_5_icon','71'),(2819,180,'_s2-list_5_icon','field_60bf76ecf46ef'),(2820,180,'s2-list_5_icon-hover','72'),(2821,180,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(2822,180,'s2-list_5_text','Перегрівання в спекотну погоду'),(2823,180,'_s2-list_5_text','field_60bf7712f46f1'),(2824,180,'s1-slogan','Коли звичайної води замало!'),(2825,180,'_s1-slogan','field_60bf7ab4d9ba9'),(2826,180,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(2827,180,'_s3-text','field_60bf7bb5a7e2b'),(2828,180,'s4-ttl','РеО – вода для медичних цілей'),(2829,180,'_s4-ttl','field_60bf7c831f58c'),(2830,180,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(2831,180,'_s4-notes','field_60bf7ca31f58d'),(2832,180,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(2833,180,'_s5-video','field_60bf7ccfa01a5'),(2834,180,'s6-ttl','Коли звичайної води замало!'),(2835,180,'_s6-ttl','field_60bf7cfb10d31'),(2836,180,'s6-list','6'),(2837,180,'_s6-list','field_60bf7d0410d32'),(2838,180,'s6-list_0_icon','92'),(2839,180,'_s6-list_0_icon','field_60bf7d1810d33'),(2840,180,'s6-list_0_text','При підвищеній температурі'),(2841,180,'_s6-list_0_text','field_60bf7d2710d34'),(2842,180,'s6-list_1_icon','93'),(2843,180,'_s6-list_1_icon','field_60bf7d1810d33'),(2844,180,'s6-list_1_text','При харчових отруєннях'),(2845,180,'_s6-list_1_text','field_60bf7d2710d34'),(2846,180,'s6-list_2_icon','94'),(2847,180,'_s6-list_2_icon','field_60bf7d1810d33'),(2848,180,'s6-list_2_text','При кишкових інфекціях'),(2849,180,'_s6-list_2_text','field_60bf7d2710d34'),(2850,180,'s6-list_3_icon','95'),(2851,180,'_s6-list_3_icon','field_60bf7d1810d33'),(2852,180,'s6-list_3_text','Під час вагітності'),(2853,180,'_s6-list_3_text','field_60bf7d2710d34'),(2854,180,'s6-list_4_icon','96'),(2855,180,'_s6-list_4_icon','field_60bf7d1810d33'),(2856,180,'s6-list_4_text','Під час заняття спортом'),(2857,180,'_s6-list_4_text','field_60bf7d2710d34'),(2858,180,'s6-list_5_icon','97'),(2859,180,'_s6-list_5_icon','field_60bf7d1810d33'),(2860,180,'s6-list_5_text','При похмільному синдромі'),(2861,180,'_s6-list_5_text','field_60bf7d2710d34'),(2862,180,'s4-list_0_ttl','Натрій'),(2863,180,'_s4-list_0_ttl','field_60bf7fa95a92c'),(2864,180,'s4-list_0_formula','Na<sup>+</sup>'),(2865,180,'_s4-list_0_formula','field_60bf7fc65a92d'),(2866,180,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(2867,180,'_s4-list_0_text','field_60bf7fd35a92e'),(2868,180,'s4-list_1_ttl','Вода'),(2869,180,'_s4-list_1_ttl','field_60bf7fa95a92c'),(2870,180,'s4-list_1_formula','H<sub>2</sub>O'),(2871,180,'_s4-list_1_formula','field_60bf7fc65a92d'),(2872,180,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(2873,180,'_s4-list_1_text','field_60bf7fd35a92e'),(2874,180,'s4-list','9'),(2875,180,'_s4-list','field_60bf7f985a92b'),(2876,180,'s4-list_2_ttl','Калій'),(2877,180,'_s4-list_2_ttl','field_60bf7fa95a92c'),(2878,180,'s4-list_2_formula','K<sup>+</sup>'),(2879,180,'_s4-list_2_formula','field_60bf7fc65a92d'),(2880,180,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(2881,180,'_s4-list_2_text','field_60bf7fd35a92e'),(2882,180,'s4-list_3_ttl','Гідрокарбонати'),(2883,180,'_s4-list_3_ttl','field_60bf7fa95a92c'),(2884,180,'s4-list_3_formula','HCO<sup>3+</sup>'),(2885,180,'_s4-list_3_formula','field_60bf7fc65a92d'),(2886,180,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(2887,180,'_s4-list_3_text','field_60bf7fd35a92e'),(2888,180,'s4-list_4_ttl','Магній'),(2889,180,'_s4-list_4_ttl','field_60bf7fa95a92c'),(2890,180,'s4-list_4_formula','Mg<sup>2+</sup>'),(2891,180,'_s4-list_4_formula','field_60bf7fc65a92d'),(2892,180,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(2893,180,'_s4-list_4_text','field_60bf7fd35a92e'),(2894,180,'s4-list_5_ttl','Вуглекислий газ'),(2895,180,'_s4-list_5_ttl','field_60bf7fa95a92c'),(2896,180,'s4-list_5_formula','CO<sup>2</sup>+'),(2897,180,'_s4-list_5_formula','field_60bf7fc65a92d'),(2898,180,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(2899,180,'_s4-list_5_text','field_60bf7fd35a92e'),(2900,180,'s4-list_6_ttl','Кальцій'),(2901,180,'_s4-list_6_ttl','field_60bf7fa95a92c'),(2902,180,'s4-list_6_formula','Ca<sup>2+</sup>'),(2903,180,'_s4-list_6_formula','field_60bf7fc65a92d'),(2904,180,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(2905,180,'_s4-list_6_text','field_60bf7fd35a92e'),(2906,180,'s4-list_7_ttl','Сорбіт'),(2907,180,'_s4-list_7_ttl','field_60bf7fa95a92c'),(2908,180,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(2909,180,'_s4-list_7_formula','field_60bf7fc65a92d'),(2910,180,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(2911,180,'_s4-list_7_text','field_60bf7fd35a92e'),(2912,180,'s4-list_8_ttl','Хлор'),(2913,180,'_s4-list_8_ttl','field_60bf7fa95a92c'),(2914,180,'s4-list_8_formula','Cl'),(2915,180,'_s4-list_8_formula','field_60bf7fc65a92d'),(2916,180,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(2917,180,'_s4-list_8_text','field_60bf7fd35a92e'),(2918,180,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(2919,180,'_s4-feature1','field_60bf80ca480ea'),(2920,180,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(2921,180,'_s4-feature2','field_60bf80de480eb'),(2922,180,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(2923,180,'_s4-feature3','field_60bf80e2480ec'),(2924,180,'s4-feature4','Приємна на смак та легко п’єтьсянавіть при відчутті нудоти<sup>1,3</sup>'),(2925,180,'_s4-feature4','field_60bf80e5480ed'),(2926,178,'_edit_last','1'),(2927,182,'_menu_item_type','post_type'),(2928,182,'_menu_item_menu_item_parent','0'),(2929,182,'_menu_item_object_id','177'),(2930,182,'_menu_item_object','page'),(2931,182,'_menu_item_target',''),(2932,182,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2933,182,'_menu_item_xfn',''),(2934,182,'_menu_item_url',''),(2935,183,'_menu_item_type','custom'),(2936,183,'_menu_item_menu_item_parent','0'),(2937,183,'_menu_item_object_id','183'),(2938,183,'_menu_item_object','custom'),(2939,183,'_menu_item_target',''),(2940,183,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2941,183,'_menu_item_xfn',''),(2942,183,'_menu_item_url','#'),(2943,184,'_menu_item_type','custom'),(2944,184,'_menu_item_menu_item_parent','0'),(2945,184,'_menu_item_object_id','184'),(2946,184,'_menu_item_object','custom'),(2947,184,'_menu_item_target',''),(2948,184,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2949,184,'_menu_item_xfn',''),(2950,184,'_menu_item_url','#'),(2951,185,'_menu_item_type','post_type'),(2952,185,'_menu_item_menu_item_parent','0'),(2953,185,'_menu_item_object_id','178'),(2954,185,'_menu_item_object','page'),(2955,185,'_menu_item_target',''),(2956,185,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2957,185,'_menu_item_xfn',''),(2958,185,'_menu_item_url',''),(2959,186,'_menu_item_type','custom'),(2960,186,'_menu_item_menu_item_parent','0'),(2961,186,'_menu_item_object_id','186'),(2962,186,'_menu_item_object','custom'),(2963,186,'_menu_item_target',''),(2964,186,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2965,186,'_menu_item_xfn',''),(2966,186,'_menu_item_url','#'),(2967,187,'_menu_item_type','custom'),(2968,187,'_menu_item_menu_item_parent','0'),(2969,187,'_menu_item_object_id','187'),(2970,187,'_menu_item_object','custom'),(2971,187,'_menu_item_target',''),(2972,187,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2973,187,'_menu_item_xfn',''),(2974,187,'_menu_item_url','#'),(2975,188,'_menu_item_type','custom'),(2976,188,'_menu_item_menu_item_parent','0'),(2977,188,'_menu_item_object_id','188'),(2978,188,'_menu_item_object','custom'),(2979,188,'_menu_item_target',''),(2980,188,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2981,188,'_menu_item_xfn',''),(2982,188,'_menu_item_url','#'),(2983,189,'_menu_item_type','custom'),(2984,189,'_menu_item_menu_item_parent','188'),(2985,189,'_menu_item_object_id','189'),(2986,189,'_menu_item_object','custom'),(2987,189,'_menu_item_target',''),(2988,189,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2989,189,'_menu_item_xfn',''),(2990,189,'_menu_item_url','#'),(2991,190,'_menu_item_type','custom'),(2992,190,'_menu_item_menu_item_parent','188'),(2993,190,'_menu_item_object_id','190'),(2994,190,'_menu_item_object','custom'),(2995,190,'_menu_item_target',''),(2996,190,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(2997,190,'_menu_item_xfn',''),(2998,190,'_menu_item_url','#'),(2999,191,'_menu_item_type','custom'),(3000,191,'_menu_item_menu_item_parent','188'),(3001,191,'_menu_item_object_id','191'),(3002,191,'_menu_item_object','custom'),(3003,191,'_menu_item_target',''),(3004,191,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3005,191,'_menu_item_xfn',''),(3006,191,'_menu_item_url','#'),(3007,192,'_menu_item_type','custom'),(3008,192,'_menu_item_menu_item_parent','188'),(3009,192,'_menu_item_object_id','192'),(3010,192,'_menu_item_object','custom'),(3011,192,'_menu_item_target',''),(3012,192,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3013,192,'_menu_item_xfn',''),(3014,192,'_menu_item_url','#'),(3015,193,'_menu_item_type','custom'),(3016,193,'_menu_item_menu_item_parent','188'),(3017,193,'_menu_item_object_id','193'),(3018,193,'_menu_item_object','custom'),(3019,193,'_menu_item_target',''),(3020,193,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3021,193,'_menu_item_xfn',''),(3022,193,'_menu_item_url','#'),(3023,194,'_menu_item_type','custom'),(3024,194,'_menu_item_menu_item_parent','188'),(3025,194,'_menu_item_object_id','194'),(3026,194,'_menu_item_object','custom'),(3027,194,'_menu_item_target',''),(3028,194,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3029,194,'_menu_item_xfn',''),(3030,194,'_menu_item_url','#'),(3031,195,'_menu_item_type','custom'),(3032,195,'_menu_item_menu_item_parent','0'),(3033,195,'_menu_item_object_id','195'),(3034,195,'_menu_item_object','custom'),(3035,195,'_menu_item_target',''),(3036,195,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3037,195,'_menu_item_xfn',''),(3038,195,'_menu_item_url','#'),(3039,196,'_menu_item_type','custom'),(3040,196,'_menu_item_menu_item_parent','195'),(3041,196,'_menu_item_object_id','196'),(3042,196,'_menu_item_object','custom'),(3043,196,'_menu_item_target',''),(3044,196,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(3045,196,'_menu_item_xfn',''),(3046,196,'_menu_item_url','#'),(3047,197,'_menu_item_type','custom'),(3048,197,'_menu_item_menu_item_parent','195'),(3049,197,'_menu_item_object_id','197'),(3050,197,'_menu_item_object','custom'),(3051,197,'_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состояния организма, которые приводят к нарушению водно-солевого баланса:'),(3114,205,'_s2-ttl','field_60bf76d1f46ed'),(3115,205,'slider','8'),(3116,205,'_slider','field_60bf767ef46ea'),(3117,205,'slider_0_slide','50'),(3118,205,'_slider_0_slide','field_60bf7688f46eb'),(3119,205,'slider_1_slide','51'),(3120,205,'_slider_1_slide','field_60bf7688f46eb'),(3121,205,'slider_2_slide','52'),(3122,205,'_slider_2_slide','field_60bf7688f46eb'),(3123,205,'slider_3_slide','53'),(3124,205,'_slider_3_slide','field_60bf7688f46eb'),(3125,205,'slider_4_slide','54'),(3126,205,'_slider_4_slide','field_60bf7688f46eb'),(3127,205,'slider_5_slide','55'),(3128,205,'_slider_5_slide','field_60bf7688f46eb'),(3129,205,'slider_6_slide','56'),(3130,205,'_slider_6_slide','field_60bf7688f46eb'),(3131,205,'slider_7_slide','57'),(3132,205,'_slider_7_slide','field_60bf7688f46eb'),(3133,205,'s2-list_0_icon','61'),(3134,205,'_s2-list_0_icon','field_60bf76ecf46ef'),(3135,205,'s2-list_0_icon-hover','62'),(3136,205,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(3137,205,'s2-list_0_text','Лихорадка'),(3138,205,'_s2-list_0_text','field_60bf7712f46f1'),(3139,205,'s2-list_1_icon','63'),(3140,205,'_s2-list_1_icon','field_60bf76ecf46ef'),(3141,205,'s2-list_1_icon-hover','64'),(3142,205,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(3143,205,'s2-list_1_text','Похмельный синдром'),(3144,205,'_s2-list_1_text','field_60bf7712f46f1'),(3145,205,'s2-list_2_icon','65'),(3146,205,'_s2-list_2_icon','field_60bf76ecf46ef'),(3147,205,'s2-list_2_icon-hover','66'),(3148,205,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(3149,205,'s2-list_2_text','Диарея'),(3150,205,'_s2-list_2_text','field_60bf7712f46f1'),(3151,205,'s2-list_3_icon','67'),(3152,205,'_s2-list_3_icon','field_60bf76ecf46ef'),(3153,205,'s2-list_3_icon-hover','68'),(3154,205,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(3155,205,'s2-list_3_text','Рвота'),(3156,205,'_s2-list_3_text','field_60bf7712f46f1'),(3157,205,'s2-list_4_icon','69'),(3158,205,'_s2-list_4_icon','field_60bf76ecf46ef'),(3159,205,'s2-list_4_icon-hover','70'),(3160,205,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(3161,205,'s2-list_4_text','Интенсивные физические нагрузки'),(3162,205,'_s2-list_4_text','field_60bf7712f46f1'),(3163,205,'s2-list_5_icon','71'),(3164,205,'_s2-list_5_icon','field_60bf76ecf46ef'),(3165,205,'s2-list_5_icon-hover','72'),(3166,205,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(3167,205,'s2-list_5_text','Перегрев в жаркую погоду'),(3168,205,'_s2-list_5_text','field_60bf7712f46f1'),(3169,205,'s1-slogan','Когда обычной воды недостаточно!'),(3170,205,'_s1-slogan','field_60bf7ab4d9ba9'),(3171,205,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(3172,205,'_s3-text','field_60bf7bb5a7e2b'),(3173,205,'s4-ttl','РеО – вода для медицинских целей!'),(3174,205,'_s4-ttl','field_60bf7c831f58c'),(3175,205,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(3176,205,'_s4-notes','field_60bf7ca31f58d'),(3177,205,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(3178,205,'_s5-video','field_60bf7ccfa01a5'),(3179,205,'s6-ttl','Когда обычной воды недостаточно!'),(3180,205,'_s6-ttl','field_60bf7cfb10d31'),(3181,205,'s6-list','6'),(3182,205,'_s6-list','field_60bf7d0410d32'),(3183,205,'s6-list_0_icon','92'),(3184,205,'_s6-list_0_icon','field_60bf7d1810d33'),(3185,205,'s6-list_0_text','При повышенной температуре'),(3186,205,'_s6-list_0_text','field_60bf7d2710d34'),(3187,205,'s6-list_1_icon','93'),(3188,205,'_s6-list_1_icon','field_60bf7d1810d33'),(3189,205,'s6-list_1_text','При пищевых отравлениях'),(3190,205,'_s6-list_1_text','field_60bf7d2710d34'),(3191,205,'s6-list_2_icon','94'),(3192,205,'_s6-list_2_icon','field_60bf7d1810d33'),(3193,205,'s6-list_2_text','При кишечных инфекциях'),(3194,205,'_s6-list_2_text','field_60bf7d2710d34'),(3195,205,'s6-list_3_icon','95'),(3196,205,'_s6-list_3_icon','field_60bf7d1810d33'),(3197,205,'s6-list_3_text','Во время беременности'),(3198,205,'_s6-list_3_text','field_60bf7d2710d34'),(3199,205,'s6-list_4_icon','96'),(3200,205,'_s6-list_4_icon','field_60bf7d1810d33'),(3201,205,'s6-list_4_text','Во время занятий спортом'),(3202,205,'_s6-list_4_text','field_60bf7d2710d34'),(3203,205,'s6-list_5_icon','97'),(3204,205,'_s6-list_5_icon','field_60bf7d1810d33'),(3205,205,'s6-list_5_text','При похмельном синдроме'),(3206,205,'_s6-list_5_text','field_60bf7d2710d34'),(3207,205,'s4-list_0_ttl','Натрій'),(3208,205,'_s4-list_0_ttl','field_60bf7fa95a92c'),(3209,205,'s4-list_0_formula','Na<sup>+</sup>'),(3210,205,'_s4-list_0_formula','field_60bf7fc65a92d'),(3211,205,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(3212,205,'_s4-list_0_text','field_60bf7fd35a92e'),(3213,205,'s4-list_1_ttl','Вода'),(3214,205,'_s4-list_1_ttl','field_60bf7fa95a92c'),(3215,205,'s4-list_1_formula','H<sub>2</sub>O'),(3216,205,'_s4-list_1_formula','field_60bf7fc65a92d'),(3217,205,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(3218,205,'_s4-list_1_text','field_60bf7fd35a92e'),(3219,205,'s4-list','9'),(3220,205,'_s4-list','field_60bf7f985a92b'),(3221,205,'s4-list_2_ttl','Калій'),(3222,205,'_s4-list_2_ttl','field_60bf7fa95a92c'),(3223,205,'s4-list_2_formula','K<sup>+</sup>'),(3224,205,'_s4-list_2_formula','field_60bf7fc65a92d'),(3225,205,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(3226,205,'_s4-list_2_text','field_60bf7fd35a92e'),(3227,205,'s4-list_3_ttl','Гідрокарбонати'),(3228,205,'_s4-list_3_ttl','field_60bf7fa95a92c'),(3229,205,'s4-list_3_formula','HCO<sup>3+</sup>'),(3230,205,'_s4-list_3_formula','field_60bf7fc65a92d'),(3231,205,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(3232,205,'_s4-list_3_text','field_60bf7fd35a92e'),(3233,205,'s4-list_4_ttl','Магній'),(3234,205,'_s4-list_4_ttl','field_60bf7fa95a92c'),(3235,205,'s4-list_4_formula','Mg<sup>2+</sup>'),(3236,205,'_s4-list_4_formula','field_60bf7fc65a92d'),(3237,205,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(3238,205,'_s4-list_4_text','field_60bf7fd35a92e'),(3239,205,'s4-list_5_ttl','Вуглекислий газ'),(3240,205,'_s4-list_5_ttl','field_60bf7fa95a92c'),(3241,205,'s4-list_5_formula','CO<sup>2</sup>+'),(3242,205,'_s4-list_5_formula','field_60bf7fc65a92d'),(3243,205,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(3244,205,'_s4-list_5_text','field_60bf7fd35a92e'),(3245,205,'s4-list_6_ttl','Кальцій'),(3246,205,'_s4-list_6_ttl','field_60bf7fa95a92c'),(3247,205,'s4-list_6_formula','Ca<sup>2+</sup>'),(3248,205,'_s4-list_6_formula','field_60bf7fc65a92d'),(3249,205,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(3250,205,'_s4-list_6_text','field_60bf7fd35a92e'),(3251,205,'s4-list_7_ttl','Сорбіт'),(3252,205,'_s4-list_7_ttl','field_60bf7fa95a92c'),(3253,205,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(3254,205,'_s4-list_7_formula','field_60bf7fc65a92d'),(3255,205,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(3256,205,'_s4-list_7_text','field_60bf7fd35a92e'),(3257,205,'s4-list_8_ttl','Хлор'),(3258,205,'_s4-list_8_ttl','field_60bf7fa95a92c'),(3259,205,'s4-list_8_formula','Cl'),(3260,205,'_s4-list_8_formula','field_60bf7fc65a92d'),(3261,205,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(3262,205,'_s4-list_8_text','field_60bf7fd35a92e'),(3263,205,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(3264,205,'_s4-feature1','field_60bf80ca480ea'),(3265,205,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(3266,205,'_s4-feature2','field_60bf80de480eb'),(3267,205,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(3268,205,'_s4-feature3','field_60bf80e2480ec'),(3269,205,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(3270,205,'_s4-feature4','field_60bf80e5480ed'),(3271,206,'s2-list','6'),(3272,206,'_s2-list','field_60bf76e0f46ee'),(3273,206,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(3274,206,'_s2-ttl','field_60bf76d1f46ed'),(3275,206,'slider','8'),(3276,206,'_slider','field_60bf767ef46ea'),(3277,206,'slider_0_slide','50'),(3278,206,'_slider_0_slide','field_60bf7688f46eb'),(3279,206,'slider_1_slide','51'),(3280,206,'_slider_1_slide','field_60bf7688f46eb'),(3281,206,'slider_2_slide','52'),(3282,206,'_slider_2_slide','field_60bf7688f46eb'),(3283,206,'slider_3_slide','53'),(3284,206,'_slider_3_slide','field_60bf7688f46eb'),(3285,206,'slider_4_slide','54'),(3286,206,'_slider_4_slide','field_60bf7688f46eb'),(3287,206,'slider_5_slide','55'),(3288,206,'_slider_5_slide','field_60bf7688f46eb'),(3289,206,'slider_6_slide','56'),(3290,206,'_slider_6_slide','field_60bf7688f46eb'),(3291,206,'slider_7_slide','57'),(3292,206,'_slider_7_slide','field_60bf7688f46eb'),(3293,206,'s2-list_0_icon','61'),(3294,206,'_s2-list_0_icon','field_60bf76ecf46ef'),(3295,206,'s2-list_0_icon-hover','62'),(3296,206,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(3297,206,'s2-list_0_text','Лихорадка'),(3298,206,'_s2-list_0_text','field_60bf7712f46f1'),(3299,206,'s2-list_1_icon','63'),(3300,206,'_s2-list_1_icon','field_60bf76ecf46ef'),(3301,206,'s2-list_1_icon-hover','64'),(3302,206,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(3303,206,'s2-list_1_text','Похмельный синдром'),(3304,206,'_s2-list_1_text','field_60bf7712f46f1'),(3305,206,'s2-list_2_icon','65'),(3306,206,'_s2-list_2_icon','field_60bf76ecf46ef'),(3307,206,'s2-list_2_icon-hover','66'),(3308,206,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(3309,206,'s2-list_2_text','Диарея'),(3310,206,'_s2-list_2_text','field_60bf7712f46f1'),(3311,206,'s2-list_3_icon','67'),(3312,206,'_s2-list_3_icon','field_60bf76ecf46ef'),(3313,206,'s2-list_3_icon-hover','68'),(3314,206,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(3315,206,'s2-list_3_text','Рвота'),(3316,206,'_s2-list_3_text','field_60bf7712f46f1'),(3317,206,'s2-list_4_icon','69'),(3318,206,'_s2-list_4_icon','field_60bf76ecf46ef'),(3319,206,'s2-list_4_icon-hover','70'),(3320,206,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(3321,206,'s2-list_4_text','Интенсивные физические нагрузки'),(3322,206,'_s2-list_4_text','field_60bf7712f46f1'),(3323,206,'s2-list_5_icon','71'),(3324,206,'_s2-list_5_icon','field_60bf76ecf46ef'),(3325,206,'s2-list_5_icon-hover','72'),(3326,206,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(3327,206,'s2-list_5_text','Перегрев в жаркую погоду'),(3328,206,'_s2-list_5_text','field_60bf7712f46f1'),(3329,206,'s1-slogan','Когда обычной воды недостаточно!'),(3330,206,'_s1-slogan','field_60bf7ab4d9ba9'),(3331,206,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(3332,206,'_s3-text','field_60bf7bb5a7e2b'),(3333,206,'s4-ttl','РеО – вода для медицинских целей!'),(3334,206,'_s4-ttl','field_60bf7c831f58c'),(3335,206,'s4-notes','<ol>\r\n <li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навігатор Фармації 2021.</li>\r\n <li>Цюпа І. Зневоднення у дітей: як запобігті, а не боротися з наслідкамі? «Здоров\'я України» No3 2020.</li>\r\n <li>Ешімбетова Г. З. \"Нудота і блювання вагітних. Тактика ведення на основі патогенезу\". Матеріали доповідей IV МІЖНАРОДНОГО конгрес з інфузійної терапії. Київ 2020р.</li>\r\n <li>Мається на увазі, что до складу води Рео входять електроліти (натрій, калій, хлор, магній, кальцій), Які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншімі електролітамі.</li>\r\n</ol>'),(3336,206,'_s4-notes','field_60bf7ca31f58d'),(3337,206,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(3338,206,'_s5-video','field_60bf7ccfa01a5'),(3339,206,'s6-ttl','Когда обычной воды недостаточно!'),(3340,206,'_s6-ttl','field_60bf7cfb10d31'),(3341,206,'s6-list','6'),(3342,206,'_s6-list','field_60bf7d0410d32'),(3343,206,'s6-list_0_icon','92'),(3344,206,'_s6-list_0_icon','field_60bf7d1810d33'),(3345,206,'s6-list_0_text','При повышенной температуре'),(3346,206,'_s6-list_0_text','field_60bf7d2710d34'),(3347,206,'s6-list_1_icon','93'),(3348,206,'_s6-list_1_icon','field_60bf7d1810d33'),(3349,206,'s6-list_1_text','При пищевых отравлениях'),(3350,206,'_s6-list_1_text','field_60bf7d2710d34'),(3351,206,'s6-list_2_icon','94'),(3352,206,'_s6-list_2_icon','field_60bf7d1810d33'),(3353,206,'s6-list_2_text','При кишечных инфекциях'),(3354,206,'_s6-list_2_text','field_60bf7d2710d34'),(3355,206,'s6-list_3_icon','95'),(3356,206,'_s6-list_3_icon','field_60bf7d1810d33'),(3357,206,'s6-list_3_text','Во время беременности'),(3358,206,'_s6-list_3_text','field_60bf7d2710d34'),(3359,206,'s6-list_4_icon','96'),(3360,206,'_s6-list_4_icon','field_60bf7d1810d33'),(3361,206,'s6-list_4_text','Во время занятий спортом'),(3362,206,'_s6-list_4_text','field_60bf7d2710d34'),(3363,206,'s6-list_5_icon','97'),(3364,206,'_s6-list_5_icon','field_60bf7d1810d33'),(3365,206,'s6-list_5_text','При похмельном синдроме'),(3366,206,'_s6-list_5_text','field_60bf7d2710d34'),(3367,206,'s4-list_0_ttl','Натрій'),(3368,206,'_s4-list_0_ttl','field_60bf7fa95a92c'),(3369,206,'s4-list_0_formula','Na<sup>+</sup>'),(3370,206,'_s4-list_0_formula','field_60bf7fc65a92d'),(3371,206,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(3372,206,'_s4-list_0_text','field_60bf7fd35a92e'),(3373,206,'s4-list_1_ttl','Вода'),(3374,206,'_s4-list_1_ttl','field_60bf7fa95a92c'),(3375,206,'s4-list_1_formula','H<sub>2</sub>O'),(3376,206,'_s4-list_1_formula','field_60bf7fc65a92d'),(3377,206,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(3378,206,'_s4-list_1_text','field_60bf7fd35a92e'),(3379,206,'s4-list','9'),(3380,206,'_s4-list','field_60bf7f985a92b'),(3381,206,'s4-list_2_ttl','Калій'),(3382,206,'_s4-list_2_ttl','field_60bf7fa95a92c'),(3383,206,'s4-list_2_formula','K<sup>+</sup>'),(3384,206,'_s4-list_2_formula','field_60bf7fc65a92d'),(3385,206,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(3386,206,'_s4-list_2_text','field_60bf7fd35a92e'),(3387,206,'s4-list_3_ttl','Гідрокарбонати'),(3388,206,'_s4-list_3_ttl','field_60bf7fa95a92c'),(3389,206,'s4-list_3_formula','HCO<sup>3+</sup>'),(3390,206,'_s4-list_3_formula','field_60bf7fc65a92d'),(3391,206,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(3392,206,'_s4-list_3_text','field_60bf7fd35a92e'),(3393,206,'s4-list_4_ttl','Магній'),(3394,206,'_s4-list_4_ttl','field_60bf7fa95a92c'),(3395,206,'s4-list_4_formula','Mg<sup>2+</sup>'),(3396,206,'_s4-list_4_formula','field_60bf7fc65a92d'),(3397,206,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(3398,206,'_s4-list_4_text','field_60bf7fd35a92e'),(3399,206,'s4-list_5_ttl','Вуглекислий газ'),(3400,206,'_s4-list_5_ttl','field_60bf7fa95a92c'),(3401,206,'s4-list_5_formula','CO<sup>2</sup>+'),(3402,206,'_s4-list_5_formula','field_60bf7fc65a92d'),(3403,206,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(3404,206,'_s4-list_5_text','field_60bf7fd35a92e'),(3405,206,'s4-list_6_ttl','Кальцій'),(3406,206,'_s4-list_6_ttl','field_60bf7fa95a92c'),(3407,206,'s4-list_6_formula','Ca<sup>2+</sup>'),(3408,206,'_s4-list_6_formula','field_60bf7fc65a92d'),(3409,206,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(3410,206,'_s4-list_6_text','field_60bf7fd35a92e'),(3411,206,'s4-list_7_ttl','Сорбіт'),(3412,206,'_s4-list_7_ttl','field_60bf7fa95a92c'),(3413,206,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(3414,206,'_s4-list_7_formula','field_60bf7fc65a92d'),(3415,206,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(3416,206,'_s4-list_7_text','field_60bf7fd35a92e'),(3417,206,'s4-list_8_ttl','Хлор'),(3418,206,'_s4-list_8_ttl','field_60bf7fa95a92c'),(3419,206,'s4-list_8_formula','Cl'),(3420,206,'_s4-list_8_formula','field_60bf7fc65a92d'),(3421,206,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(3422,206,'_s4-list_8_text','field_60bf7fd35a92e'),(3423,206,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(3424,206,'_s4-feature1','field_60bf80ca480ea'),(3425,206,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(3426,206,'_s4-feature2','field_60bf80de480eb'),(3427,206,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(3428,206,'_s4-feature3','field_60bf80e2480ec'),(3429,206,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(3430,206,'_s4-feature4','field_60bf80e5480ed'),(3431,207,'s2-list','6'),(3432,207,'_s2-list','field_60bf76e0f46ee'),(3433,207,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(3434,207,'_s2-ttl','field_60bf76d1f46ed'),(3435,207,'slider','8'),(3436,207,'_slider','field_60bf767ef46ea'),(3437,207,'slider_0_slide','50'),(3438,207,'_slider_0_slide','field_60bf7688f46eb'),(3439,207,'slider_1_slide','51'),(3440,207,'_slider_1_slide','field_60bf7688f46eb'),(3441,207,'slider_2_slide','52'),(3442,207,'_slider_2_slide','field_60bf7688f46eb'),(3443,207,'slider_3_slide','53'),(3444,207,'_slider_3_slide','field_60bf7688f46eb'),(3445,207,'slider_4_slide','54'),(3446,207,'_slider_4_slide','field_60bf7688f46eb'),(3447,207,'slider_5_slide','55'),(3448,207,'_slider_5_slide','field_60bf7688f46eb'),(3449,207,'slider_6_slide','56'),(3450,207,'_slider_6_slide','field_60bf7688f46eb'),(3451,207,'slider_7_slide','57'),(3452,207,'_slider_7_slide','field_60bf7688f46eb'),(3453,207,'s2-list_0_icon','61'),(3454,207,'_s2-list_0_icon','field_60bf76ecf46ef'),(3455,207,'s2-list_0_icon-hover','62'),(3456,207,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(3457,207,'s2-list_0_text','Лихорадка'),(3458,207,'_s2-list_0_text','field_60bf7712f46f1'),(3459,207,'s2-list_1_icon','63'),(3460,207,'_s2-list_1_icon','field_60bf76ecf46ef'),(3461,207,'s2-list_1_icon-hover','64'),(3462,207,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(3463,207,'s2-list_1_text','Похмельный синдром'),(3464,207,'_s2-list_1_text','field_60bf7712f46f1'),(3465,207,'s2-list_2_icon','65'),(3466,207,'_s2-list_2_icon','field_60bf76ecf46ef'),(3467,207,'s2-list_2_icon-hover','66'),(3468,207,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(3469,207,'s2-list_2_text','Диарея'),(3470,207,'_s2-list_2_text','field_60bf7712f46f1'),(3471,207,'s2-list_3_icon','67'),(3472,207,'_s2-list_3_icon','field_60bf76ecf46ef'),(3473,207,'s2-list_3_icon-hover','68'),(3474,207,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(3475,207,'s2-list_3_text','Рвота'),(3476,207,'_s2-list_3_text','field_60bf7712f46f1'),(3477,207,'s2-list_4_icon','69'),(3478,207,'_s2-list_4_icon','field_60bf76ecf46ef'),(3479,207,'s2-list_4_icon-hover','70'),(3480,207,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(3481,207,'s2-list_4_text','Интенсивные физические нагрузки'),(3482,207,'_s2-list_4_text','field_60bf7712f46f1'),(3483,207,'s2-list_5_icon','71'),(3484,207,'_s2-list_5_icon','field_60bf76ecf46ef'),(3485,207,'s2-list_5_icon-hover','72'),(3486,207,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(3487,207,'s2-list_5_text','Перегрев в жаркую погоду'),(3488,207,'_s2-list_5_text','field_60bf7712f46f1'),(3489,207,'s1-slogan','Когда обычной воды недостаточно!'),(3490,207,'_s1-slogan','field_60bf7ab4d9ba9'),(3491,207,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(3492,207,'_s3-text','field_60bf7bb5a7e2b'),(3493,207,'s4-ttl','РеО – вода для медицинских целей!'),(3494,207,'_s4-ttl','field_60bf7c831f58c'),(3495,207,'s4-notes','<ol>\r\n <li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навігатор Фармації 2021.</li>\r\n <li>Цюпа І. Зневоднення у дітей: як запобігті, а не боротися з наслідкамі? «Здоров\'я України» No3 2020.</li>\r\n <li>Ешімбетова Г. З. \"Нудота і блювання вагітних. Тактика ведення на основі патогенезу\". Матеріали доповідей IV МІЖНАРОДНОГО конгрес з інфузійної терапії. Київ 2020р.</li>\r\n <li>Мається на увазі, что до складу води Рео входять електроліти (натрій, калій, хлор, магній, кальцій), Які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншімі електролітамі.</li>\r\n</ol>'),(3496,207,'_s4-notes','field_60bf7ca31f58d'),(3497,207,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(3498,207,'_s5-video','field_60bf7ccfa01a5'),(3499,207,'s6-ttl','Когда обычной воды недостаточно!'),(3500,207,'_s6-ttl','field_60bf7cfb10d31'),(3501,207,'s6-list','6'),(3502,207,'_s6-list','field_60bf7d0410d32'),(3503,207,'s6-list_0_icon','92'),(3504,207,'_s6-list_0_icon','field_60bf7d1810d33'),(3505,207,'s6-list_0_text','При повышенной температуре'),(3506,207,'_s6-list_0_text','field_60bf7d2710d34'),(3507,207,'s6-list_1_icon','93'),(3508,207,'_s6-list_1_icon','field_60bf7d1810d33'),(3509,207,'s6-list_1_text','При пищевых отравлениях'),(3510,207,'_s6-list_1_text','field_60bf7d2710d34'),(3511,207,'s6-list_2_icon','94'),(3512,207,'_s6-list_2_icon','field_60bf7d1810d33'),(3513,207,'s6-list_2_text','При кишечных инфекциях'),(3514,207,'_s6-list_2_text','field_60bf7d2710d34'),(3515,207,'s6-list_3_icon','95'),(3516,207,'_s6-list_3_icon','field_60bf7d1810d33'),(3517,207,'s6-list_3_text','Во время беременности'),(3518,207,'_s6-list_3_text','field_60bf7d2710d34'),(3519,207,'s6-list_4_icon','96'),(3520,207,'_s6-list_4_icon','field_60bf7d1810d33'),(3521,207,'s6-list_4_text','Во время занятий спортом'),(3522,207,'_s6-list_4_text','field_60bf7d2710d34'),(3523,207,'s6-list_5_icon','97'),(3524,207,'_s6-list_5_icon','field_60bf7d1810d33'),(3525,207,'s6-list_5_text','При похмельном синдроме'),(3526,207,'_s6-list_5_text','field_60bf7d2710d34'),(3527,207,'s4-list_0_ttl','Натрий'),(3528,207,'_s4-list_0_ttl','field_60bf7fa95a92c'),(3529,207,'s4-list_0_formula','Na<sup>+</sup>'),(3530,207,'_s4-list_0_formula','field_60bf7fc65a92d'),(3531,207,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(3532,207,'_s4-list_0_text','field_60bf7fd35a92e'),(3533,207,'s4-list_1_ttl','Вода'),(3534,207,'_s4-list_1_ttl','field_60bf7fa95a92c'),(3535,207,'s4-list_1_formula','H<sub>2</sub>O'),(3536,207,'_s4-list_1_formula','field_60bf7fc65a92d'),(3537,207,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(3538,207,'_s4-list_1_text','field_60bf7fd35a92e'),(3539,207,'s4-list','9'),(3540,207,'_s4-list','field_60bf7f985a92b'),(3541,207,'s4-list_2_ttl','Калий'),(3542,207,'_s4-list_2_ttl','field_60bf7fa95a92c'),(3543,207,'s4-list_2_formula','K<sup>+</sup>'),(3544,207,'_s4-list_2_formula','field_60bf7fc65a92d'),(3545,207,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость, поставляя мозг кислородом. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(3546,207,'_s4-list_2_text','field_60bf7fd35a92e'),(3547,207,'s4-list_3_ttl','Гидрокарбонаты'),(3548,207,'_s4-list_3_ttl','field_60bf7fa95a92c'),(3549,207,'s4-list_3_formula','HCO<sup>3+</sup>'),(3550,207,'_s4-list_3_formula','field_60bf7fc65a92d'),(3551,207,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(3552,207,'_s4-list_3_text','field_60bf7fd35a92e'),(3553,207,'s4-list_4_ttl','Магний'),(3554,207,'_s4-list_4_ttl','field_60bf7fa95a92c'),(3555,207,'s4-list_4_formula','Mg<sup>2+</sup>'),(3556,207,'_s4-list_4_formula','field_60bf7fc65a92d'),(3557,207,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(3558,207,'_s4-list_4_text','field_60bf7fd35a92e'),(3559,207,'s4-list_5_ttl','Углекислый газ'),(3560,207,'_s4-list_5_ttl','field_60bf7fa95a92c'),(3561,207,'s4-list_5_formula','CO<sup>2</sup>+'),(3562,207,'_s4-list_5_formula','field_60bf7fc65a92d'),(3563,207,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(3564,207,'_s4-list_5_text','field_60bf7fd35a92e'),(3565,207,'s4-list_6_ttl','Кальций'),(3566,207,'_s4-list_6_ttl','field_60bf7fa95a92c'),(3567,207,'s4-list_6_formula','Ca<sup>2+</sup>'),(3568,207,'_s4-list_6_formula','field_60bf7fc65a92d'),(3569,207,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительных тканей, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(3570,207,'_s4-list_6_text','field_60bf7fd35a92e'),(3571,207,'s4-list_7_ttl','Сорбит'),(3572,207,'_s4-list_7_ttl','field_60bf7fa95a92c'),(3573,207,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(3574,207,'_s4-list_7_formula','field_60bf7fc65a92d'),(3575,207,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(3576,207,'_s4-list_7_text','field_60bf7fd35a92e'),(3577,207,'s4-list_8_ttl','Хлор'),(3578,207,'_s4-list_8_ttl','field_60bf7fa95a92c'),(3579,207,'s4-list_8_formula','Cl'),(3580,207,'_s4-list_8_formula','field_60bf7fc65a92d'),(3581,207,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(3582,207,'_s4-list_8_text','field_60bf7fd35a92e'),(3583,207,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(3584,207,'_s4-feature1','field_60bf80ca480ea'),(3585,207,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(3586,207,'_s4-feature2','field_60bf80de480eb'),(3587,207,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(3588,207,'_s4-feature3','field_60bf80e2480ec'),(3589,207,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(3590,207,'_s4-feature4','field_60bf80e5480ed'),(3591,208,'s2-list','6'),(3592,208,'_s2-list','field_60bf76e0f46ee'),(3593,208,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(3594,208,'_s2-ttl','field_60bf76d1f46ed'),(3595,208,'slider','8'),(3596,208,'_slider','field_60bf767ef46ea'),(3597,208,'slider_0_slide','50'),(3598,208,'_slider_0_slide','field_60bf7688f46eb'),(3599,208,'slider_1_slide','51'),(3600,208,'_slider_1_slide','field_60bf7688f46eb'),(3601,208,'slider_2_slide','52'),(3602,208,'_slider_2_slide','field_60bf7688f46eb'),(3603,208,'slider_3_slide','53'),(3604,208,'_slider_3_slide','field_60bf7688f46eb'),(3605,208,'slider_4_slide','54'),(3606,208,'_slider_4_slide','field_60bf7688f46eb'),(3607,208,'slider_5_slide','55'),(3608,208,'_slider_5_slide','field_60bf7688f46eb'),(3609,208,'slider_6_slide','56'),(3610,208,'_slider_6_slide','field_60bf7688f46eb'),(3611,208,'slider_7_slide','57'),(3612,208,'_slider_7_slide','field_60bf7688f46eb'),(3613,208,'s2-list_0_icon','61'),(3614,208,'_s2-list_0_icon','field_60bf76ecf46ef'),(3615,208,'s2-list_0_icon-hover','62'),(3616,208,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(3617,208,'s2-list_0_text','Лихорадка'),(3618,208,'_s2-list_0_text','field_60bf7712f46f1'),(3619,208,'s2-list_1_icon','63'),(3620,208,'_s2-list_1_icon','field_60bf76ecf46ef'),(3621,208,'s2-list_1_icon-hover','64'),(3622,208,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(3623,208,'s2-list_1_text','Похмельный синдром'),(3624,208,'_s2-list_1_text','field_60bf7712f46f1'),(3625,208,'s2-list_2_icon','65'),(3626,208,'_s2-list_2_icon','field_60bf76ecf46ef'),(3627,208,'s2-list_2_icon-hover','66'),(3628,208,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(3629,208,'s2-list_2_text','Диарея'),(3630,208,'_s2-list_2_text','field_60bf7712f46f1'),(3631,208,'s2-list_3_icon','67'),(3632,208,'_s2-list_3_icon','field_60bf76ecf46ef'),(3633,208,'s2-list_3_icon-hover','68'),(3634,208,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(3635,208,'s2-list_3_text','Рвота'),(3636,208,'_s2-list_3_text','field_60bf7712f46f1'),(3637,208,'s2-list_4_icon','69'),(3638,208,'_s2-list_4_icon','field_60bf76ecf46ef'),(3639,208,'s2-list_4_icon-hover','70'),(3640,208,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(3641,208,'s2-list_4_text','Интенсивные физические нагрузки'),(3642,208,'_s2-list_4_text','field_60bf7712f46f1'),(3643,208,'s2-list_5_icon','71'),(3644,208,'_s2-list_5_icon','field_60bf76ecf46ef'),(3645,208,'s2-list_5_icon-hover','72'),(3646,208,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(3647,208,'s2-list_5_text','Перегрев в жаркую погоду'),(3648,208,'_s2-list_5_text','field_60bf7712f46f1'),(3649,208,'s1-slogan','Когда обычной воды недостаточно!'),(3650,208,'_s1-slogan','field_60bf7ab4d9ba9'),(3651,208,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(3652,208,'_s3-text','field_60bf7bb5a7e2b'),(3653,208,'s4-ttl','РеО – вода для медицинских целей!'),(3654,208,'_s4-ttl','field_60bf7c831f58c'),(3655,208,'s4-notes','<ol>\r\n <li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021. </li>\r\n <li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n <li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n <li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(3656,208,'_s4-notes','field_60bf7ca31f58d'),(3657,208,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(3658,208,'_s5-video','field_60bf7ccfa01a5'),(3659,208,'s6-ttl','Когда обычной воды недостаточно!'),(3660,208,'_s6-ttl','field_60bf7cfb10d31'),(3661,208,'s6-list','6'),(3662,208,'_s6-list','field_60bf7d0410d32'),(3663,208,'s6-list_0_icon','92'),(3664,208,'_s6-list_0_icon','field_60bf7d1810d33'),(3665,208,'s6-list_0_text','При повышенной температуре'),(3666,208,'_s6-list_0_text','field_60bf7d2710d34'),(3667,208,'s6-list_1_icon','93'),(3668,208,'_s6-list_1_icon','field_60bf7d1810d33'),(3669,208,'s6-list_1_text','При пищевых отравлениях'),(3670,208,'_s6-list_1_text','field_60bf7d2710d34'),(3671,208,'s6-list_2_icon','94'),(3672,208,'_s6-list_2_icon','field_60bf7d1810d33'),(3673,208,'s6-list_2_text','При кишечных инфекциях'),(3674,208,'_s6-list_2_text','field_60bf7d2710d34'),(3675,208,'s6-list_3_icon','95'),(3676,208,'_s6-list_3_icon','field_60bf7d1810d33'),(3677,208,'s6-list_3_text','Во время беременности'),(3678,208,'_s6-list_3_text','field_60bf7d2710d34'),(3679,208,'s6-list_4_icon','96'),(3680,208,'_s6-list_4_icon','field_60bf7d1810d33'),(3681,208,'s6-list_4_text','Во время занятий спортом'),(3682,208,'_s6-list_4_text','field_60bf7d2710d34'),(3683,208,'s6-list_5_icon','97'),(3684,208,'_s6-list_5_icon','field_60bf7d1810d33'),(3685,208,'s6-list_5_text','При похмельном синдроме'),(3686,208,'_s6-list_5_text','field_60bf7d2710d34'),(3687,208,'s4-list_0_ttl','Натрий'),(3688,208,'_s4-list_0_ttl','field_60bf7fa95a92c'),(3689,208,'s4-list_0_formula','Na<sup>+</sup>'),(3690,208,'_s4-list_0_formula','field_60bf7fc65a92d'),(3691,208,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(3692,208,'_s4-list_0_text','field_60bf7fd35a92e'),(3693,208,'s4-list_1_ttl','Вода'),(3694,208,'_s4-list_1_ttl','field_60bf7fa95a92c'),(3695,208,'s4-list_1_formula','H<sub>2</sub>O'),(3696,208,'_s4-list_1_formula','field_60bf7fc65a92d'),(3697,208,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(3698,208,'_s4-list_1_text','field_60bf7fd35a92e'),(3699,208,'s4-list','9'),(3700,208,'_s4-list','field_60bf7f985a92b'),(3701,208,'s4-list_2_ttl','Калий'),(3702,208,'_s4-list_2_ttl','field_60bf7fa95a92c'),(3703,208,'s4-list_2_formula','K<sup>+</sup>'),(3704,208,'_s4-list_2_formula','field_60bf7fc65a92d'),(3705,208,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость, поставляя мозг кислородом. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(3706,208,'_s4-list_2_text','field_60bf7fd35a92e'),(3707,208,'s4-list_3_ttl','Гидрокарбонаты'),(3708,208,'_s4-list_3_ttl','field_60bf7fa95a92c'),(3709,208,'s4-list_3_formula','HCO<sup>3+</sup>'),(3710,208,'_s4-list_3_formula','field_60bf7fc65a92d'),(3711,208,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(3712,208,'_s4-list_3_text','field_60bf7fd35a92e'),(3713,208,'s4-list_4_ttl','Магний'),(3714,208,'_s4-list_4_ttl','field_60bf7fa95a92c'),(3715,208,'s4-list_4_formula','Mg<sup>2+</sup>'),(3716,208,'_s4-list_4_formula','field_60bf7fc65a92d'),(3717,208,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(3718,208,'_s4-list_4_text','field_60bf7fd35a92e'),(3719,208,'s4-list_5_ttl','Углекислый газ'),(3720,208,'_s4-list_5_ttl','field_60bf7fa95a92c'),(3721,208,'s4-list_5_formula','CO<sup>2</sup>+'),(3722,208,'_s4-list_5_formula','field_60bf7fc65a92d'),(3723,208,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(3724,208,'_s4-list_5_text','field_60bf7fd35a92e'),(3725,208,'s4-list_6_ttl','Кальций'),(3726,208,'_s4-list_6_ttl','field_60bf7fa95a92c'),(3727,208,'s4-list_6_formula','Ca<sup>2+</sup>'),(3728,208,'_s4-list_6_formula','field_60bf7fc65a92d'),(3729,208,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительных тканей, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(3730,208,'_s4-list_6_text','field_60bf7fd35a92e'),(3731,208,'s4-list_7_ttl','Сорбит'),(3732,208,'_s4-list_7_ttl','field_60bf7fa95a92c'),(3733,208,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(3734,208,'_s4-list_7_formula','field_60bf7fc65a92d'),(3735,208,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(3736,208,'_s4-list_7_text','field_60bf7fd35a92e'),(3737,208,'s4-list_8_ttl','Хлор'),(3738,208,'_s4-list_8_ttl','field_60bf7fa95a92c'),(3739,208,'s4-list_8_formula','Cl'),(3740,208,'_s4-list_8_formula','field_60bf7fc65a92d'),(3741,208,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(3742,208,'_s4-list_8_text','field_60bf7fd35a92e'),(3743,208,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(3744,208,'_s4-feature1','field_60bf80ca480ea'),(3745,208,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(3746,208,'_s4-feature2','field_60bf80de480eb'),(3747,208,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(3748,208,'_s4-feature3','field_60bf80e2480ec'),(3749,208,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(3750,208,'_s4-feature4','field_60bf80e5480ed'),(3751,177,'_edit_last','1'),(3752,209,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(3753,209,'_s1-text','field_60c069d69838b'),(3754,209,'s3-list','5'),(3755,209,'_s3-list','field_60c06d9298394'),(3756,209,'s3-list2','3'),(3757,209,'_s3-list2','field_60c06dd498396'),(3758,209,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(3759,209,'_s4-ttl','field_60c06ba39838e'),(3760,209,'s4-list','7'),(3761,209,'_s4-list','field_60c06bb39838f'),(3762,209,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(3763,209,'_s4-slogan','field_60c06d6d98392'),(3764,209,'s4-list_0_icon','127'),(3765,209,'_s4-list_0_icon','field_60c06bc298390'),(3766,209,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(3767,209,'_s4-list_0_text','field_60c06bce98391'),(3768,209,'s4-list_1_icon','128'),(3769,209,'_s4-list_1_icon','field_60c06bc298390'),(3770,209,'s4-list_1_text','<strong>головокружение</strong>'),(3771,209,'_s4-list_1_text','field_60c06bce98391'),(3772,209,'s4-list_2_icon','68'),(3773,209,'_s4-list_2_icon','field_60c06bc298390'),(3774,209,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(3775,209,'_s4-list_2_text','field_60c06bce98391'),(3776,209,'s4-list_3_icon','64'),(3777,209,'_s4-list_3_icon','field_60c06bc298390'),(3778,209,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(3779,209,'_s4-list_3_text','field_60c06bce98391'),(3780,209,'s4-list_4_icon','129'),(3781,209,'_s4-list_4_icon','field_60c06bc298390'),(3782,209,'s4-list_4_text','<strong>диарея</strong>'),(3783,209,'_s4-list_4_text','field_60c06bce98391'),(3784,209,'s4-list_5_icon','130'),(3785,209,'_s4-list_5_icon','field_60c06bc298390'),(3786,209,'s4-list_5_text','Сухость во\r\n<strong>рту </strong>'),(3787,209,'_s4-list_5_text','field_60c06bce98391'),(3788,209,'s4-list_6_icon','131'),(3789,209,'_s4-list_6_icon','field_60c06bc298390'),(3790,209,'s4-list_6_text','<strong>Головная</strong>\r\nболь'),(3791,209,'_s4-list_6_text','field_60c06bce98391'),(3792,209,'s3-list_0_li','имеет сбалансированный<br /> состав'),(3793,209,'_s3-list_0_li','field_60c06db098395'),(3794,209,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(3795,209,'_s3-list_1_li','field_60c06db098395'),(3796,209,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(3797,209,'_s3-list_2_li','field_60c06db098395'),(3798,209,'s3-list_3_li','имеет приятный вкус и легко пьется даже при ощущении тошноты'),(3799,209,'_s3-list_3_li','field_60c06db098395'),(3800,209,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(3801,209,'_s3-list_4_li','field_60c06db098395'),(3802,209,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(3803,209,'_s3-list2_0_li','field_60c06dd498397'),(3804,209,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(3805,209,'_s3-list2_1_li','field_60c06dd498397'),(3806,209,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс в стационаре и после выписки на дом'),(3807,209,'_s3-list2_2_li','field_60c06dd498397'),(3808,209,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(3809,209,'_s2-list_3_text','field_60c0749d53147'),(3810,209,'s2-list_3_size','- 900 мл/г'),(3811,209,'_s2-list_3_size','field_60c0749553146'),(3812,209,'s2-list_3_formula','Na<sup>+</sup>'),(3813,209,'_s2-list_3_formula','field_60c0747253145'),(3814,209,'s2-list_3_ttl','Натрій'),(3815,209,'_s2-list_3_ttl','field_60c0745253144'),(3816,209,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(3817,209,'_s2-list_2_text','field_60c0749d53147'),(3818,209,'s2-list_2_size','до 900 мл/г'),(3819,209,'_s2-list_2_size','field_60c0749553146'),(3820,209,'s2-list_2_formula','Сорбітол'),(3821,209,'_s2-list_2_formula','field_60c0747253145'),(3822,209,'s2-list_2_ttl','Сорбітол'),(3823,209,'_s2-list_2_ttl','field_60c0745253144'),(3824,209,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(3825,209,'_s2-list_1_text','field_60c0749d53147'),(3826,209,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(3827,209,'_s2-list_1_size','field_60c0749553146'),(3828,209,'s2-list_1_formula','Мiнералiзацiя'),(3829,209,'_s2-list_1_formula','field_60c0747253145'),(3830,209,'s2-list_1_ttl','Мiнералiзацiя'),(3831,209,'_s2-list_1_ttl','field_60c0745253144'),(3832,209,'s2-list_0_ttl','Вуглекислота'),(3833,209,'_s2-list_0_ttl','field_60c0745253144'),(3834,209,'s2-list_0_formula','Вуглекислота'),(3835,209,'_s2-list_0_formula','field_60c0747253145'),(3836,209,'s2-list_0_size','- 0,05-0,3%'),(3837,209,'_s2-list_0_size','field_60c0749553146'),(3838,209,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(3839,209,'_s2-list_0_text','field_60c0749d53147'),(3840,209,'s2-list','9'),(3841,209,'_s2-list','field_60c0743a53143'),(3842,209,'s2-list_4_ttl','Магній'),(3843,209,'_s2-list_4_ttl','field_60c0745253144'),(3844,209,'s2-list_4_formula','Mg<sup>2+</sup>'),(3845,209,'_s2-list_4_formula','field_60c0747253145'),(3846,209,'s2-list_4_size','- 50 мл/г'),(3847,209,'_s2-list_4_size','field_60c0749553146'),(3848,209,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(3849,209,'_s2-list_4_text','field_60c0749d53147'),(3850,209,'s2-list_5_ttl','Хлор'),(3851,209,'_s2-list_5_ttl','field_60c0745253144'),(3852,209,'s2-list_5_formula','Cl<sup>-</sup>'),(3853,209,'_s2-list_5_formula','field_60c0747253145'),(3854,209,'s2-list_5_size','- 600 мл/г'),(3855,209,'_s2-list_5_size','field_60c0749553146'),(3856,209,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(3857,209,'_s2-list_5_text','field_60c0749d53147'),(3858,209,'s2-list_6_ttl','Калій'),(3859,209,'_s2-list_6_ttl','field_60c0745253144'),(3860,209,'s2-list_6_formula','K<sup>+</sup>'),(3861,209,'_s2-list_6_formula','field_60c0747253145'),(3862,209,'s2-list_6_size','- 160 мл/г'),(3863,209,'_s2-list_6_size','field_60c0749553146'),(3864,209,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(3865,209,'_s2-list_6_text','field_60c0749d53147'),(3866,209,'s2-list_7_ttl','Кальцій'),(3867,209,'_s2-list_7_ttl','field_60c0745253144'),(3868,209,'s2-list_7_formula','Ca<sup>2+</sup>'),(3869,209,'_s2-list_7_formula','field_60c0747253145'),(3870,209,'s2-list_7_size','- 50 мл/г'),(3871,209,'_s2-list_7_size','field_60c0749553146'),(3872,209,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(3873,209,'_s2-list_7_text','field_60c0749d53147'),(3874,209,'s2-list_8_ttl','Гідрокарбонати'),(3875,209,'_s2-list_8_ttl','field_60c0745253144'),(3876,209,'s2-list_8_formula','HCO<sup>3+</sup>'),(3877,209,'_s2-list_8_formula','field_60c0747253145'),(3878,209,'s2-list_8_size','- 300 мл/г'),(3879,209,'_s2-list_8_size','field_60c0749553146'),(3880,209,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(3881,209,'_s2-list_8_text','field_60c0749d53147'),(3882,210,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(3883,210,'_s1-text','field_60c069d69838b'),(3884,210,'s3-list','5'),(3885,210,'_s3-list','field_60c06d9298394'),(3886,210,'s3-list2','3'),(3887,210,'_s3-list2','field_60c06dd498396'),(3888,210,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(3889,210,'_s4-ttl','field_60c06ba39838e'),(3890,210,'s4-list','7'),(3891,210,'_s4-list','field_60c06bb39838f'),(3892,210,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(3893,210,'_s4-slogan','field_60c06d6d98392'),(3894,210,'s4-list_0_icon','127'),(3895,210,'_s4-list_0_icon','field_60c06bc298390'),(3896,210,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(3897,210,'_s4-list_0_text','field_60c06bce98391'),(3898,210,'s4-list_1_icon','128'),(3899,210,'_s4-list_1_icon','field_60c06bc298390'),(3900,210,'s4-list_1_text','<strong>головокружение</strong>'),(3901,210,'_s4-list_1_text','field_60c06bce98391'),(3902,210,'s4-list_2_icon','68'),(3903,210,'_s4-list_2_icon','field_60c06bc298390'),(3904,210,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(3905,210,'_s4-list_2_text','field_60c06bce98391'),(3906,210,'s4-list_3_icon','64'),(3907,210,'_s4-list_3_icon','field_60c06bc298390'),(3908,210,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(3909,210,'_s4-list_3_text','field_60c06bce98391'),(3910,210,'s4-list_4_icon','129'),(3911,210,'_s4-list_4_icon','field_60c06bc298390'),(3912,210,'s4-list_4_text','<strong>диарея</strong>'),(3913,210,'_s4-list_4_text','field_60c06bce98391'),(3914,210,'s4-list_5_icon','130'),(3915,210,'_s4-list_5_icon','field_60c06bc298390'),(3916,210,'s4-list_5_text','Сухость во\r\n<strong>рту </strong>'),(3917,210,'_s4-list_5_text','field_60c06bce98391'),(3918,210,'s4-list_6_icon','131'),(3919,210,'_s4-list_6_icon','field_60c06bc298390'),(3920,210,'s4-list_6_text','<strong>Головная</strong>\r\nболь'),(3921,210,'_s4-list_6_text','field_60c06bce98391'),(3922,210,'s3-list_0_li','имеет сбалансированный<br /> состав'),(3923,210,'_s3-list_0_li','field_60c06db098395'),(3924,210,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(3925,210,'_s3-list_1_li','field_60c06db098395'),(3926,210,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(3927,210,'_s3-list_2_li','field_60c06db098395'),(3928,210,'s3-list_3_li','имеет приятный вкус и легко пьется даже при ощущении тошноты'),(3929,210,'_s3-list_3_li','field_60c06db098395'),(3930,210,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(3931,210,'_s3-list_4_li','field_60c06db098395'),(3932,210,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(3933,210,'_s3-list2_0_li','field_60c06dd498397'),(3934,210,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(3935,210,'_s3-list2_1_li','field_60c06dd498397'),(3936,210,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс в стационаре и после выписки на дом'),(3937,210,'_s3-list2_2_li','field_60c06dd498397'),(3938,210,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(3939,210,'_s2-list_3_text','field_60c0749d53147'),(3940,210,'s2-list_3_size','- 900 мл/г'),(3941,210,'_s2-list_3_size','field_60c0749553146'),(3942,210,'s2-list_3_formula','Na<sup>+</sup>'),(3943,210,'_s2-list_3_formula','field_60c0747253145'),(3944,210,'s2-list_3_ttl','Натрий'),(3945,210,'_s2-list_3_ttl','field_60c0745253144'),(3946,210,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(3947,210,'_s2-list_2_text','field_60c0749d53147'),(3948,210,'s2-list_2_size','до 900 мл/г'),(3949,210,'_s2-list_2_size','field_60c0749553146'),(3950,210,'s2-list_2_formula','Сорбитол'),(3951,210,'_s2-list_2_formula','field_60c0747253145'),(3952,210,'s2-list_2_ttl','Сорбитол'),(3953,210,'_s2-list_2_ttl','field_60c0745253144'),(3954,210,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(3955,210,'_s2-list_1_text','field_60c0749d53147'),(3956,210,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(3957,210,'_s2-list_1_size','field_60c0749553146'),(3958,210,'s2-list_1_formula','Минерализация'),(3959,210,'_s2-list_1_formula','field_60c0747253145'),(3960,210,'s2-list_1_ttl','Минерализация'),(3961,210,'_s2-list_1_ttl','field_60c0745253144'),(3962,210,'s2-list_0_ttl','Углекислота'),(3963,210,'_s2-list_0_ttl','field_60c0745253144'),(3964,210,'s2-list_0_formula','Углекислота'),(3965,210,'_s2-list_0_formula','field_60c0747253145'),(3966,210,'s2-list_0_size','- 0,05-0,3%'),(3967,210,'_s2-list_0_size','field_60c0749553146'),(3968,210,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(3969,210,'_s2-list_0_text','field_60c0749d53147'),(3970,210,'s2-list','9'),(3971,210,'_s2-list','field_60c0743a53143'),(3972,210,'s2-list_4_ttl','Магний'),(3973,210,'_s2-list_4_ttl','field_60c0745253144'),(3974,210,'s2-list_4_formula','Mg<sup>2+</sup>'),(3975,210,'_s2-list_4_formula','field_60c0747253145'),(3976,210,'s2-list_4_size','- 50 мл/г'),(3977,210,'_s2-list_4_size','field_60c0749553146'),(3978,210,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(3979,210,'_s2-list_4_text','field_60c0749d53147'),(3980,210,'s2-list_5_ttl','Хлор'),(3981,210,'_s2-list_5_ttl','field_60c0745253144'),(3982,210,'s2-list_5_formula','Cl<sup>-</sup>'),(3983,210,'_s2-list_5_formula','field_60c0747253145'),(3984,210,'s2-list_5_size','- 600 мл/г'),(3985,210,'_s2-list_5_size','field_60c0749553146'),(3986,210,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(3987,210,'_s2-list_5_text','field_60c0749d53147'),(3988,210,'s2-list_6_ttl','Калий'),(3989,210,'_s2-list_6_ttl','field_60c0745253144'),(3990,210,'s2-list_6_formula','K<sup>+</sup>'),(3991,210,'_s2-list_6_formula','field_60c0747253145'),(3992,210,'s2-list_6_size','- 160 мл/г'),(3993,210,'_s2-list_6_size','field_60c0749553146'),(3994,210,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость, поставляя мозг кислородом. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(3995,210,'_s2-list_6_text','field_60c0749d53147'),(3996,210,'s2-list_7_ttl','Кальций'),(3997,210,'_s2-list_7_ttl','field_60c0745253144'),(3998,210,'s2-list_7_formula','Ca<sup>2+</sup>'),(3999,210,'_s2-list_7_formula','field_60c0747253145'),(4000,210,'s2-list_7_size','- 50 мл/г'),(4001,210,'_s2-list_7_size','field_60c0749553146'),(4002,210,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительных тканей, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(4003,210,'_s2-list_7_text','field_60c0749d53147'),(4004,210,'s2-list_8_ttl','Гидрокарбонаты'),(4005,210,'_s2-list_8_ttl','field_60c0745253144'),(4006,210,'s2-list_8_formula','HCO<sup>3+</sup>'),(4007,210,'_s2-list_8_formula','field_60c0747253145'),(4008,210,'s2-list_8_size','- 300 мл/г'),(4009,210,'_s2-list_8_size','field_60c0749553146'),(4010,210,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(4011,210,'_s2-list_8_text','field_60c0749d53147'),(4012,211,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(4013,211,'_s1-text','field_60c069d69838b'),(4014,211,'s3-list','5'),(4015,211,'_s3-list','field_60c06d9298394'),(4016,211,'s3-list2','3'),(4017,211,'_s3-list2','field_60c06dd498396'),(4018,211,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(4019,211,'_s4-ttl','field_60c06ba39838e'),(4020,211,'s4-list','7'),(4021,211,'_s4-list','field_60c06bb39838f'),(4022,211,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(4023,211,'_s4-slogan','field_60c06d6d98392'),(4024,211,'s4-list_0_icon','127'),(4025,211,'_s4-list_0_icon','field_60c06bc298390'),(4026,211,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(4027,211,'_s4-list_0_text','field_60c06bce98391'),(4028,211,'s4-list_1_icon','128'),(4029,211,'_s4-list_1_icon','field_60c06bc298390'),(4030,211,'s4-list_1_text','<strong>головокружение</strong>'),(4031,211,'_s4-list_1_text','field_60c06bce98391'),(4032,211,'s4-list_2_icon','68'),(4033,211,'_s4-list_2_icon','field_60c06bc298390'),(4034,211,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(4035,211,'_s4-list_2_text','field_60c06bce98391'),(4036,211,'s4-list_3_icon','64'),(4037,211,'_s4-list_3_icon','field_60c06bc298390'),(4038,211,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(4039,211,'_s4-list_3_text','field_60c06bce98391'),(4040,211,'s4-list_4_icon','129'),(4041,211,'_s4-list_4_icon','field_60c06bc298390'),(4042,211,'s4-list_4_text','<strong>диарея</strong>'),(4043,211,'_s4-list_4_text','field_60c06bce98391'),(4044,211,'s4-list_5_icon','130'),(4045,211,'_s4-list_5_icon','field_60c06bc298390'),(4046,211,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(4047,211,'_s4-list_5_text','field_60c06bce98391'),(4048,211,'s4-list_6_icon','131'),(4049,211,'_s4-list_6_icon','field_60c06bc298390'),(4050,211,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(4051,211,'_s4-list_6_text','field_60c06bce98391'),(4052,211,'s3-list_0_li','имеет сбалансированный<br /> состав'),(4053,211,'_s3-list_0_li','field_60c06db098395'),(4054,211,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(4055,211,'_s3-list_1_li','field_60c06db098395'),(4056,211,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(4057,211,'_s3-list_2_li','field_60c06db098395'),(4058,211,'s3-list_3_li','имеет приятный вкус и легко пьется даже при ощущении тошноты'),(4059,211,'_s3-list_3_li','field_60c06db098395'),(4060,211,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(4061,211,'_s3-list_4_li','field_60c06db098395'),(4062,211,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(4063,211,'_s3-list2_0_li','field_60c06dd498397'),(4064,211,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(4065,211,'_s3-list2_1_li','field_60c06dd498397'),(4066,211,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс в стационаре и после выписки на дом'),(4067,211,'_s3-list2_2_li','field_60c06dd498397'),(4068,211,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(4069,211,'_s2-list_3_text','field_60c0749d53147'),(4070,211,'s2-list_3_size','- 900 мл/г'),(4071,211,'_s2-list_3_size','field_60c0749553146'),(4072,211,'s2-list_3_formula','Na<sup>+</sup>'),(4073,211,'_s2-list_3_formula','field_60c0747253145'),(4074,211,'s2-list_3_ttl','Натрий'),(4075,211,'_s2-list_3_ttl','field_60c0745253144'),(4076,211,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(4077,211,'_s2-list_2_text','field_60c0749d53147'),(4078,211,'s2-list_2_size','до 900 мл/г'),(4079,211,'_s2-list_2_size','field_60c0749553146'),(4080,211,'s2-list_2_formula','Сорбитол'),(4081,211,'_s2-list_2_formula','field_60c0747253145'),(4082,211,'s2-list_2_ttl','Сорбитол'),(4083,211,'_s2-list_2_ttl','field_60c0745253144'),(4084,211,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(4085,211,'_s2-list_1_text','field_60c0749d53147'),(4086,211,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(4087,211,'_s2-list_1_size','field_60c0749553146'),(4088,211,'s2-list_1_formula','Минерализация'),(4089,211,'_s2-list_1_formula','field_60c0747253145'),(4090,211,'s2-list_1_ttl','Минерализация'),(4091,211,'_s2-list_1_ttl','field_60c0745253144'),(4092,211,'s2-list_0_ttl','Углекислота'),(4093,211,'_s2-list_0_ttl','field_60c0745253144'),(4094,211,'s2-list_0_formula','Углекислота'),(4095,211,'_s2-list_0_formula','field_60c0747253145'),(4096,211,'s2-list_0_size','- 0,05-0,3%'),(4097,211,'_s2-list_0_size','field_60c0749553146'),(4098,211,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(4099,211,'_s2-list_0_text','field_60c0749d53147'),(4100,211,'s2-list','9'),(4101,211,'_s2-list','field_60c0743a53143'),(4102,211,'s2-list_4_ttl','Магний'),(4103,211,'_s2-list_4_ttl','field_60c0745253144'),(4104,211,'s2-list_4_formula','Mg<sup>2+</sup>'),(4105,211,'_s2-list_4_formula','field_60c0747253145'),(4106,211,'s2-list_4_size','- 50 мл/г'),(4107,211,'_s2-list_4_size','field_60c0749553146'),(4108,211,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(4109,211,'_s2-list_4_text','field_60c0749d53147'),(4110,211,'s2-list_5_ttl','Хлор'),(4111,211,'_s2-list_5_ttl','field_60c0745253144'),(4112,211,'s2-list_5_formula','Cl<sup>-</sup>'),(4113,211,'_s2-list_5_formula','field_60c0747253145'),(4114,211,'s2-list_5_size','- 600 мл/г'),(4115,211,'_s2-list_5_size','field_60c0749553146'),(4116,211,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(4117,211,'_s2-list_5_text','field_60c0749d53147'),(4118,211,'s2-list_6_ttl','Калий'),(4119,211,'_s2-list_6_ttl','field_60c0745253144'),(4120,211,'s2-list_6_formula','K<sup>+</sup>'),(4121,211,'_s2-list_6_formula','field_60c0747253145'),(4122,211,'s2-list_6_size','- 160 мл/г'),(4123,211,'_s2-list_6_size','field_60c0749553146'),(4124,211,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость, поставляя мозг кислородом. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(4125,211,'_s2-list_6_text','field_60c0749d53147'),(4126,211,'s2-list_7_ttl','Кальций'),(4127,211,'_s2-list_7_ttl','field_60c0745253144'),(4128,211,'s2-list_7_formula','Ca<sup>2+</sup>'),(4129,211,'_s2-list_7_formula','field_60c0747253145'),(4130,211,'s2-list_7_size','- 50 мл/г'),(4131,211,'_s2-list_7_size','field_60c0749553146'),(4132,211,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительных тканей, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(4133,211,'_s2-list_7_text','field_60c0749d53147'),(4134,211,'s2-list_8_ttl','Гидрокарбонаты'),(4135,211,'_s2-list_8_ttl','field_60c0745253144'),(4136,211,'s2-list_8_formula','HCO<sup>3+</sup>'),(4137,211,'_s2-list_8_formula','field_60c0747253145'),(4138,211,'s2-list_8_size','- 300 мл/г'),(4139,211,'_s2-list_8_size','field_60c0749553146'),(4140,211,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(4141,211,'_s2-list_8_text','field_60c0749d53147'),(4150,178,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4149,212,'_edit_lock','1623745945:1'),(4148,212,'_edit_last','1'),(4151,178,'_sc1-afterlogo','field_60c85338b3453'),(4152,178,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4153,178,'_sc1-left','field_60c85356b3454'),(4154,178,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4155,178,'_sc1-right','field_60c85408b3455'),(4156,181,'sc1-afterlogo',''),(4157,181,'_sc1-afterlogo','field_60c85338b3453'),(4158,181,'sc1-left',''),(4159,181,'_sc1-left','field_60c85356b3454'),(4160,181,'sc1-right',''),(4161,181,'_sc1-right','field_60c85408b3455'),(4162,218,'sc1-afterlogo','Международная специализированная фармацевтическая корпорация:'),(4163,218,'_sc1-afterlogo','field_60c85338b3453'),(4164,218,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4165,218,'_sc1-left','field_60c85356b3454'),(4166,218,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4167,218,'_sc1-right','field_60c85408b3455'),(4211,235,'_wp_attachment_metadata','a:0:{}'),(4212,235,'_wp_attached_file','2021/06/facts-icon-2.svg'),(4210,234,'_wp_attached_file','2021/06/facts-icon-2.svg'),(4209,233,'wpml_media_processed','1'),(4208,233,'_wp_attached_file','2021/06/facts-icon-1.svg'),(4207,233,'_wp_attachment_metadata','a:0:{}'),(4206,232,'_wp_attached_file','2021/06/facts-icon-1.svg'),(4174,220,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4175,220,'_sc1-afterlogo','field_60c85338b3453'),(4176,220,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4177,220,'_sc1-left','field_60c85356b3454'),(4178,220,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4179,220,'_sc1-right','field_60c85408b3455'),(4180,178,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4181,178,'_sc2-ttl','field_60c8556cfdbcb'),(4182,178,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4183,178,'_sc2-round1','field_60c855a5fdbcc'),(4184,178,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4185,178,'_sc2-round2','field_60c855b6fdbcd'),(4186,178,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4187,178,'_sc2-mission','field_60c855bffdbce'),(4188,178,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4189,178,'_sc2-filosophy','field_60c855cafdbcf'),(4190,226,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4191,226,'_sc1-afterlogo','field_60c85338b3453'),(4192,226,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4193,226,'_sc1-left','field_60c85356b3454'),(4194,226,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4195,226,'_sc1-right','field_60c85408b3455'),(4196,226,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4197,226,'_sc2-ttl','field_60c8556cfdbcb'),(4198,226,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4199,226,'_sc2-round1','field_60c855a5fdbcc'),(4200,226,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4201,226,'_sc2-round2','field_60c855b6fdbcd'),(4202,226,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4203,226,'_sc2-mission','field_60c855bffdbce'),(4204,226,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4205,226,'_sc2-filosophy','field_60c855cafdbcf'),(4213,235,'wpml_media_processed','1'),(4214,236,'_wp_attached_file','2021/06/facts-icon-3.svg'),(4215,237,'_wp_attachment_metadata','a:0:{}'),(4216,237,'_wp_attached_file','2021/06/facts-icon-3.svg'),(4217,237,'wpml_media_processed','1'),(4218,238,'_wp_attached_file','2021/06/facts-icon-4.svg'),(4219,239,'_wp_attachment_metadata','a:0:{}'),(4220,239,'_wp_attached_file','2021/06/facts-icon-4.svg'),(4221,239,'wpml_media_processed','1'),(4222,240,'_wp_attached_file','2021/06/facts-icon-5.svg'),(4223,241,'_wp_attachment_metadata','a:0:{}'),(4224,241,'_wp_attached_file','2021/06/facts-icon-5.svg'),(4225,241,'wpml_media_processed','1'),(4226,242,'_wp_attached_file','2021/06/facts-icon-6.svg'),(4227,243,'_wp_attachment_metadata','a:0:{}'),(4228,243,'_wp_attached_file','2021/06/facts-icon-6.svg'),(4229,243,'wpml_media_processed','1'),(4230,178,'sc3-ttl','Краткие факты о нашем производстве:'),(4231,178,'_sc3-ttl','field_60c85818d1bf2'),(4232,178,'sc3-list_0_icon','232'),(4233,178,'_sc3-list_0_icon','field_60c85834d1bf4'),(4234,178,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4235,178,'_sc3-list_0_text','field_60c85852d1bf5'),(4236,178,'sc3-list_1_icon','234'),(4237,178,'_sc3-list_1_icon','field_60c85834d1bf4'),(4238,178,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4239,178,'_sc3-list_1_text','field_60c85852d1bf5'),(4240,178,'sc3-list_2_icon','236'),(4241,178,'_sc3-list_2_icon','field_60c85834d1bf4'),(4242,178,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4243,178,'_sc3-list_2_text','field_60c85852d1bf5'),(4244,178,'sc3-list_3_icon','238'),(4245,178,'_sc3-list_3_icon','field_60c85834d1bf4'),(4246,178,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4247,178,'_sc3-list_3_text','field_60c85852d1bf5'),(4248,178,'sc3-list_4_icon','240'),(4249,178,'_sc3-list_4_icon','field_60c85834d1bf4'),(4250,178,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4251,178,'_sc3-list_4_text','field_60c85852d1bf5'),(4252,178,'sc3-list_5_icon','242'),(4253,178,'_sc3-list_5_icon','field_60c85834d1bf4'),(4254,178,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4255,178,'_sc3-list_5_text','field_60c85852d1bf5'),(4256,178,'sc3-list','6'),(4257,178,'_sc3-list','field_60c85827d1bf3'),(4258,244,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4259,244,'_sc1-afterlogo','field_60c85338b3453'),(4260,244,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4261,244,'_sc1-left','field_60c85356b3454'),(4262,244,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4263,244,'_sc1-right','field_60c85408b3455'),(4264,244,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4265,244,'_sc2-ttl','field_60c8556cfdbcb'),(4266,244,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4267,244,'_sc2-round1','field_60c855a5fdbcc'),(4268,244,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4269,244,'_sc2-round2','field_60c855b6fdbcd'),(4270,244,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4271,244,'_sc2-mission','field_60c855bffdbce'),(4272,244,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4273,244,'_sc2-filosophy','field_60c855cafdbcf'),(4274,244,'sc3-ttl','Краткие факты о нашем производстве:'),(4275,244,'_sc3-ttl','field_60c85818d1bf2'),(4276,244,'sc3-list_0_icon','232'),(4277,244,'_sc3-list_0_icon','field_60c85834d1bf4'),(4278,244,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4279,244,'_sc3-list_0_text','field_60c85852d1bf5'),(4280,244,'sc3-list_1_icon','234'),(4281,244,'_sc3-list_1_icon','field_60c85834d1bf4'),(4282,244,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4283,244,'_sc3-list_1_text','field_60c85852d1bf5'),(4284,244,'sc3-list_2_icon','236'),(4285,244,'_sc3-list_2_icon','field_60c85834d1bf4'),(4286,244,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4287,244,'_sc3-list_2_text','field_60c85852d1bf5'),(4288,244,'sc3-list_3_icon','238'),(4289,244,'_sc3-list_3_icon','field_60c85834d1bf4'),(4290,244,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4291,244,'_sc3-list_3_text','field_60c85852d1bf5'),(4292,244,'sc3-list_4_icon','240'),(4293,244,'_sc3-list_4_icon','field_60c85834d1bf4'),(4294,244,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4295,244,'_sc3-list_4_text','field_60c85852d1bf5'),(4296,244,'sc3-list_5_icon','242'),(4297,244,'_sc3-list_5_icon','field_60c85834d1bf4'),(4298,244,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4299,244,'_sc3-list_5_text','field_60c85852d1bf5'),(4300,244,'sc3-list','6'),(4301,244,'_sc3-list','field_60c85827d1bf3'),(4302,178,'sc4-list_0_num','2500'),(4303,178,'_sc4-list_0_num','field_60c85bf773ac3'),(4304,178,'sc4-list_0_text','сотрудников'),(4305,178,'_sc4-list_0_text','field_60c85c0173ac4'),(4306,178,'sc4-list_1_num','160'),(4307,178,'_sc4-list_1_num','field_60c85bf773ac3'),(4308,178,'sc4-list_1_text','позиций'),(4309,178,'_sc4-list_1_text','field_60c85c0173ac4'),(4310,178,'sc4-list_2_num','20'),(4311,178,'_sc4-list_2_num','field_60c85bf773ac3'),(4312,178,'sc4-list_2_text','стран мира'),(4313,178,'_sc4-list_2_text','field_60c85c0173ac4'),(4314,178,'sc4-list','3'),(4315,178,'_sc4-list','field_60c85be773ac2'),(4316,178,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4317,178,'_sc4-text','field_60c85c0d73ac5'),(4318,178,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4319,178,'_sc5-ttl','field_60c85c2b73ac7'),(4320,178,'sc5-list','2'),(4321,178,'_sc5-list','field_60c85c6373ac8'),(4322,178,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4323,178,'_sc6-text','field_60c85cad73acc'),(4324,178,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(4325,178,'_sc7-video','field_60c85cca73ace'),(4326,178,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(4327,178,'_sc7-text','field_60c85ce173acf'),(4328,178,'sc7-textborder','Жизнь – главная земная ценность. \r\nМы призваны сохранять и улучшать ее!'),(4329,178,'_sc7-textborder','field_60c85cea73ad0'),(4330,261,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4331,261,'_sc1-afterlogo','field_60c85338b3453'),(4332,261,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4333,261,'_sc1-left','field_60c85356b3454'),(4334,261,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4335,261,'_sc1-right','field_60c85408b3455'),(4336,261,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4337,261,'_sc2-ttl','field_60c8556cfdbcb'),(4338,261,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4339,261,'_sc2-round1','field_60c855a5fdbcc'),(4340,261,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4341,261,'_sc2-round2','field_60c855b6fdbcd'),(4342,261,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4343,261,'_sc2-mission','field_60c855bffdbce'),(4344,261,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4345,261,'_sc2-filosophy','field_60c855cafdbcf'),(4346,261,'sc3-ttl','Краткие факты о нашем производстве:'),(4347,261,'_sc3-ttl','field_60c85818d1bf2'),(4348,261,'sc3-list_0_icon','232'),(4349,261,'_sc3-list_0_icon','field_60c85834d1bf4'),(4350,261,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4351,261,'_sc3-list_0_text','field_60c85852d1bf5'),(4352,261,'sc3-list_1_icon','234'),(4353,261,'_sc3-list_1_icon','field_60c85834d1bf4'),(4354,261,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4355,261,'_sc3-list_1_text','field_60c85852d1bf5'),(4356,261,'sc3-list_2_icon','236'),(4357,261,'_sc3-list_2_icon','field_60c85834d1bf4'),(4358,261,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4359,261,'_sc3-list_2_text','field_60c85852d1bf5'),(4360,261,'sc3-list_3_icon','238'),(4361,261,'_sc3-list_3_icon','field_60c85834d1bf4'),(4362,261,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4363,261,'_sc3-list_3_text','field_60c85852d1bf5'),(4364,261,'sc3-list_4_icon','240'),(4365,261,'_sc3-list_4_icon','field_60c85834d1bf4'),(4366,261,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4367,261,'_sc3-list_4_text','field_60c85852d1bf5'),(4368,261,'sc3-list_5_icon','242'),(4369,261,'_sc3-list_5_icon','field_60c85834d1bf4'),(4370,261,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4371,261,'_sc3-list_5_text','field_60c85852d1bf5'),(4372,261,'sc3-list','6'),(4373,261,'_sc3-list','field_60c85827d1bf3'),(4374,261,'sc4-list_0_num','2500'),(4375,261,'_sc4-list_0_num','field_60c85bf773ac3'),(4376,261,'sc4-list_0_text','сотрудников'),(4377,261,'_sc4-list_0_text','field_60c85c0173ac4'),(4378,261,'sc4-list_1_num','160'),(4379,261,'_sc4-list_1_num','field_60c85bf773ac3'),(4380,261,'sc4-list_1_text','позиций'),(4381,261,'_sc4-list_1_text','field_60c85c0173ac4'),(4382,261,'sc4-list_2_num','20'),(4383,261,'_sc4-list_2_num','field_60c85bf773ac3'),(4384,261,'sc4-list_2_text','стран мира'),(4385,261,'_sc4-list_2_text','field_60c85c0173ac4'),(4386,261,'sc4-list','3'),(4387,261,'_sc4-list','field_60c85be773ac2'),(4388,261,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4389,261,'_sc4-text','field_60c85c0d73ac5'),(4390,261,'sc5-ttl',''),(4391,261,'_sc5-ttl','field_60c85c2b73ac7'),(4392,261,'sc5-list',''),(4393,261,'_sc5-list','field_60c85c6373ac8'),(4394,261,'sc6-text',''),(4395,261,'_sc6-text','field_60c85cad73acc'),(4396,261,'sc7-video',''),(4397,261,'_sc7-video','field_60c85cca73ace'),(4398,261,'sc7-text',''),(4399,261,'_sc7-text','field_60c85ce173acf'),(4400,261,'sc7-textborder',''),(4401,261,'_sc7-textborder','field_60c85cea73ad0'),(4402,262,'_wp_attached_file','2021/06/sertificat-gmp.svg'),(4403,263,'_wp_attachment_metadata','a:0:{}'),(4404,263,'_wp_attached_file','2021/06/sertificat-gmp.svg'),(4405,263,'wpml_media_processed','1'),(4406,264,'_wp_attached_file','2021/06/sertificat-iso.svg'),(4407,265,'_wp_attachment_metadata','a:0:{}'),(4408,265,'_wp_attached_file','2021/06/sertificat-iso.svg'),(4409,265,'wpml_media_processed','1'),(4410,178,'sc5-list_0_logo','262'),(4411,178,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4412,178,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4413,178,'_sc5-list_0_text','field_60c85c7e73aca'),(4414,178,'sc5-list_1_logo','264'),(4415,178,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4416,178,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4417,178,'_sc5-list_1_text','field_60c85c7e73aca'),(4418,266,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4419,266,'_sc1-afterlogo','field_60c85338b3453'),(4420,266,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4421,266,'_sc1-left','field_60c85356b3454'),(4422,266,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4423,266,'_sc1-right','field_60c85408b3455'),(4424,266,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4425,266,'_sc2-ttl','field_60c8556cfdbcb'),(4426,266,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4427,266,'_sc2-round1','field_60c855a5fdbcc'),(4428,266,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4429,266,'_sc2-round2','field_60c855b6fdbcd'),(4430,266,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4431,266,'_sc2-mission','field_60c855bffdbce'),(4432,266,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4433,266,'_sc2-filosophy','field_60c855cafdbcf'),(4434,266,'sc3-ttl','Краткие факты о нашем производстве:'),(4435,266,'_sc3-ttl','field_60c85818d1bf2'),(4436,266,'sc3-list_0_icon','232'),(4437,266,'_sc3-list_0_icon','field_60c85834d1bf4'),(4438,266,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4439,266,'_sc3-list_0_text','field_60c85852d1bf5'),(4440,266,'sc3-list_1_icon','234'),(4441,266,'_sc3-list_1_icon','field_60c85834d1bf4'),(4442,266,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4443,266,'_sc3-list_1_text','field_60c85852d1bf5'),(4444,266,'sc3-list_2_icon','236'),(4445,266,'_sc3-list_2_icon','field_60c85834d1bf4'),(4446,266,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4447,266,'_sc3-list_2_text','field_60c85852d1bf5'),(4448,266,'sc3-list_3_icon','238'),(4449,266,'_sc3-list_3_icon','field_60c85834d1bf4'),(4450,266,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4451,266,'_sc3-list_3_text','field_60c85852d1bf5'),(4452,266,'sc3-list_4_icon','240'),(4453,266,'_sc3-list_4_icon','field_60c85834d1bf4'),(4454,266,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4455,266,'_sc3-list_4_text','field_60c85852d1bf5'),(4456,266,'sc3-list_5_icon','242'),(4457,266,'_sc3-list_5_icon','field_60c85834d1bf4'),(4458,266,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4459,266,'_sc3-list_5_text','field_60c85852d1bf5'),(4460,266,'sc3-list','6'),(4461,266,'_sc3-list','field_60c85827d1bf3'),(4462,266,'sc4-list_0_num','2500'),(4463,266,'_sc4-list_0_num','field_60c85bf773ac3'),(4464,266,'sc4-list_0_text','сотрудников'),(4465,266,'_sc4-list_0_text','field_60c85c0173ac4'),(4466,266,'sc4-list_1_num','160'),(4467,266,'_sc4-list_1_num','field_60c85bf773ac3'),(4468,266,'sc4-list_1_text','позиций'),(4469,266,'_sc4-list_1_text','field_60c85c0173ac4'),(4470,266,'sc4-list_2_num','20'),(4471,266,'_sc4-list_2_num','field_60c85bf773ac3'),(4472,266,'sc4-list_2_text','стран мира'),(4473,266,'_sc4-list_2_text','field_60c85c0173ac4'),(4474,266,'sc4-list','3'),(4475,266,'_sc4-list','field_60c85be773ac2'),(4476,266,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4477,266,'_sc4-text','field_60c85c0d73ac5'),(4478,266,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4479,266,'_sc5-ttl','field_60c85c2b73ac7'),(4480,266,'sc5-list','2'),(4481,266,'_sc5-list','field_60c85c6373ac8'),(4482,266,'sc6-text',''),(4483,266,'_sc6-text','field_60c85cad73acc'),(4484,266,'sc7-video',''),(4485,266,'_sc7-video','field_60c85cca73ace'),(4486,266,'sc7-text',''),(4487,266,'_sc7-text','field_60c85ce173acf'),(4488,266,'sc7-textborder',''),(4489,266,'_sc7-textborder','field_60c85cea73ad0'),(4490,266,'sc5-list_0_logo','262'),(4491,266,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4492,266,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4493,266,'_sc5-list_0_text','field_60c85c7e73aca'),(4494,266,'sc5-list_1_logo','264'),(4495,266,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4496,266,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4497,266,'_sc5-list_1_text','field_60c85c7e73aca'),(4580,269,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4498,267,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4499,267,'_sc1-afterlogo','field_60c85338b3453'),(4500,267,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4501,267,'_sc1-left','field_60c85356b3454'),(4502,267,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4503,267,'_sc1-right','field_60c85408b3455'),(4504,267,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4505,267,'_sc2-ttl','field_60c8556cfdbcb'),(4506,267,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4507,267,'_sc2-round1','field_60c855a5fdbcc'),(4508,267,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4509,267,'_sc2-round2','field_60c855b6fdbcd'),(4510,267,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4511,267,'_sc2-mission','field_60c855bffdbce'),(4512,267,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4513,267,'_sc2-filosophy','field_60c855cafdbcf'),(4514,267,'sc3-ttl','Краткие факты о нашем производстве:'),(4515,267,'_sc3-ttl','field_60c85818d1bf2'),(4516,267,'sc3-list_0_icon','232'),(4517,267,'_sc3-list_0_icon','field_60c85834d1bf4'),(4518,267,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4519,267,'_sc3-list_0_text','field_60c85852d1bf5'),(4520,267,'sc3-list_1_icon','234'),(4521,267,'_sc3-list_1_icon','field_60c85834d1bf4'),(4522,267,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4523,267,'_sc3-list_1_text','field_60c85852d1bf5'),(4524,267,'sc3-list_2_icon','236'),(4525,267,'_sc3-list_2_icon','field_60c85834d1bf4'),(4526,267,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4527,267,'_sc3-list_2_text','field_60c85852d1bf5'),(4528,267,'sc3-list_3_icon','238'),(4529,267,'_sc3-list_3_icon','field_60c85834d1bf4'),(4530,267,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4531,267,'_sc3-list_3_text','field_60c85852d1bf5'),(4532,267,'sc3-list_4_icon','240'),(4533,267,'_sc3-list_4_icon','field_60c85834d1bf4'),(4534,267,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4535,267,'_sc3-list_4_text','field_60c85852d1bf5'),(4536,267,'sc3-list_5_icon','242'),(4537,267,'_sc3-list_5_icon','field_60c85834d1bf4'),(4538,267,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4539,267,'_sc3-list_5_text','field_60c85852d1bf5'),(4540,267,'sc3-list','6'),(4541,267,'_sc3-list','field_60c85827d1bf3'),(4542,267,'sc4-list_0_num','2500'),(4543,267,'_sc4-list_0_num','field_60c85bf773ac3'),(4544,267,'sc4-list_0_text','сотрудников'),(4545,267,'_sc4-list_0_text','field_60c85c0173ac4'),(4546,267,'sc4-list_1_num','160'),(4547,267,'_sc4-list_1_num','field_60c85bf773ac3'),(4548,267,'sc4-list_1_text','позиций'),(4549,267,'_sc4-list_1_text','field_60c85c0173ac4'),(4550,267,'sc4-list_2_num','20'),(4551,267,'_sc4-list_2_num','field_60c85bf773ac3'),(4552,267,'sc4-list_2_text','стран мира'),(4553,267,'_sc4-list_2_text','field_60c85c0173ac4'),(4554,267,'sc4-list','3'),(4555,267,'_sc4-list','field_60c85be773ac2'),(4556,267,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4557,267,'_sc4-text','field_60c85c0d73ac5'),(4558,267,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4559,267,'_sc5-ttl','field_60c85c2b73ac7'),(4560,267,'sc5-list','2'),(4561,267,'_sc5-list','field_60c85c6373ac8'),(4562,267,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4563,267,'_sc6-text','field_60c85cad73acc'),(4564,267,'sc7-video',''),(4565,267,'_sc7-video','field_60c85cca73ace'),(4566,267,'sc7-text',''),(4567,267,'_sc7-text','field_60c85ce173acf'),(4568,267,'sc7-textborder',''),(4569,267,'_sc7-textborder','field_60c85cea73ad0'),(4570,267,'sc5-list_0_logo','262'),(4571,267,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4572,267,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4573,267,'_sc5-list_0_text','field_60c85c7e73aca'),(4574,267,'sc5-list_1_logo','264'),(4575,267,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4576,267,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4577,267,'_sc5-list_1_text','field_60c85c7e73aca'),(4578,178,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(4579,178,'_sc6-ttl','field_60c85f2f52aa8'),(4581,269,'_sc1-afterlogo','field_60c85338b3453'),(4582,269,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4583,269,'_sc1-left','field_60c85356b3454'),(4584,269,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4585,269,'_sc1-right','field_60c85408b3455'),(4586,269,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4587,269,'_sc2-ttl','field_60c8556cfdbcb'),(4588,269,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4589,269,'_sc2-round1','field_60c855a5fdbcc'),(4590,269,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4591,269,'_sc2-round2','field_60c855b6fdbcd'),(4592,269,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4593,269,'_sc2-mission','field_60c855bffdbce'),(4594,269,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4595,269,'_sc2-filosophy','field_60c855cafdbcf'),(4596,269,'sc3-ttl','Краткие факты о нашем производстве:'),(4597,269,'_sc3-ttl','field_60c85818d1bf2'),(4598,269,'sc3-list_0_icon','232'),(4599,269,'_sc3-list_0_icon','field_60c85834d1bf4'),(4600,269,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4601,269,'_sc3-list_0_text','field_60c85852d1bf5'),(4602,269,'sc3-list_1_icon','234'),(4603,269,'_sc3-list_1_icon','field_60c85834d1bf4'),(4604,269,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4605,269,'_sc3-list_1_text','field_60c85852d1bf5'),(4606,269,'sc3-list_2_icon','236'),(4607,269,'_sc3-list_2_icon','field_60c85834d1bf4'),(4608,269,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4609,269,'_sc3-list_2_text','field_60c85852d1bf5'),(4610,269,'sc3-list_3_icon','238'),(4611,269,'_sc3-list_3_icon','field_60c85834d1bf4'),(4612,269,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4613,269,'_sc3-list_3_text','field_60c85852d1bf5'),(4614,269,'sc3-list_4_icon','240'),(4615,269,'_sc3-list_4_icon','field_60c85834d1bf4'),(4616,269,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4617,269,'_sc3-list_4_text','field_60c85852d1bf5'),(4618,269,'sc3-list_5_icon','242'),(4619,269,'_sc3-list_5_icon','field_60c85834d1bf4'),(4620,269,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4621,269,'_sc3-list_5_text','field_60c85852d1bf5'),(4622,269,'sc3-list','6'),(4623,269,'_sc3-list','field_60c85827d1bf3'),(4624,269,'sc4-list_0_num','2500'),(4625,269,'_sc4-list_0_num','field_60c85bf773ac3'),(4626,269,'sc4-list_0_text','сотрудников'),(4627,269,'_sc4-list_0_text','field_60c85c0173ac4'),(4628,269,'sc4-list_1_num','160'),(4629,269,'_sc4-list_1_num','field_60c85bf773ac3'),(4630,269,'sc4-list_1_text','позиций'),(4631,269,'_sc4-list_1_text','field_60c85c0173ac4'),(4632,269,'sc4-list_2_num','20'),(4633,269,'_sc4-list_2_num','field_60c85bf773ac3'),(4634,269,'sc4-list_2_text','стран мира'),(4635,269,'_sc4-list_2_text','field_60c85c0173ac4'),(4636,269,'sc4-list','3'),(4637,269,'_sc4-list','field_60c85be773ac2'),(4638,269,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4639,269,'_sc4-text','field_60c85c0d73ac5'),(4640,269,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4641,269,'_sc5-ttl','field_60c85c2b73ac7'),(4642,269,'sc5-list','2'),(4643,269,'_sc5-list','field_60c85c6373ac8'),(4644,269,'sc6-text','ежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4645,269,'_sc6-text','field_60c85cad73acc'),(4646,269,'sc7-video',''),(4647,269,'_sc7-video','field_60c85cca73ace'),(4648,269,'sc7-text',''),(4649,269,'_sc7-text','field_60c85ce173acf'),(4650,269,'sc7-textborder',''),(4651,269,'_sc7-textborder','field_60c85cea73ad0'),(4652,269,'sc5-list_0_logo','262'),(4653,269,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4654,269,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4655,269,'_sc5-list_0_text','field_60c85c7e73aca'),(4656,269,'sc5-list_1_logo','264'),(4657,269,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4658,269,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4659,269,'_sc5-list_1_text','field_60c85c7e73aca'),(4660,269,'sc6-ttl','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>'),(4661,269,'_sc6-ttl','field_60c85f2f52aa8'),(4662,270,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4663,270,'_sc1-afterlogo','field_60c85338b3453'),(4664,270,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4665,270,'_sc1-left','field_60c85356b3454'),(4666,270,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4667,270,'_sc1-right','field_60c85408b3455'),(4668,270,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4669,270,'_sc2-ttl','field_60c8556cfdbcb'),(4670,270,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4671,270,'_sc2-round1','field_60c855a5fdbcc'),(4672,270,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4673,270,'_sc2-round2','field_60c855b6fdbcd'),(4674,270,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4675,270,'_sc2-mission','field_60c855bffdbce'),(4676,270,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4677,270,'_sc2-filosophy','field_60c855cafdbcf'),(4678,270,'sc3-ttl','Краткие факты о нашем производстве:'),(4679,270,'_sc3-ttl','field_60c85818d1bf2'),(4680,270,'sc3-list_0_icon','232'),(4681,270,'_sc3-list_0_icon','field_60c85834d1bf4'),(4682,270,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4683,270,'_sc3-list_0_text','field_60c85852d1bf5'),(4684,270,'sc3-list_1_icon','234'),(4685,270,'_sc3-list_1_icon','field_60c85834d1bf4'),(4686,270,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4687,270,'_sc3-list_1_text','field_60c85852d1bf5'),(4688,270,'sc3-list_2_icon','236'),(4689,270,'_sc3-list_2_icon','field_60c85834d1bf4'),(4690,270,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4691,270,'_sc3-list_2_text','field_60c85852d1bf5'),(4692,270,'sc3-list_3_icon','238'),(4693,270,'_sc3-list_3_icon','field_60c85834d1bf4'),(4694,270,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4695,270,'_sc3-list_3_text','field_60c85852d1bf5'),(4696,270,'sc3-list_4_icon','240'),(4697,270,'_sc3-list_4_icon','field_60c85834d1bf4'),(4698,270,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4699,270,'_sc3-list_4_text','field_60c85852d1bf5'),(4700,270,'sc3-list_5_icon','242'),(4701,270,'_sc3-list_5_icon','field_60c85834d1bf4'),(4702,270,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4703,270,'_sc3-list_5_text','field_60c85852d1bf5'),(4704,270,'sc3-list','6'),(4705,270,'_sc3-list','field_60c85827d1bf3'),(4706,270,'sc4-list_0_num','2500'),(4707,270,'_sc4-list_0_num','field_60c85bf773ac3'),(4708,270,'sc4-list_0_text','сотрудников'),(4709,270,'_sc4-list_0_text','field_60c85c0173ac4'),(4710,270,'sc4-list_1_num','160'),(4711,270,'_sc4-list_1_num','field_60c85bf773ac3'),(4712,270,'sc4-list_1_text','позиций'),(4713,270,'_sc4-list_1_text','field_60c85c0173ac4'),(4714,270,'sc4-list_2_num','20'),(4715,270,'_sc4-list_2_num','field_60c85bf773ac3'),(4716,270,'sc4-list_2_text','стран мира'),(4717,270,'_sc4-list_2_text','field_60c85c0173ac4'),(4718,270,'sc4-list','3'),(4719,270,'_sc4-list','field_60c85be773ac2'),(4720,270,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4721,270,'_sc4-text','field_60c85c0d73ac5'),(4722,270,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4723,270,'_sc5-ttl','field_60c85c2b73ac7'),(4724,270,'sc5-list','2'),(4725,270,'_sc5-list','field_60c85c6373ac8'),(4726,270,'sc6-text','ежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4727,270,'_sc6-text','field_60c85cad73acc'),(4728,270,'sc7-video',''),(4729,270,'_sc7-video','field_60c85cca73ace'),(4730,270,'sc7-text',''),(4731,270,'_sc7-text','field_60c85ce173acf'),(4732,270,'sc7-textborder',''),(4733,270,'_sc7-textborder','field_60c85cea73ad0'),(4734,270,'sc5-list_0_logo','262'),(4735,270,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4736,270,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4737,270,'_sc5-list_0_text','field_60c85c7e73aca'),(4738,270,'sc5-list_1_logo','264'),(4739,270,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4740,270,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4741,270,'_sc5-list_1_text','field_60c85c7e73aca'),(4742,270,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(4743,270,'_sc6-ttl','field_60c85f2f52aa8'),(4744,271,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4745,271,'_sc1-afterlogo','field_60c85338b3453'),(4746,271,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4747,271,'_sc1-left','field_60c85356b3454'),(4748,271,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4749,271,'_sc1-right','field_60c85408b3455'),(4750,271,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4751,271,'_sc2-ttl','field_60c8556cfdbcb'),(4752,271,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4753,271,'_sc2-round1','field_60c855a5fdbcc'),(4754,271,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4755,271,'_sc2-round2','field_60c855b6fdbcd'),(4756,271,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4757,271,'_sc2-mission','field_60c855bffdbce'),(4758,271,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4759,271,'_sc2-filosophy','field_60c855cafdbcf'),(4760,271,'sc3-ttl','Краткие факты о нашем производстве:'),(4761,271,'_sc3-ttl','field_60c85818d1bf2'),(4762,271,'sc3-list_0_icon','232'),(4763,271,'_sc3-list_0_icon','field_60c85834d1bf4'),(4764,271,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4765,271,'_sc3-list_0_text','field_60c85852d1bf5'),(4766,271,'sc3-list_1_icon','234'),(4767,271,'_sc3-list_1_icon','field_60c85834d1bf4'),(4768,271,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4769,271,'_sc3-list_1_text','field_60c85852d1bf5'),(4770,271,'sc3-list_2_icon','236'),(4771,271,'_sc3-list_2_icon','field_60c85834d1bf4'),(4772,271,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4773,271,'_sc3-list_2_text','field_60c85852d1bf5'),(4774,271,'sc3-list_3_icon','238'),(4775,271,'_sc3-list_3_icon','field_60c85834d1bf4'),(4776,271,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4777,271,'_sc3-list_3_text','field_60c85852d1bf5'),(4778,271,'sc3-list_4_icon','240'),(4779,271,'_sc3-list_4_icon','field_60c85834d1bf4'),(4780,271,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4781,271,'_sc3-list_4_text','field_60c85852d1bf5'),(4782,271,'sc3-list_5_icon','242'),(4783,271,'_sc3-list_5_icon','field_60c85834d1bf4'),(4784,271,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4785,271,'_sc3-list_5_text','field_60c85852d1bf5'),(4786,271,'sc3-list','6'),(4787,271,'_sc3-list','field_60c85827d1bf3'),(4788,271,'sc4-list_0_num','2500'),(4789,271,'_sc4-list_0_num','field_60c85bf773ac3'),(4790,271,'sc4-list_0_text','сотрудников'),(4791,271,'_sc4-list_0_text','field_60c85c0173ac4'),(4792,271,'sc4-list_1_num','160'),(4793,271,'_sc4-list_1_num','field_60c85bf773ac3'),(4794,271,'sc4-list_1_text','позиций'),(4795,271,'_sc4-list_1_text','field_60c85c0173ac4'),(4796,271,'sc4-list_2_num','20'),(4797,271,'_sc4-list_2_num','field_60c85bf773ac3'),(4798,271,'sc4-list_2_text','стран мира'),(4799,271,'_sc4-list_2_text','field_60c85c0173ac4'),(4800,271,'sc4-list','3'),(4801,271,'_sc4-list','field_60c85be773ac2'),(4802,271,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4803,271,'_sc4-text','field_60c85c0d73ac5'),(4804,271,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4805,271,'_sc5-ttl','field_60c85c2b73ac7'),(4806,271,'sc5-list','2'),(4807,271,'_sc5-list','field_60c85c6373ac8'),(4808,271,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4809,271,'_sc6-text','field_60c85cad73acc'),(4810,271,'sc7-video',''),(4811,271,'_sc7-video','field_60c85cca73ace'),(4812,271,'sc7-text',''),(4813,271,'_sc7-text','field_60c85ce173acf'),(4814,271,'sc7-textborder',''),(4815,271,'_sc7-textborder','field_60c85cea73ad0'),(4816,271,'sc5-list_0_logo','262'),(4817,271,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4818,271,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4819,271,'_sc5-list_0_text','field_60c85c7e73aca'),(4820,271,'sc5-list_1_logo','264'),(4821,271,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4822,271,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4823,271,'_sc5-list_1_text','field_60c85c7e73aca'),(4824,271,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(4825,271,'_sc6-ttl','field_60c85f2f52aa8'),(4826,272,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4827,272,'_sc1-afterlogo','field_60c85338b3453'),(4828,272,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4829,272,'_sc1-left','field_60c85356b3454'),(4830,272,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4831,272,'_sc1-right','field_60c85408b3455'),(4832,272,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4833,272,'_sc2-ttl','field_60c8556cfdbcb'),(4834,272,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4835,272,'_sc2-round1','field_60c855a5fdbcc'),(4836,272,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4837,272,'_sc2-round2','field_60c855b6fdbcd'),(4838,272,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4839,272,'_sc2-mission','field_60c855bffdbce'),(4840,272,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4841,272,'_sc2-filosophy','field_60c855cafdbcf'),(4842,272,'sc3-ttl','Краткие факты о нашем производстве:'),(4843,272,'_sc3-ttl','field_60c85818d1bf2'),(4844,272,'sc3-list_0_icon','232'),(4845,272,'_sc3-list_0_icon','field_60c85834d1bf4'),(4846,272,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4847,272,'_sc3-list_0_text','field_60c85852d1bf5'),(4848,272,'sc3-list_1_icon','234'),(4849,272,'_sc3-list_1_icon','field_60c85834d1bf4'),(4850,272,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4851,272,'_sc3-list_1_text','field_60c85852d1bf5'),(4852,272,'sc3-list_2_icon','236'),(4853,272,'_sc3-list_2_icon','field_60c85834d1bf4'),(4854,272,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4855,272,'_sc3-list_2_text','field_60c85852d1bf5'),(4856,272,'sc3-list_3_icon','238'),(4857,272,'_sc3-list_3_icon','field_60c85834d1bf4'),(4858,272,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4859,272,'_sc3-list_3_text','field_60c85852d1bf5'),(4860,272,'sc3-list_4_icon','240'),(4861,272,'_sc3-list_4_icon','field_60c85834d1bf4'),(4862,272,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4863,272,'_sc3-list_4_text','field_60c85852d1bf5'),(4864,272,'sc3-list_5_icon','242'),(4865,272,'_sc3-list_5_icon','field_60c85834d1bf4'),(4866,272,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4867,272,'_sc3-list_5_text','field_60c85852d1bf5'),(4868,272,'sc3-list','6'),(4869,272,'_sc3-list','field_60c85827d1bf3'),(4870,272,'sc4-list_0_num','2500'),(4871,272,'_sc4-list_0_num','field_60c85bf773ac3'),(4872,272,'sc4-list_0_text','сотрудников'),(4873,272,'_sc4-list_0_text','field_60c85c0173ac4'),(4874,272,'sc4-list_1_num','160'),(4875,272,'_sc4-list_1_num','field_60c85bf773ac3'),(4876,272,'sc4-list_1_text','позиций'),(4877,272,'_sc4-list_1_text','field_60c85c0173ac4'),(4878,272,'sc4-list_2_num','20'),(4879,272,'_sc4-list_2_num','field_60c85bf773ac3'),(4880,272,'sc4-list_2_text','стран мира'),(4881,272,'_sc4-list_2_text','field_60c85c0173ac4'),(4882,272,'sc4-list','3'),(4883,272,'_sc4-list','field_60c85be773ac2'),(4884,272,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4885,272,'_sc4-text','field_60c85c0d73ac5'),(4886,272,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4887,272,'_sc5-ttl','field_60c85c2b73ac7'),(4888,272,'sc5-list','2'),(4889,272,'_sc5-list','field_60c85c6373ac8'),(4890,272,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4891,272,'_sc6-text','field_60c85cad73acc'),(4892,272,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(4893,272,'_sc7-video','field_60c85cca73ace'),(4894,272,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(4895,272,'_sc7-text','field_60c85ce173acf'),(4896,272,'sc7-textborder','Жизнь – главная земная ценность. \r\nМы призваны сохранять и улучшать ее!'),(4897,272,'_sc7-textborder','field_60c85cea73ad0'),(4898,272,'sc5-list_0_logo','262'),(4899,272,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4900,272,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4901,272,'_sc5-list_0_text','field_60c85c7e73aca'),(4902,272,'sc5-list_1_logo','264'),(4903,272,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4904,272,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4905,272,'_sc5-list_1_text','field_60c85c7e73aca'),(4906,272,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(4907,272,'_sc6-ttl','field_60c85f2f52aa8'),(4908,178,'sc7-ttl','Больше о нас в коротком видео:'),(4909,178,'_sc7-ttl','field_60c860b4429a2'),(4910,275,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(4911,275,'_sc1-afterlogo','field_60c85338b3453'),(4912,275,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(4913,275,'_sc1-left','field_60c85356b3454'),(4914,275,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(4915,275,'_sc1-right','field_60c85408b3455'),(4916,275,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(4917,275,'_sc2-ttl','field_60c8556cfdbcb'),(4918,275,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(4919,275,'_sc2-round1','field_60c855a5fdbcc'),(4920,275,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(4921,275,'_sc2-round2','field_60c855b6fdbcd'),(4922,275,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(4923,275,'_sc2-mission','field_60c855bffdbce'),(4924,275,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(4925,275,'_sc2-filosophy','field_60c855cafdbcf'),(4926,275,'sc3-ttl','Краткие факты о нашем производстве:'),(4927,275,'_sc3-ttl','field_60c85818d1bf2'),(4928,275,'sc3-list_0_icon','232'),(4929,275,'_sc3-list_0_icon','field_60c85834d1bf4'),(4930,275,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(4931,275,'_sc3-list_0_text','field_60c85852d1bf5'),(4932,275,'sc3-list_1_icon','234'),(4933,275,'_sc3-list_1_icon','field_60c85834d1bf4'),(4934,275,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(4935,275,'_sc3-list_1_text','field_60c85852d1bf5'),(4936,275,'sc3-list_2_icon','236'),(4937,275,'_sc3-list_2_icon','field_60c85834d1bf4'),(4938,275,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(4939,275,'_sc3-list_2_text','field_60c85852d1bf5'),(4940,275,'sc3-list_3_icon','238'),(4941,275,'_sc3-list_3_icon','field_60c85834d1bf4'),(4942,275,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(4943,275,'_sc3-list_3_text','field_60c85852d1bf5'),(4944,275,'sc3-list_4_icon','240'),(4945,275,'_sc3-list_4_icon','field_60c85834d1bf4'),(4946,275,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(4947,275,'_sc3-list_4_text','field_60c85852d1bf5'),(4948,275,'sc3-list_5_icon','242'),(4949,275,'_sc3-list_5_icon','field_60c85834d1bf4'),(4950,275,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(4951,275,'_sc3-list_5_text','field_60c85852d1bf5'),(4952,275,'sc3-list','6'),(4953,275,'_sc3-list','field_60c85827d1bf3'),(4954,275,'sc4-list_0_num','2500'),(4955,275,'_sc4-list_0_num','field_60c85bf773ac3'),(4956,275,'sc4-list_0_text','сотрудников'),(4957,275,'_sc4-list_0_text','field_60c85c0173ac4'),(4958,275,'sc4-list_1_num','160'),(4959,275,'_sc4-list_1_num','field_60c85bf773ac3'),(4960,275,'sc4-list_1_text','позиций'),(4961,275,'_sc4-list_1_text','field_60c85c0173ac4'),(4962,275,'sc4-list_2_num','20'),(4963,275,'_sc4-list_2_num','field_60c85bf773ac3'),(4964,275,'sc4-list_2_text','стран мира'),(4965,275,'_sc4-list_2_text','field_60c85c0173ac4'),(4966,275,'sc4-list','3'),(4967,275,'_sc4-list','field_60c85be773ac2'),(4968,275,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(4969,275,'_sc4-text','field_60c85c0d73ac5'),(4970,275,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(4971,275,'_sc5-ttl','field_60c85c2b73ac7'),(4972,275,'sc5-list','2'),(4973,275,'_sc5-list','field_60c85c6373ac8'),(4974,275,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(4975,275,'_sc6-text','field_60c85cad73acc'),(4976,275,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(4977,275,'_sc7-video','field_60c85cca73ace'),(4978,275,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(4979,275,'_sc7-text','field_60c85ce173acf'),(4980,275,'sc7-textborder','Жизнь – главная земная ценность. \r\nМы призваны сохранять и улучшать ее!'),(4981,275,'_sc7-textborder','field_60c85cea73ad0'),(4982,275,'sc5-list_0_logo','262'),(4983,275,'_sc5-list_0_logo','field_60c85c6f73ac9'),(4984,275,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(4985,275,'_sc5-list_0_text','field_60c85c7e73aca'),(4986,275,'sc5-list_1_logo','264'),(4987,275,'_sc5-list_1_logo','field_60c85c6f73ac9'),(4988,275,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(4989,275,'_sc5-list_1_text','field_60c85c7e73aca'),(4990,275,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(4991,275,'_sc6-ttl','field_60c85f2f52aa8'),(4992,275,'sc7-ttl','Больше о нас в коротком видео:'),(4993,275,'_sc7-ttl','field_60c860b4429a2'),(5152,276,'sc6-text','<h2>Більш\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nодиниць продукції</h2>\r\nщорічно забезпечують десятки тисяч лікарів ефективними засобами для лікування та оздоровлення людей. Щоб бути ближче до них ми створили власну службу дистрибуції. Щодня зі складів по всій Україні відправляються тисячі тонн інфузійних препаратів і виробів медичного призначення, дозволяє лікарям рятувати сотні тисяч життів.'),(5151,276,'_sc5-list','field_60c85c6373ac8'),(5149,276,'_sc5-ttl','field_60c85c2b73ac7'),(5150,276,'sc5-list','2'),(5147,276,'_sc4-text','field_60c85c0d73ac5'),(5148,276,'sc5-ttl','Міжнародні сертифікати, \r\nякі гарантують якість \r\nнашої продукції:'),(5144,276,'sc4-list','3'),(5145,276,'_sc4-list','field_60c85be773ac2'),(5146,276,'sc4-text','Щоденна праця <strong>2500 співробітників</strong> дозволяє виробляти і постачати продукцію, асортиментом понад <strong>160 позицій</strong>, лікувально-профілактичним закладам більш ніж у <strong>20 країнах світу</strong>. Це оригінальні інфузійні препарати власної розробки, антибіотики, фунгіцидні препарати, розчини для пиття, антисептики, препарати для парентерального харчування, протитуберкульозні препарати, шприци, системи для інфузій і багато іншого.'),(5143,276,'_sc4-list_2_text','field_60c85c0173ac4'),(5140,276,'sc4-list_2_num','20'),(5141,276,'_sc4-list_2_num','field_60c85bf773ac3'),(5142,276,'sc4-list_2_text','країн світу'),(5139,276,'_sc4-list_1_text','field_60c85c0173ac4'),(5138,276,'sc4-list_1_text','позицій'),(5135,276,'_sc4-list_0_text','field_60c85c0173ac4'),(5136,276,'sc4-list_1_num','160'),(5137,276,'_sc4-list_1_num','field_60c85bf773ac3'),(5134,276,'sc4-list_0_text','співробітників'),(5133,276,'_sc4-list_0_num','field_60c85bf773ac3'),(5130,276,'sc3-list','6'),(5131,276,'_sc3-list','field_60c85827d1bf3'),(5132,276,'sc4-list_0_num','2500'),(5129,276,'_sc3-list_5_text','field_60c85852d1bf5'),(5128,276,'sc3-list_5_text','<h3>виробів медичного призначення -\r\n<strong>більше <i class=\"counter-value\">86</i> млн</strong></h3>'),(5127,276,'_sc3-list_5_icon','field_60c85834d1bf4'),(5126,276,'sc3-list_5_icon','242'),(5125,276,'_sc3-list_4_text','field_60c85852d1bf5'),(5124,276,'sc3-list_4_text','<h3>виробничі потужності:\r\n<strong>більше <i class=\"counter-value\">290</i> млн</strong>\r\nодиниць продукції на рік</h3>'),(5123,276,'_sc3-list_4_icon','field_60c85834d1bf4'),(5114,276,'sc3-list_2_icon','236'),(5115,276,'_sc3-list_2_icon','field_60c85834d1bf4'),(5116,276,'sc3-list_2_text','<h3>лікарських засобів -\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(5117,276,'_sc3-list_2_text','field_60c85852d1bf5'),(5118,276,'sc3-list_3_icon','238'),(5119,276,'_sc3-list_3_icon','field_60c85834d1bf4'),(5120,276,'sc3-list_3_text','<h3>виробничі площі:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(5121,276,'_sc3-list_3_text','field_60c85852d1bf5'),(5122,276,'sc3-list_4_icon','240'),(5113,276,'_sc3-list_1_text','field_60c85852d1bf5'),(5112,276,'sc3-list_1_text','<h3>виробничих ліній:\r\n<strong class=\"counter-value\">41</strong></h3>'),(5111,276,'_sc3-list_1_icon','field_60c85834d1bf4'),(5110,276,'sc3-list_1_icon','234'),(5103,276,'_sc2-filosophy','field_60c855cafdbcf'),(5104,276,'sc3-ttl','Короткі факти про наше виробництво:'),(5105,276,'_sc3-ttl','field_60c85818d1bf2'),(5106,276,'sc3-list_0_icon','232'),(5107,276,'_sc3-list_0_icon','field_60c85834d1bf4'),(5108,276,'sc3-list_0_text','<h3>зосереджено в\r\n<strong>м. Черкаси </strong></h3>'),(5109,276,'_sc3-list_0_text','field_60c85852d1bf5'),(5101,276,'_sc2-mission','field_60c855bffdbce'),(5102,276,'sc2-filosophy','<strong>Наша філософія</strong>\r\nЖиття - головна земна цінність.\r\nМи покликані зберігати і покращувати його!'),(5100,276,'sc2-mission','<strong>Наша місія</strong> –\r\nстворювати унікальні рішення\r\nдля оздоровлення та лікування людей.'),(5097,276,'_sc2-round1','field_60c855a5fdbcc'),(5098,276,'sc2-round2','<h3>ТОП-10</h3>\r\nлідерів фармацевтичного\r\nринку України'),(5099,276,'_sc2-round2','field_60c855b6fdbcd'),(5095,276,'_sc2-ttl','field_60c8556cfdbcb'),(5096,276,'sc2-round1','<h3>TOП-3</h3>\r\nнайбільших вітчизняних\r\nфармацевтичних\r\nвиробників'),(5094,276,'sc2-ttl','Корпорація «Юрія-Фарм» входить до:'),(5092,276,'sc1-right','лідер госпітальних \r\nпродажів в Україні'),(5093,276,'_sc1-right','field_60c85408b3455'),(5091,276,'_sc1-left','field_60c85356b3454'),(5287,289,'sc1-afterlogo','Міжнародна спеціалізована \r\nфармацевтична корпорація:'),(5089,276,'_sc1-afterlogo','field_60c85338b3453'),(5090,276,'sc1-left','визнаний лідер ринку \r\nвнутрішньсудинних препаратів'),(5088,276,'sc1-afterlogo','Міжнародна спеціалізована \r\nфармацевтична корпорація:'),(5087,276,'_wpml_media_duplicate','1'),(5086,276,'_wpml_media_featured','1'),(5085,276,'_yoast_wpseo_estimated-reading-time-minutes',''),(5173,276,'_edit_last','1'),(5157,276,'_sc7-text','field_60c85ce173acf'),(5158,276,'sc7-textborder','Життя - головна земна цінність.\r\nМи покликані зберігати і покращувати її!'),(5159,276,'_sc7-textborder','field_60c85cea73ad0'),(5160,276,'sc5-list_0_logo','262'),(5161,276,'_sc5-list_0_logo','field_60c85c6f73ac9'),(5162,276,'sc5-list_0_text','GMP України, GMP EU, GMP Кенія - \r\nналежна виробнича \r\nпрактика'),(5163,276,'_sc5-list_0_text','field_60c85c7e73aca'),(5164,276,'sc5-list_1_logo','264'),(5165,276,'_sc5-list_1_logo','field_60c85c6f73ac9'),(5166,276,'sc5-list_1_text','ISO 9001: 2009 - \r\nвиробництво та оптовий \r\nпродаж фармацевтичної \r\nпродукції'),(5167,276,'_sc5-list_1_text','field_60c85c7e73aca'),(5168,276,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(5169,276,'_sc6-ttl','field_60c85f2f52aa8'),(5170,276,'sc7-ttl','Більше про нас в короткому відео:'),(5171,276,'_sc7-ttl','field_60c860b4429a2'),(5172,276,'_edit_lock','1623746577:1'),(5174,279,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(5175,279,'_sc1-afterlogo','field_60c85338b3453'),(5176,279,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(5177,279,'_sc1-left','field_60c85356b3454'),(5178,279,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(5179,279,'_sc1-right','field_60c85408b3455'),(5180,279,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(5181,279,'_sc2-ttl','field_60c8556cfdbcb'),(5182,279,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(5183,279,'_sc2-round1','field_60c855a5fdbcc'),(5184,279,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(5185,279,'_sc2-round2','field_60c855b6fdbcd'),(5186,279,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(5187,279,'_sc2-mission','field_60c855bffdbce'),(5188,279,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(5189,279,'_sc2-filosophy','field_60c855cafdbcf'),(5190,279,'sc3-ttl','Краткие факты о нашем производстве:'),(5191,279,'_sc3-ttl','field_60c85818d1bf2'),(5192,279,'sc3-list_0_icon','232'),(5193,279,'_sc3-list_0_icon','field_60c85834d1bf4'),(5194,279,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(5195,279,'_sc3-list_0_text','field_60c85852d1bf5'),(5196,279,'sc3-list_1_icon','234'),(5197,279,'_sc3-list_1_icon','field_60c85834d1bf4'),(5198,279,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(5199,279,'_sc3-list_1_text','field_60c85852d1bf5'),(5200,279,'sc3-list_2_icon','236'),(5201,279,'_sc3-list_2_icon','field_60c85834d1bf4'),(5202,279,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(5203,279,'_sc3-list_2_text','field_60c85852d1bf5'),(5204,279,'sc3-list_3_icon','238'),(5205,279,'_sc3-list_3_icon','field_60c85834d1bf4'),(5206,279,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(5207,279,'_sc3-list_3_text','field_60c85852d1bf5'),(5208,279,'sc3-list_4_icon','240'),(5209,279,'_sc3-list_4_icon','field_60c85834d1bf4'),(5210,279,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(5211,279,'_sc3-list_4_text','field_60c85852d1bf5'),(5212,279,'sc3-list_5_icon','242'),(5213,279,'_sc3-list_5_icon','field_60c85834d1bf4'),(5214,279,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(5215,279,'_sc3-list_5_text','field_60c85852d1bf5'),(5216,279,'sc3-list','6'),(5217,279,'_sc3-list','field_60c85827d1bf3'),(5218,279,'sc4-list_0_num','2500'),(5219,279,'_sc4-list_0_num','field_60c85bf773ac3'),(5220,279,'sc4-list_0_text','сотрудников'),(5221,279,'_sc4-list_0_text','field_60c85c0173ac4'),(5222,279,'sc4-list_1_num','160'),(5223,279,'_sc4-list_1_num','field_60c85bf773ac3'),(5224,279,'sc4-list_1_text','позиций'),(5225,279,'_sc4-list_1_text','field_60c85c0173ac4'),(5226,279,'sc4-list_2_num','20'),(5227,279,'_sc4-list_2_num','field_60c85bf773ac3'),(5228,279,'sc4-list_2_text','стран мира'),(5229,279,'_sc4-list_2_text','field_60c85c0173ac4'),(5230,279,'sc4-list','3'),(5231,279,'_sc4-list','field_60c85be773ac2'),(5232,279,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(5233,279,'_sc4-text','field_60c85c0d73ac5'),(5234,279,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(5235,279,'_sc5-ttl','field_60c85c2b73ac7'),(5236,279,'sc5-list','2'),(5237,279,'_sc5-list','field_60c85c6373ac8'),(5238,279,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(5239,279,'_sc6-text','field_60c85cad73acc'),(5240,279,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(5241,279,'_sc7-video','field_60c85cca73ace'),(5242,279,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(5243,279,'_sc7-text','field_60c85ce173acf'),(5244,279,'sc7-textborder','Жизнь – главная земная ценность. \r\nМы призваны сохранять и улучшать ее!'),(5245,279,'_sc7-textborder','field_60c85cea73ad0'),(5246,279,'sc5-list_0_logo','262'),(5247,279,'_sc5-list_0_logo','field_60c85c6f73ac9'),(5248,279,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(5249,279,'_sc5-list_0_text','field_60c85c7e73aca'),(5250,279,'sc5-list_1_logo','264'),(5251,279,'_sc5-list_1_logo','field_60c85c6f73ac9'),(5252,279,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(5253,279,'_sc5-list_1_text','field_60c85c7e73aca'),(5254,279,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(5255,279,'_sc6-ttl','field_60c85f2f52aa8'),(5256,279,'sc7-ttl','Больше о нас в коротком видео:'),(5257,279,'_sc7-ttl','field_60c860b4429a2'),(5258,281,'_menu_item_type','post_type'),(5259,281,'_menu_item_menu_item_parent','0'),(5260,281,'_menu_item_object_id','276'),(5261,281,'_menu_item_object','page'),(5262,281,'_menu_item_target',''),(5263,281,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(5264,281,'_menu_item_xfn',''),(5265,281,'_menu_item_url',''),(5270,18,'_wp_old_date','2021-06-08'),(5267,14,'_wp_old_date','2021-06-08'),(5268,15,'_wp_old_date','2021-06-08'),(7138,747,'_yoast_wpseo_content_score','90'),(5410,5,'_wp_old_slug','%d0%ba%d0%be%d0%bd%d1%82%d0%b0%d0%ba%d1%82%d0%bd%d0%b0%d1%8f-%d1%84%d0%be%d1%80%d0%bc%d0%b0-1'),(5272,282,'_edit_last','1'),(5273,282,'_wp_page_template','page-order.php'),(5274,282,'_yoast_wpseo_estimated-reading-time-minutes',''),(5275,282,'_wpml_media_duplicate','1'),(5276,282,'_wpml_media_featured','1'),(5277,282,'_edit_lock','1657792209:1'),(5281,284,'_yoast_wpseo_estimated-reading-time-minutes',''),(5280,284,'_wp_page_template','page-order.php'),(5282,284,'_wpml_media_duplicate','1'),(5283,284,'_wpml_media_featured','1'),(5286,284,'_edit_last','1'),(5285,284,'_edit_lock','1656335176:1'),(5288,289,'_sc1-afterlogo','field_60c85338b3453'),(5289,289,'sc1-left','визнаний лідер ринку \r\nвнутрішньсудинних препаратів'),(5290,289,'_sc1-left','field_60c85356b3454'),(5291,289,'sc1-right','лідер госпітальних \r\nпродажів в Україні'),(5292,289,'_sc1-right','field_60c85408b3455'),(5293,289,'sc2-ttl','Корпорація «Юрія-Фарм» входить до:'),(5294,289,'_sc2-ttl','field_60c8556cfdbcb'),(5295,289,'sc2-round1','<h3>TOП-3</h3>\r\nнайбільших вітчизняних\r\nфармацевтичних\r\nвиробників'),(5296,289,'_sc2-round1','field_60c855a5fdbcc'),(5297,289,'sc2-round2','<h3>ТОП-10</h3>\r\nлідерів фармацевтичного\r\nринку України'),(5298,289,'_sc2-round2','field_60c855b6fdbcd'),(5299,289,'sc2-mission','<strong>Наша місія</strong> –\r\nстворювати унікальні рішення\r\nдля оздоровлення та лікування людей.'),(5300,289,'_sc2-mission','field_60c855bffdbce'),(5301,289,'sc2-filosophy','<strong>Наша філософія</strong>\r\nЖиття - головна земна цінність.\r\nМи покликані зберігати і покращувати його!'),(5302,289,'_sc2-filosophy','field_60c855cafdbcf'),(5303,289,'sc3-ttl','Короткі факти про наше виробництво:'),(5304,289,'_sc3-ttl','field_60c85818d1bf2'),(5305,289,'sc3-list_0_icon','232'),(5306,289,'_sc3-list_0_icon','field_60c85834d1bf4'),(5307,289,'sc3-list_0_text','<h3>зосереджено в\r\n<strong>м. Черкаси </strong></h3>'),(5308,289,'_sc3-list_0_text','field_60c85852d1bf5'),(5309,289,'sc3-list_1_icon','234'),(5310,289,'_sc3-list_1_icon','field_60c85834d1bf4'),(5311,289,'sc3-list_1_text','<h3>виробничих ліній:\r\n<strong class=\"counter-value\">41</strong></h3>'),(5312,289,'_sc3-list_1_text','field_60c85852d1bf5'),(5313,289,'sc3-list_2_icon','236'),(5314,289,'_sc3-list_2_icon','field_60c85834d1bf4'),(5315,289,'sc3-list_2_text','<h3>лікарських засобів -\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(5316,289,'_sc3-list_2_text','field_60c85852d1bf5'),(5317,289,'sc3-list_3_icon','238'),(5318,289,'_sc3-list_3_icon','field_60c85834d1bf4'),(5319,289,'sc3-list_3_text','<h3>виробничі площі:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(5320,289,'_sc3-list_3_text','field_60c85852d1bf5'),(5321,289,'sc3-list_4_icon','240'),(5322,289,'_sc3-list_4_icon','field_60c85834d1bf4'),(5323,289,'sc3-list_4_text','<h3>виробничі потужності:\r\n<strong>більше <i class=\"counter-value\">290</i> млн</strong>\r\nодиниць продукції на рік</h3>'),(5324,289,'_sc3-list_4_text','field_60c85852d1bf5'),(5325,289,'sc3-list_5_icon','242'),(5326,289,'_sc3-list_5_icon','field_60c85834d1bf4'),(5327,289,'sc3-list_5_text','<h3>виробів медичного призначення -\r\n<strong>більше <i class=\"counter-value\">86</i> млн</strong></h3>'),(5328,289,'_sc3-list_5_text','field_60c85852d1bf5'),(5329,289,'sc3-list','6'),(5330,289,'_sc3-list','field_60c85827d1bf3'),(5331,289,'sc4-list_0_num','2500'),(5332,289,'_sc4-list_0_num','field_60c85bf773ac3'),(5333,289,'sc4-list_0_text','співробітників'),(5334,289,'_sc4-list_0_text','field_60c85c0173ac4'),(5335,289,'sc4-list_1_num','160'),(5336,289,'_sc4-list_1_num','field_60c85bf773ac3'),(5337,289,'sc4-list_1_text','позицій'),(5338,289,'_sc4-list_1_text','field_60c85c0173ac4'),(5339,289,'sc4-list_2_num','20'),(5340,289,'_sc4-list_2_num','field_60c85bf773ac3'),(5341,289,'sc4-list_2_text','країн світу'),(5342,289,'_sc4-list_2_text','field_60c85c0173ac4'),(5343,289,'sc4-list','3'),(5344,289,'_sc4-list','field_60c85be773ac2'),(5345,289,'sc4-text','Щоденна праця <strong>2500 співробітників</strong> дозволяє виробляти і постачати продукцію, асортиментом понад <strong>160 позицій</strong>, лікувально-профілактичним закладам більш ніж у <strong>20 країнах світу</strong>. Це оригінальні інфузійні препарати власної розробки, антибіотики, фунгіцидні препарати, розчини для пиття, антисептики, препарати для парентерального харчування, протитуберкульозні препарати, шприци, системи для інфузій і багато іншого.'),(5346,289,'_sc4-text','field_60c85c0d73ac5'),(5347,289,'sc5-ttl','Міжнародні сертифікати, \r\nякі гарантують якість \r\nнашої продукції:'),(5348,289,'_sc5-ttl','field_60c85c2b73ac7'),(5349,289,'sc5-list','2'),(5350,289,'_sc5-list','field_60c85c6373ac8'),(5351,289,'sc6-text','<h2>Більш\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nодиниць продукції</h2>\r\nщорічно забезпечують десятки тисяч лікарів ефективними засобами для лікування та оздоровлення людей. Щоб бути ближче до них ми створили власну службу дистрибуції. Щодня зі складів по всій Україні відправляються тисячі тонн інфузійних препаратів і виробів медичного призначення, дозволяє лікарям рятувати сотні тисяч життів.'),(5352,289,'_sc6-text','field_60c85cad73acc'),(5353,289,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(5354,289,'_sc7-video','field_60c85cca73ace'),(5355,289,'sc7-text','Використовуючи світовий досвід виробництва інфузійних розчинів, ми працюємо над розробкою, впровадженням у виробництво і втіленням наших ідей для лікування і поліпшення якості життя хворих людей.'),(5356,289,'_sc7-text','field_60c85ce173acf'),(5357,289,'sc7-textborder','Життя - головна земна цінність.\r\nМи покликані зберігати і покращувати її!'),(5358,289,'_sc7-textborder','field_60c85cea73ad0'),(5359,289,'sc5-list_0_logo','262'),(5360,289,'_sc5-list_0_logo','field_60c85c6f73ac9'),(5361,289,'sc5-list_0_text','GMP України, GMP EU, GMP Кенія - \r\nналежна виробнича \r\nпрактика'),(5362,289,'_sc5-list_0_text','field_60c85c7e73aca'),(5363,289,'sc5-list_1_logo','264'),(5364,289,'_sc5-list_1_logo','field_60c85c6f73ac9'),(5365,289,'sc5-list_1_text','ISO 9001: 2009 - \r\nвиробництво та оптовий \r\nпродаж фармацевтичної \r\nпродукції'),(5366,289,'_sc5-list_1_text','field_60c85c7e73aca'),(5367,289,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(5368,289,'_sc6-ttl','field_60c85f2f52aa8'),(5369,289,'sc7-ttl','Більше про нас в короткому відео:'),(5370,289,'_sc7-ttl','field_60c860b4429a2'),(5371,290,'_edit_last','1'),(5372,290,'_wpml_media_featured','1'),(5373,290,'_wpml_media_duplicate','1'),(5374,290,'_edit_lock','1663252679:1'),(5375,290,'_wp_page_template','default'),(5376,290,'_yoast_wpseo_content_score','30'),(5377,290,'_yoast_wpseo_estimated-reading-time-minutes','15'),(5382,293,'_wpml_media_duplicate','1'),(5381,293,'_wpml_media_featured','1'),(5380,293,'_wp_page_template','default'),(5383,293,'_yoast_wpseo_content_score','30'),(5384,293,'_yoast_wpseo_estimated-reading-time-minutes','15'),(5387,293,'_edit_last','1'),(5386,293,'_edit_lock','1663255211:1'),(7129,752,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(7113,747,'_yoast_wpseo_estimated-reading-time-minutes','1'),(7110,747,'_wpml_media_duplicate','1'),(7109,747,'_wpml_media_featured','1'),(5394,301,'_edit_last','1'),(5395,301,'_wpml_media_featured','1'),(5396,301,'_wpml_media_duplicate','1'),(5397,301,'_edit_lock','1630410991:1'),(5398,301,'_wp_page_template','page-contacts.php'),(5399,301,'_yoast_wpseo_estimated-reading-time-minutes','1'),(5400,301,'_yoast_wpseo_content_score','60'),(5401,305,'_menu_item_type','post_type'),(5402,305,'_menu_item_menu_item_parent','0'),(5403,305,'_menu_item_object_id','301'),(5404,305,'_menu_item_object','page'),(5405,305,'_menu_item_target',''),(5406,305,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(5407,305,'_menu_item_xfn',''),(5408,305,'_menu_item_url',''),(5436,313,'_form','<div class=\"row align-center order-header\">\n<div class=\"col-md-4 col-sm-4 col-xs-4\">\n<p>Цена <span>(за единицу)</span></p>\n</div>\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Количество</p></div>\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Сумма</p></div>\n</div>\n<div class=\"row body-order text-center\">\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"price\" data-price=\"47\"></p></div>\n<div class=\"col-md-4 col-sm-4 col-xs-4 flex-center\">\n<div class=\"number-input\">\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepDown()\" id=\"minus\" class=\"minus\"></button>\n[number products class:quantity class:form_ajax_js id:quantity min:1 \"1\"]\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepUp()\" id=\"plus\" class=\"plus\"></button>\n<input type=\"hidden\" id=\"hidden_sum_js\" name=\"appbundle_order[sum]\" class=\"form_ajax_js\" value=\"90\">\n</div>\n</div>\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"total-price\"></p></div>\n<div class=\"col-md-12\"><p class=\"align-center\">В одной упаковке 12 бутылок</p>\n</div>\n</div>\n<div class=\"row\">\n<div class=\"col-md-6\" style=\"z-index: 999;\">\n<div class=\"form-group\">[tel* tel class:form-control class:phone-select placeholder \"Контактный телефон*\"]</div>\n</div>\n<div class=\"col-md-6\">\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Имя*\"]</div>\n</div>\n<div class=\"col-md-6\" style=\"z-index: 999;\">\n<div class=\"form-group\">[email* email class:form-control placeholder \"Email*\"]</div>\n</div>\n<div class=\"col-md-6\">\n<div class=\"form-group\">[text* adress class:form-control placeholder \"Адреса доставки*\"]</div>\n</div>\n</div>\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я соглашаюсь с <a href=\"/ru/terms-of-use/\" target=\"_blank\">Политикой конфиденциальности</a>.</div>\n<div class=\"form-group align-right\">[submit class:butn class:order-butn \"Оформить заказ\"]</div>\n<div class=\"form-group requaired\"><p>* Поля, отмеченные звездочкой, обязательны для заполнения.</p></div>\n\n<div class=\"order-additional-conditions\">\nПри сумме заказа <strong>от 550 грн</strong> доставка <strong>бесплатна</strong>.\nПри сумме заказа <strong>менее 550 грн</strong> стоимость доставки составит <strong>49 грн</strong>.\n</div>\n<hr />\n<p class=\"align-center\">Время работы колл-центра с 9:00 до 18:00</p>'),(5412,307,'_form','<div class=\"title\"><h3>Напишіть нам</h3></div>\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Iм\'я*\"]</div>\n<div class=\"form-group\">[email* email class:form-control placeholder \"Контактний e-mail*\"]</div>\n<div class=\"form-group\">[tel* tel class:form-control placeholder \"Контактний телефон*\"]</div>\n<div class=\"form-group\">[textarea mailtext class:form-control placeholder \"Повідомлення\"]</div>\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я погоджуюсь з <a href=\"/terms-of-use/\" target=\"_blank\">Політикою конфіденційності</a>.</div>\n<div class=\"form-group align-right\">[submit class:butn \"Надіслати\"]</div>\n<div class=\"form-group requaired\"><p>* Поля, позначені зірочкою, обов\'язкові для заповнення.</p></div>'),(5413,307,'_mail','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:27:\"Обратная связь\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:90:\"n.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\";s:4:\"body\";s:179:\"<p><strong>Имя:</strong> [nname]</p>\n<p><strong>Email:</strong> [email]</p>\n<p><strong>Телефон:</strong> [tel]</p>\n<p><strong>Сообщение:</strong> [mailtext]</p>\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:1;}'),(5414,307,'_mail_2','a:9:{s:6:\"active\";b:0;s:7:\"subject\";s:30:\"[_site_title] \"[your-subject]\"\";s:6:\"sender\";s:43:\"[_site_title] <wordpress@reo.tonic-adv.com>\";s:9:\"recipient\";s:12:\"[your-email]\";s:4:\"body\";s:128:\"Сообщение:\n[your-message]\n\n-- \nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\";s:18:\"additional_headers\";s:29:\"Reply-To: [_site_admin_email]\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:0;s:13:\"exclude_blank\";b:0;}'),(5415,307,'_messages','a:22:{s:12:\"mail_sent_ok\";s:92:\"Дякую за ваше повідомлення. Воно було відправлено.\";s:12:\"mail_sent_ng\";s:179:\"Сталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\";s:16:\"validation_error\";s:166:\"Одне або декілька полів містять помилкові дані. Будь ласка перевірте їх і спробуйте ще раз.\";s:4:\"spam\";s:179:\"Сталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\";s:12:\"accept_terms\";s:153:\"Ви повинні прийняти умови та положення перед тим, як відправляти Ваше повідомлення.\";s:16:\"invalid_required\";s:31:\"Поле обов\'язково.\";s:16:\"invalid_too_long\";s:24:\"Поле задовге.\";s:17:\"invalid_too_short\";s:41:\"Поле занадто короткий.\";s:13:\"upload_failed\";s:97:\"Під час завантаження файлу сталася невідома помилка.\";s:24:\"upload_file_type_invalid\";s:87:\"Ви не дозволено завантажувати файли цього типу.\";s:21:\"upload_file_too_large\";s:39:\"Файл занадто великий.\";s:23:\"upload_failed_php_error\";s:80:\"Під час завантаження файлу сталася помилка.\";s:12:\"invalid_date\";s:45:\"Формат дати некоректний.\";s:14:\"date_too_early\";s:74:\"Введённая дата слишком далеко в прошлом.\";s:13:\"date_too_late\";s:68:\"Введена дата надто далеко в минулому.\";s:14:\"invalid_number\";s:47:\"Формат числа некоректний.\";s:16:\"number_too_small\";s:66:\"Число менше мінімально допустимого.\";s:16:\"number_too_large\";s:70:\"Число більше максимально допустимого.\";s:23:\"quiz_answer_not_correct\";s:81:\"Неправильна відповідь на перевірки питання.\";s:13:\"invalid_email\";s:66:\"Невірно введений електронну адресу.\";s:11:\"invalid_url\";s:55:\"Введено некоректний URL адресу.\";s:11:\"invalid_tel\";s:70:\"Введено некоректний телефонний номер.\";}'),(5416,307,'_additional_settings',''),(5417,307,'_locale','ru_RU'),(5422,308,'_wpml_media_duplicate','1'),(5421,308,'_wpml_media_featured','1'),(5420,308,'_wp_page_template','page-contacts.php'),(5423,308,'_yoast_wpseo_estimated-reading-time-minutes','1'),(5424,308,'_yoast_wpseo_content_score','60'),(5427,308,'_edit_last','1'),(5426,308,'_edit_lock','1630410988:1'),(5428,311,'_menu_item_type','post_type'),(5429,311,'_menu_item_menu_item_parent','0'),(5430,311,'_menu_item_object_id','308'),(5431,311,'_menu_item_object','page'),(5432,311,'_menu_item_target',''),(5433,311,'_menu_item_classes','a:1:{i:0;s:0:\"\";}'),(5434,311,'_menu_item_xfn',''),(5435,311,'_menu_item_url',''),(7130,752,'_menu_item_xfn',''),(5437,313,'_mail','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:27:\"Новый заказ (ReO)\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:90:\"n.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\";s:4:\"body\";s:244:\"<p><strong>Количество:</strong> [products]</p>\n<p><strong>Имя:</strong> [nname]</p>\n<p><strong>Телефон:</strong> [tel]</p>\n<p><strong>E-mail:</strong> [email]</p>\n<p><strong>Адрес доставки:</strong> [adress]</p>\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:1;}'),(5438,313,'_mail_2','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:55:\"ReO - Вода для медицинских целей\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:7:\"[email]\";s:4:\"body\";s:370:\"Спасибо за заказ! В ближайшее время с Вами свяжется call-центр для подтверждения заказа и уточнения деталей!\n\nС уважением, компания «Юрия - Фарм»\n<img src=\"https://reo.ua/wp-content/themes/reo/images/uria-pharm.jpg\" width=\"231\" alt=\"Юрия - Фарм\" />\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:0;}'),(5439,313,'_messages','a:22:{s:12:\"mail_sent_ok\";s:194:\"Спасибо за заказ! В ближайшее время с Вами свяжется call-центр для подтверждения заказа и уточнения деталей!\";s:12:\"mail_sent_ng\";s:144:\"При отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\";s:16:\"validation_error\";s:180:\"Одно или несколько полей содержат ошибочные данные. Пожалуйста, проверьте их и попробуйте ещё раз.\";s:4:\"spam\";s:144:\"При отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\";s:12:\"accept_terms\";s:132:\"Вы должны принять условия и положения перед отправкой вашего сообщения.\";s:16:\"invalid_required\";s:60:\"Поле обязательно для заполнения.\";s:16:\"invalid_too_long\";s:39:\"Поле слишком длинное.\";s:17:\"invalid_too_short\";s:41:\"Поле слишком короткое.\";s:13:\"upload_failed\";s:90:\"При загрузке файла произошла неизвестная ошибка.\";s:24:\"upload_file_type_invalid\";s:81:\"Вам не разрешено загружать файлы этого типа.\";s:21:\"upload_file_too_large\";s:39:\"Файл слишком большой.\";s:23:\"upload_failed_php_error\";s:67:\"При загрузке файла произошла ошибка.\";s:12:\"invalid_date\";s:45:\"Формат даты некорректен.\";s:14:\"date_too_early\";s:74:\"Введённая дата слишком далеко в прошлом.\";s:13:\"date_too_late\";s:74:\"Введённая дата слишком далеко в будущем.\";s:14:\"invalid_number\";s:47:\"Формат числа некорректен.\";s:16:\"number_too_small\";s:68:\"Число меньше минимально допустимого.\";s:16:\"number_too_large\";s:70:\"Число больше максимально допустимого.\";s:23:\"quiz_answer_not_correct\";s:69:\"Неверный ответ на проверочный вопрос.\";s:13:\"invalid_email\";s:62:\"Неверно введён электронный адрес.\";s:11:\"invalid_url\";s:53:\"Введён некорректный URL адрес.\";s:11:\"invalid_tel\";s:70:\"Введён некорректный телефонный номер.\";}'),(5440,313,'_additional_settings',''),(5441,313,'_locale','ru_RU'),(7112,747,'_wp_page_template','page-wheretobuy.php'),(5445,316,'_form','<div class=\"row align-center order-header\">\n<div class=\"col-md-4 col-sm-4 col-xs-4\">\n<p>Ціна <span>(за одиницю)</span></p>\n</div>\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Кількість</p></div>\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Сума</p></div>\n</div>\n<div class=\"row body-order text-center\">\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"price\" data-price=\"47\"></p></div>\n<div class=\"col-md-4 col-sm-4 col-xs-4 flex-center\">\n<div class=\"number-input\">\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepDown()\" id=\"minus\" class=\"minus\"></button>\n[number products class:quantity class:form_ajax_js id:quantity min:1 \"1\"]\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepUp()\" id=\"plus\" class=\"plus\"></button>\n<input type=\"hidden\" id=\"hidden_sum_js\" name=\"appbundle_order[sum]\" class=\"form_ajax_js\" value=\"90\">\n</div>\n</div>\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"total-price\"></p></div>\n<div class=\"col-md-12\"><p class=\"align-center\">В одній упаковці 12 пляшок</p>\n</div>\n</div>\n<div class=\"row\">\n<div class=\"col-md-6\" style=\"z-index: 999;\">\n<div class=\"form-group\">[tel* tel class:form-control class:phone-select placeholder \"Контактний телефон*\"]</div>\n</div>\n<div class=\"col-md-6\">\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Iм\'я*\"]</div>\n</div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">[email* email class:form-control placeholder \"Email*\"]</div>\n</div>\n<div class=\"col-md-6\">\n<div class=\"form-group\">[text* adress class:form-control placeholder \"Адреса доставки*\"]</div>\n</div>\n</div>\n\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я погоджуюсь з <a href=\"/ru/terms-of-use/\" target=\"_blank\">Політикою конфіденційності</a>.</div>\n<div class=\"form-group align-right\">[submit class:butn class:order-butn \"Оформити замовлення\"]</div>\n<div class=\"form-group requaired\"><p>* Поля, позначені зірочкою, обов\'язкові для заповнення.</p></div>\n\n<div class=\"order-additional-conditions\">\nЯкщо вартість замовлення перевищує <strong>550 грн</strong>,<br /> доставка здійснюється <strong>безкоштовно</strong>.<br />\nЯкщо сума замовлення менше <strong>550 грн</strong>,<br /> вартість доставки складає <strong>49 грн</strong>.\n</div>\n<hr />\n<p class=\"align-center\">Час роботи кол-центру з 9:00 до 18:00</p>'),(5446,316,'_mail','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:27:\"Новый заказ (ReO)\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:90:\"n.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\";s:4:\"body\";s:244:\"<p><strong>Количество:</strong> [products]</p>\n<p><strong>Имя:</strong> [nname]</p>\n<p><strong>Телефон:</strong> [tel]</p>\n<p><strong>E-mail:</strong> [email]</p>\n<p><strong>Адрес доставки:</strong> [adress]</p>\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:1;}'),(5447,316,'_mail_2','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:49:\"ReO - Вода для медичних цілей\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:7:\"[email]\";s:4:\"body\";s:390:\"Дякуємо за замовлення! Найближчим часом з Вами зв\'яжеться call-центр для підтвердження замовлення та уточнення деталей!\n\nЗ повагою, компанія «Юрія – Фарм»\n<img src=\"https://reo.ua/wp-content/themes/reo/images/uria-pharm.jpg\" width=\"231\" alt=\"Юрия - Фарм\" />\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:0;}'),(5448,316,'_messages','a:22:{s:12:\"mail_sent_ok\";s:216:\"Дякуємо за замовлення! Найближчим часом з Вами зв\'яжеться call-центр для підтвердження замовлення та уточнення деталей!\";s:12:\"mail_sent_ng\";s:179:\"Сталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\";s:16:\"validation_error\";s:166:\"Одне або декілька полів містять помилкові дані. Будь ласка перевірте їх і спробуйте ще раз.\";s:4:\"spam\";s:179:\"Сталася помилка під час спроби відправити Ваше повідомлення. 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состояния организма, которые приводят к нарушению водно-солевого 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синдром'),(5560,349,'_s2-list_1_text','field_60bf7712f46f1'),(5561,349,'s2-list_2_icon','65'),(5562,349,'_s2-list_2_icon','field_60bf76ecf46ef'),(5563,349,'s2-list_2_icon-hover','66'),(5564,349,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(5565,349,'s2-list_2_text','Диарея'),(5566,349,'_s2-list_2_text','field_60bf7712f46f1'),(5567,349,'s2-list_3_icon','67'),(5568,349,'_s2-list_3_icon','field_60bf76ecf46ef'),(5569,349,'s2-list_3_icon-hover','68'),(5570,349,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(5571,349,'s2-list_3_text','Рвота'),(5572,349,'_s2-list_3_text','field_60bf7712f46f1'),(5573,349,'s2-list_4_icon','69'),(5574,349,'_s2-list_4_icon','field_60bf76ecf46ef'),(5575,349,'s2-list_4_icon-hover','70'),(5576,349,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(5577,349,'s2-list_4_text','Интенсивные физические нагрузки'),(5578,349,'_s2-list_4_text','field_60bf7712f46f1'),(5579,349,'s2-list_5_icon','71'),(5580,349,'_s2-list_5_icon','field_60bf76ecf46ef'),(5581,349,'s2-list_5_icon-hover','72'),(5582,349,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(5583,349,'s2-list_5_text','Перегрев в жаркую погоду'),(5584,349,'_s2-list_5_text','field_60bf7712f46f1'),(5585,349,'s1-slogan','Когда обычной воды недостаточно!'),(5586,349,'_s1-slogan','field_60bf7ab4d9ba9'),(5587,349,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(5588,349,'_s3-text','field_60bf7bb5a7e2b'),(5589,349,'s4-ttl','РеО – вода для медицинских целей!'),(5590,349,'_s4-ttl','field_60bf7c831f58c'),(5591,349,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(5592,349,'_s4-notes','field_60bf7ca31f58d'),(5593,349,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(5594,349,'_s5-video','field_60bf7ccfa01a5'),(5595,349,'s6-ttl','Когда обычной воды недостаточно!'),(5596,349,'_s6-ttl','field_60bf7cfb10d31'),(5597,349,'s6-list','6'),(5598,349,'_s6-list','field_60bf7d0410d32'),(5599,349,'s6-list_0_icon','92'),(5600,349,'_s6-list_0_icon','field_60bf7d1810d33'),(5601,349,'s6-list_0_text','При повышенной температуре'),(5602,349,'_s6-list_0_text','field_60bf7d2710d34'),(5603,349,'s6-list_1_icon','93'),(5604,349,'_s6-list_1_icon','field_60bf7d1810d33'),(5605,349,'s6-list_1_text','При пищевых отравлениях'),(5606,349,'_s6-list_1_text','field_60bf7d2710d34'),(5607,349,'s6-list_2_icon','94'),(5608,349,'_s6-list_2_icon','field_60bf7d1810d33'),(5609,349,'s6-list_2_text','При кишечных инфекциях'),(5610,349,'_s6-list_2_text','field_60bf7d2710d34'),(5611,349,'s6-list_3_icon','95'),(5612,349,'_s6-list_3_icon','field_60bf7d1810d33'),(5613,349,'s6-list_3_text','Во время беременности'),(5614,349,'_s6-list_3_text','field_60bf7d2710d34'),(5615,349,'s6-list_4_icon','96'),(5616,349,'_s6-list_4_icon','field_60bf7d1810d33'),(5617,349,'s6-list_4_text','Во время занятий спортом'),(5618,349,'_s6-list_4_text','field_60bf7d2710d34'),(5619,349,'s6-list_5_icon','97'),(5620,349,'_s6-list_5_icon','field_60bf7d1810d33'),(5621,349,'s6-list_5_text','При похмельном синдроме'),(5622,349,'_s6-list_5_text','field_60bf7d2710d34'),(5623,349,'s4-list_0_ttl','Натрий'),(5624,349,'_s4-list_0_ttl','field_60bf7fa95a92c'),(5625,349,'s4-list_0_formula','Na<sup>+</sup>'),(5626,349,'_s4-list_0_formula','field_60bf7fc65a92d'),(5627,349,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(5628,349,'_s4-list_0_text','field_60bf7fd35a92e'),(5629,349,'s4-list_1_ttl','Вода'),(5630,349,'_s4-list_1_ttl','field_60bf7fa95a92c'),(5631,349,'s4-list_1_formula','H<sub>2</sub>O'),(5632,349,'_s4-list_1_formula','field_60bf7fc65a92d'),(5633,349,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(5634,349,'_s4-list_1_text','field_60bf7fd35a92e'),(5635,349,'s4-list','9'),(5636,349,'_s4-list','field_60bf7f985a92b'),(5637,349,'s4-list_2_ttl','Калий'),(5638,349,'_s4-list_2_ttl','field_60bf7fa95a92c'),(5639,349,'s4-list_2_formula','K<sup>+</sup>'),(5640,349,'_s4-list_2_formula','field_60bf7fc65a92d'),(5641,349,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость, поставляя мозг кислородом. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(5642,349,'_s4-list_2_text','field_60bf7fd35a92e'),(5643,349,'s4-list_3_ttl','Гидрокарбонаты'),(5644,349,'_s4-list_3_ttl','field_60bf7fa95a92c'),(5645,349,'s4-list_3_formula','HCO<sup>3+</sup>'),(5646,349,'_s4-list_3_formula','field_60bf7fc65a92d'),(5647,349,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(5648,349,'_s4-list_3_text','field_60bf7fd35a92e'),(5649,349,'s4-list_4_ttl','Магний'),(5650,349,'_s4-list_4_ttl','field_60bf7fa95a92c'),(5651,349,'s4-list_4_formula','Mg<sup>2+</sup>'),(5652,349,'_s4-list_4_formula','field_60bf7fc65a92d'),(5653,349,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(5654,349,'_s4-list_4_text','field_60bf7fd35a92e'),(5655,349,'s4-list_5_ttl','Углекислый газ'),(5656,349,'_s4-list_5_ttl','field_60bf7fa95a92c'),(5657,349,'s4-list_5_formula','CO<sup>2</sup>+'),(5658,349,'_s4-list_5_formula','field_60bf7fc65a92d'),(5659,349,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(5660,349,'_s4-list_5_text','field_60bf7fd35a92e'),(5661,349,'s4-list_6_ttl','Кальций'),(5662,349,'_s4-list_6_ttl','field_60bf7fa95a92c'),(5663,349,'s4-list_6_formula','Ca<sup>2+</sup>'),(5664,349,'_s4-list_6_formula','field_60bf7fc65a92d'),(5665,349,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительных тканей, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(5666,349,'_s4-list_6_text','field_60bf7fd35a92e'),(5667,349,'s4-list_7_ttl','Сорбит'),(5668,349,'_s4-list_7_ttl','field_60bf7fa95a92c'),(5669,349,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(5670,349,'_s4-list_7_formula','field_60bf7fc65a92d'),(5671,349,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(5672,349,'_s4-list_7_text','field_60bf7fd35a92e'),(5673,349,'s4-list_8_ttl','Хлор'),(5674,349,'_s4-list_8_ttl','field_60bf7fa95a92c'),(5675,349,'s4-list_8_formula','Cl'),(5676,349,'_s4-list_8_formula','field_60bf7fc65a92d'),(5677,349,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(5678,349,'_s4-list_8_text','field_60bf7fd35a92e'),(5679,349,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(5680,349,'_s4-feature1','field_60bf80ca480ea'),(5681,349,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(5682,349,'_s4-feature2','field_60bf80de480eb'),(5683,349,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(5684,349,'_s4-feature3','field_60bf80e2480ec'),(5685,349,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(5686,349,'_s4-feature4','field_60bf80e5480ed'),(5687,350,'layout','grid'),(5688,351,'_wpml_media_featured','1'),(5689,351,'_wpml_media_duplicate','1'),(5690,352,'layout','half'),(5691,354,'layout','thumbnail'),(5692,353,'layout','full'),(5693,355,'_wpml_media_featured','1'),(5694,355,'_wpml_media_duplicate','1'),(5695,356,'fb','https://www.facebook.com/reo.ua/'),(5696,356,'_fb','field_60c9db2f4e024'),(5697,356,'inst','https://www.instagram.com/explore/tags/reowater/'),(5698,356,'_inst','field_60c9db364e025'),(5699,330,'fb','https://www.facebook.com/reo.ua/'),(5700,330,'_fb','field_60c9db2f4e024'),(5701,330,'inst','https://www.instagram.com/explore/tags/reowater/'),(5702,330,'_inst','field_60c9db364e025'),(5703,357,'fb','https://www.facebook.com/reo.ua/'),(5704,357,'_fb','field_60c9db2f4e024'),(5705,357,'inst','https://www.instagram.com/explore/tags/reowater/'),(5706,357,'_inst','field_60c9db364e025'),(5707,308,'adress','03038, Украина, г. Киев, ул. Н. Амосова, 10'),(5708,308,'_adress','field_60cb20d1cbf7c'),(5709,308,'tel','+38 (044) 246-83-83, 275-01-08'),(5710,308,'_tel','field_60cb2128cbf7d'),(5711,308,'email','uf@uf.ua'),(5712,308,'_email','field_60cb2131cbf7e'),(5713,308,'site','www.uf.ua'),(5714,308,'_site','field_60cb213acbf7f'),(5715,363,'fb','https://www.facebook.com/reo.ua/'),(5716,363,'_fb','field_60c9db2f4e024'),(5717,363,'inst','https://www.instagram.com/explore/tags/reowater/'),(5718,363,'_inst','field_60c9db364e025'),(5719,363,'adress','03038, Україна, м. Київ, вул. М. Амосова, 10'),(5720,363,'_adress','field_60cb20d1cbf7c'),(5721,363,'tel','+38 (044) 246-83-83, 275-01-08'),(5722,363,'_tel','field_60cb2128cbf7d'),(5723,363,'email','uf@uf.ua'),(5724,363,'_email','field_60cb2131cbf7e'),(5725,363,'site','www.uf.ua'),(5726,363,'_site','field_60cb213acbf7f'),(5727,301,'adress','03038, Україна, м. Київ, вул. М. Амосова, 10'),(5728,301,'_adress','field_60cb20d1cbf7c'),(5729,301,'tel','+38 (044) 246-83-83, 275-01-08'),(5730,301,'_tel','field_60cb2128cbf7d'),(5731,301,'email','uf@uf.ua'),(5732,301,'_email','field_60cb2131cbf7e'),(5733,301,'site','www.uf.ua'),(5734,301,'_site','field_60cb213acbf7f'),(5735,364,'fb','https://www.facebook.com/reo.ua/'),(5736,364,'_fb','field_60c9db2f4e024'),(5737,364,'inst','https://www.instagram.com/explore/tags/reowater/'),(5738,364,'_inst','field_60c9db364e025'),(5739,364,'adress','03038, Україна, м. Київ, вул. М. 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Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(7767,906,'_s1-text','field_60c069d69838b'),(7768,906,'s3-list','5'),(7769,906,'_s3-list','field_60c06d9298394'),(7770,906,'s3-list2','3'),(7771,906,'_s3-list2','field_60c06dd498396'),(7772,906,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(7773,906,'_s4-ttl','field_60c06ba39838e'),(7774,906,'s4-list','7'),(7775,906,'_s4-list','field_60c06bb39838f'),(7776,906,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(7777,906,'_s4-slogan','field_60c06d6d98392'),(7778,906,'s4-list_0_icon','127'),(7779,906,'_s4-list_0_icon','field_60c06bc298390'),(7780,906,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(7781,906,'_s4-list_0_text','field_60c06bce98391'),(7782,906,'s4-list_1_icon','128'),(7783,906,'_s4-list_1_icon','field_60c06bc298390'),(7784,906,'s4-list_1_text','<strong>головокружiння</strong>'),(7785,906,'_s4-list_1_text','field_60c06bce98391'),(7786,906,'s4-list_2_icon','68'),(7787,906,'_s4-list_2_icon','field_60c06bc298390'),(7788,906,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(7789,906,'_s4-list_2_text','field_60c06bce98391'),(7790,906,'s4-list_3_icon','64'),(7791,906,'_s4-list_3_icon','field_60c06bc298390'),(7792,906,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(7793,906,'_s4-list_3_text','field_60c06bce98391'),(7794,906,'s4-list_4_icon','129'),(7795,906,'_s4-list_4_icon','field_60c06bc298390'),(7796,906,'s4-list_4_text','<strong>дiарея</strong>'),(7797,906,'_s4-list_4_text','field_60c06bce98391'),(7798,906,'s4-list_5_icon','130'),(7799,906,'_s4-list_5_icon','field_60c06bc298390'),(7800,906,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(7801,906,'_s4-list_5_text','field_60c06bce98391'),(7802,906,'s4-list_6_icon','131'),(7803,906,'_s4-list_6_icon','field_60c06bc298390'),(7804,906,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(7805,906,'_s4-list_6_text','field_60c06bce98391'),(7806,906,'s3-list_0_li','має збалансований<br /> склад'),(7807,906,'_s3-list_0_li','field_60c06db098395'),(7808,906,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(7809,906,'_s3-list_1_li','field_60c06db098395'),(7810,906,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(7811,906,'_s3-list_2_li','field_60c06db098395'),(7812,906,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(7813,906,'_s3-list_3_li','field_60c06db098395'),(7814,906,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(7815,906,'_s3-list_4_li','field_60c06db098395'),(7816,906,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(7817,906,'_s3-list2_0_li','field_60c06dd498397'),(7818,906,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(7819,906,'_s3-list2_1_li','field_60c06dd498397'),(7820,906,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс під час лікування в стаціонарі та після виписки на дому'),(7821,906,'_s3-list2_2_li','field_60c06dd498397'),(7822,906,'s2-list_0_ttl','Вуглекислота'),(7823,906,'_s2-list_0_ttl','field_60c0745253144'),(7824,906,'s2-list_0_formula','Вуглекислота'),(7825,906,'_s2-list_0_formula','field_60c0747253145'),(7826,906,'s2-list_0_size','- 0,05-0,3%'),(7827,906,'_s2-list_0_size','field_60c0749553146'),(7828,906,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(7829,906,'_s2-list_0_text','field_60c0749d53147'),(7830,906,'s2-list','9'),(7831,906,'_s2-list','field_60c0743a53143'),(7832,906,'s2-list_1_ttl','Мiнералiзацiя'),(7833,906,'_s2-list_1_ttl','field_60c0745253144'),(7834,906,'s2-list_1_formula','Мiнералiзацiя'),(7835,906,'_s2-list_1_formula','field_60c0747253145'),(7836,906,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(7837,906,'_s2-list_1_size','field_60c0749553146'),(7838,906,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(7839,906,'_s2-list_1_text','field_60c0749d53147'),(7840,906,'s2-list_2_ttl','Сорбітол'),(7841,906,'_s2-list_2_ttl','field_60c0745253144'),(7842,906,'s2-list_2_formula','Сорбітол'),(7843,906,'_s2-list_2_formula','field_60c0747253145'),(7844,906,'s2-list_2_size','до 900 мл/г'),(7845,906,'_s2-list_2_size','field_60c0749553146'),(7846,906,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(7847,906,'_s2-list_2_text','field_60c0749d53147'),(7848,906,'s2-list_3_ttl','Натрій'),(7849,906,'_s2-list_3_ttl','field_60c0745253144'),(7850,906,'s2-list_3_formula','Na<sup>+</sup>'),(7851,906,'_s2-list_3_formula','field_60c0747253145'),(7852,906,'s2-list_3_size','- 900 мл/г'),(7853,906,'_s2-list_3_size','field_60c0749553146'),(7854,906,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(7855,906,'_s2-list_3_text','field_60c0749d53147'),(7856,906,'s2-list_4_ttl','Магній'),(7857,906,'_s2-list_4_ttl','field_60c0745253144'),(7858,906,'s2-list_4_formula','Mg<sup>2+</sup>'),(7859,906,'_s2-list_4_formula','field_60c0747253145'),(7860,906,'s2-list_4_size','- 50 мл/г'),(7861,906,'_s2-list_4_size','field_60c0749553146'),(7862,906,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(7863,906,'_s2-list_4_text','field_60c0749d53147'),(7864,906,'s2-list_5_ttl','Хлор'),(7865,906,'_s2-list_5_ttl','field_60c0745253144'),(7866,906,'s2-list_5_formula','Cl<sup>-</sup>'),(7867,906,'_s2-list_5_formula','field_60c0747253145'),(7868,906,'s2-list_5_size','- 600 мл/г'),(7869,906,'_s2-list_5_size','field_60c0749553146'),(7870,906,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(7871,906,'_s2-list_5_text','field_60c0749d53147'),(7872,906,'s2-list_6_ttl','Калій'),(7873,906,'_s2-list_6_ttl','field_60c0745253144'),(7874,906,'s2-list_6_formula','K<sup>+</sup>'),(7875,906,'_s2-list_6_formula','field_60c0747253145'),(7876,906,'s2-list_6_size','- 160 мл/г'),(7877,906,'_s2-list_6_size','field_60c0749553146'),(7878,906,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(7879,906,'_s2-list_6_text','field_60c0749d53147'),(7880,906,'s2-list_7_ttl','Кальцій'),(7881,906,'_s2-list_7_ttl','field_60c0745253144'),(7882,906,'s2-list_7_formula','Ca<sup>2+</sup>'),(7883,906,'_s2-list_7_formula','field_60c0747253145'),(7884,906,'s2-list_7_size','- 50 мл/г'),(7885,906,'_s2-list_7_size','field_60c0749553146'),(7886,906,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучних тканин, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(7887,906,'_s2-list_7_text','field_60c0749d53147'),(7888,906,'s2-list_8_ttl','Гідрокарбонати'),(7889,906,'_s2-list_8_ttl','field_60c0745253144'),(7890,906,'s2-list_8_formula','HCO<sup>3+</sup>'),(7891,906,'_s2-list_8_formula','field_60c0747253145'),(7892,906,'s2-list_8_size','- 300 мл/г'),(7893,906,'_s2-list_8_size','field_60c0749553146'),(7894,906,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(7895,906,'_s2-list_8_text','field_60c0749d53147'),(7896,907,'slider','8'),(7897,907,'_slider','field_60bf767ef46ea'),(7898,907,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(7899,907,'_s2-ttl','field_60bf76d1f46ed'),(7900,907,'s2-list','6'),(7901,907,'_s2-list','field_60bf76e0f46ee'),(7902,907,'slider_0_slide','50'),(7903,907,'_slider_0_slide','field_60bf7688f46eb'),(7904,907,'slider_1_slide','51'),(7905,907,'_slider_1_slide','field_60bf7688f46eb'),(7906,907,'slider_2_slide','52'),(7907,907,'_slider_2_slide','field_60bf7688f46eb'),(7908,907,'slider_3_slide','53'),(7909,907,'_slider_3_slide','field_60bf7688f46eb'),(7910,907,'slider_4_slide','54'),(7911,907,'_slider_4_slide','field_60bf7688f46eb'),(7912,907,'slider_5_slide','55'),(7913,907,'_slider_5_slide','field_60bf7688f46eb'),(7914,907,'slider_6_slide','56'),(7915,907,'_slider_6_slide','field_60bf7688f46eb'),(7916,907,'slider_7_slide','57'),(7917,907,'_slider_7_slide','field_60bf7688f46eb'),(7918,907,'s2-list_0_icon','61'),(7919,907,'_s2-list_0_icon','field_60bf76ecf46ef'),(7920,907,'s2-list_0_icon-hover','62'),(7921,907,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(7922,907,'s2-list_0_text','Лихоманка'),(7923,907,'_s2-list_0_text','field_60bf7712f46f1'),(7924,907,'s2-list_1_icon','63'),(7925,907,'_s2-list_1_icon','field_60bf76ecf46ef'),(7926,907,'s2-list_1_icon-hover','64'),(7927,907,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(7928,907,'s2-list_1_text','Похмільний синдром'),(7929,907,'_s2-list_1_text','field_60bf7712f46f1'),(7930,907,'s2-list_2_icon','65'),(7931,907,'_s2-list_2_icon','field_60bf76ecf46ef'),(7932,907,'s2-list_2_icon-hover','66'),(7933,907,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(7934,907,'s2-list_2_text','Діарея'),(7935,907,'_s2-list_2_text','field_60bf7712f46f1'),(7936,907,'s2-list_3_icon','67'),(7937,907,'_s2-list_3_icon','field_60bf76ecf46ef'),(7938,907,'s2-list_3_icon-hover','68'),(7939,907,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(7940,907,'s2-list_3_text','Блювота'),(7941,907,'_s2-list_3_text','field_60bf7712f46f1'),(7942,907,'s2-list_4_icon','69'),(7943,907,'_s2-list_4_icon','field_60bf76ecf46ef'),(7944,907,'s2-list_4_icon-hover','70'),(7945,907,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(7946,907,'s2-list_4_text','Інтенсивні фізичні навантаження'),(7947,907,'_s2-list_4_text','field_60bf7712f46f1'),(7948,907,'s2-list_5_icon','71'),(7949,907,'_s2-list_5_icon','field_60bf76ecf46ef'),(7950,907,'s2-list_5_icon-hover','72'),(7951,907,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(7952,907,'s2-list_5_text','Перегрівання в спекотну погоду'),(7953,907,'_s2-list_5_text','field_60bf7712f46f1'),(7954,907,'s1-slogan','Коли звичайної води замало!'),(7955,907,'_s1-slogan','field_60bf7ab4d9ba9'),(7956,907,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(7957,907,'_s3-text','field_60bf7bb5a7e2b'),(7958,907,'s4-ttl','РеО – вода для медичних цілей'),(7959,907,'_s4-ttl','field_60bf7c831f58c'),(7960,907,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(7961,907,'_s4-notes','field_60bf7ca31f58d'),(7962,907,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(7963,907,'_s5-video','field_60bf7ccfa01a5'),(7964,907,'s6-ttl','Коли звичайної води замало!'),(7965,907,'_s6-ttl','field_60bf7cfb10d31'),(7966,907,'s6-list','6'),(7967,907,'_s6-list','field_60bf7d0410d32'),(7968,907,'s6-list_0_icon','92'),(7969,907,'_s6-list_0_icon','field_60bf7d1810d33'),(7970,907,'s6-list_0_text','При підвищеній температурі'),(7971,907,'_s6-list_0_text','field_60bf7d2710d34'),(7972,907,'s6-list_1_icon','93'),(7973,907,'_s6-list_1_icon','field_60bf7d1810d33'),(7974,907,'s6-list_1_text','При харчових отруєннях'),(7975,907,'_s6-list_1_text','field_60bf7d2710d34'),(7976,907,'s6-list_2_icon','94'),(7977,907,'_s6-list_2_icon','field_60bf7d1810d33'),(7978,907,'s6-list_2_text','При кишкових інфекціях'),(7979,907,'_s6-list_2_text','field_60bf7d2710d34'),(7980,907,'s6-list_3_icon','95'),(7981,907,'_s6-list_3_icon','field_60bf7d1810d33'),(7982,907,'s6-list_3_text','Під час вагітності'),(7983,907,'_s6-list_3_text','field_60bf7d2710d34'),(7984,907,'s6-list_4_icon','96'),(7985,907,'_s6-list_4_icon','field_60bf7d1810d33'),(7986,907,'s6-list_4_text','Під час заняття спортом'),(7987,907,'_s6-list_4_text','field_60bf7d2710d34'),(7988,907,'s6-list_5_icon','97'),(7989,907,'_s6-list_5_icon','field_60bf7d1810d33'),(7990,907,'s6-list_5_text','При похмільному синдромі'),(7991,907,'_s6-list_5_text','field_60bf7d2710d34'),(7992,907,'s4-list_0_ttl','Натрій'),(7993,907,'_s4-list_0_ttl','field_60bf7fa95a92c'),(7994,907,'s4-list_0_formula','Na<sup>+</sup>'),(7995,907,'_s4-list_0_formula','field_60bf7fc65a92d'),(7996,907,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(7997,907,'_s4-list_0_text','field_60bf7fd35a92e'),(7998,907,'s4-list_1_ttl','Вода'),(7999,907,'_s4-list_1_ttl','field_60bf7fa95a92c'),(8000,907,'s4-list_1_formula','H<sub>2</sub>O'),(8001,907,'_s4-list_1_formula','field_60bf7fc65a92d'),(8002,907,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(8003,907,'_s4-list_1_text','field_60bf7fd35a92e'),(8004,907,'s4-list','9'),(8005,907,'_s4-list','field_60bf7f985a92b'),(8006,907,'s4-list_2_ttl','Калій'),(8007,907,'_s4-list_2_ttl','field_60bf7fa95a92c'),(8008,907,'s4-list_2_formula','K<sup>+</sup>'),(8009,907,'_s4-list_2_formula','field_60bf7fc65a92d'),(8010,907,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(8011,907,'_s4-list_2_text','field_60bf7fd35a92e'),(8012,907,'s4-list_3_ttl','Гідрокарбонати'),(8013,907,'_s4-list_3_ttl','field_60bf7fa95a92c'),(8014,907,'s4-list_3_formula','HCO<sup>3+</sup>'),(8015,907,'_s4-list_3_formula','field_60bf7fc65a92d'),(8016,907,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(8017,907,'_s4-list_3_text','field_60bf7fd35a92e'),(8018,907,'s4-list_4_ttl','Магній'),(8019,907,'_s4-list_4_ttl','field_60bf7fa95a92c'),(8020,907,'s4-list_4_formula','Mg<sup>2+</sup>'),(8021,907,'_s4-list_4_formula','field_60bf7fc65a92d'),(8022,907,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(8023,907,'_s4-list_4_text','field_60bf7fd35a92e'),(8024,907,'s4-list_5_ttl','Вуглекислий газ'),(8025,907,'_s4-list_5_ttl','field_60bf7fa95a92c'),(8026,907,'s4-list_5_formula','CO<sup>2</sup>+'),(8027,907,'_s4-list_5_formula','field_60bf7fc65a92d'),(8028,907,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Говорячи образно, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(8029,907,'_s4-list_5_text','field_60bf7fd35a92e'),(8030,907,'s4-list_6_ttl','Кальцій'),(8031,907,'_s4-list_6_ttl','field_60bf7fa95a92c'),(8032,907,'s4-list_6_formula','Ca<sup>2+</sup>'),(8033,907,'_s4-list_6_formula','field_60bf7fc65a92d'),(8034,907,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(8035,907,'_s4-list_6_text','field_60bf7fd35a92e'),(8036,907,'s4-list_7_ttl','Сорбіт'),(8037,907,'_s4-list_7_ttl','field_60bf7fa95a92c'),(8038,907,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(8039,907,'_s4-list_7_formula','field_60bf7fc65a92d'),(8040,907,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(8041,907,'_s4-list_7_text','field_60bf7fd35a92e'),(8042,907,'s4-list_8_ttl','Хлор'),(8043,907,'_s4-list_8_ttl','field_60bf7fa95a92c'),(8044,907,'s4-list_8_formula','Cl'),(8045,907,'_s4-list_8_formula','field_60bf7fc65a92d'),(8046,907,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(8047,907,'_s4-list_8_text','field_60bf7fd35a92e'),(8048,907,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(8049,907,'_s4-feature1','field_60bf80ca480ea'),(8050,907,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(8051,907,'_s4-feature2','field_60bf80de480eb'),(8052,907,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(8053,907,'_s4-feature3','field_60bf80e2480ec'),(8054,907,'s4-feature4','Приємна на смак та легко п’єтьсянавіть при відчутті нудоти<sup>1,3</sup>'),(8055,907,'_s4-feature4','field_60bf80e5480ed'),(8056,908,'slider','8'),(8057,908,'_slider','field_60bf767ef46ea'),(8058,908,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(8059,908,'_s2-ttl','field_60bf76d1f46ed'),(8060,908,'s2-list','6'),(8061,908,'_s2-list','field_60bf76e0f46ee'),(8062,908,'slider_0_slide','50'),(8063,908,'_slider_0_slide','field_60bf7688f46eb'),(8064,908,'slider_1_slide','51'),(8065,908,'_slider_1_slide','field_60bf7688f46eb'),(8066,908,'slider_2_slide','52'),(8067,908,'_slider_2_slide','field_60bf7688f46eb'),(8068,908,'slider_3_slide','53'),(8069,908,'_slider_3_slide','field_60bf7688f46eb'),(8070,908,'slider_4_slide','54'),(8071,908,'_slider_4_slide','field_60bf7688f46eb'),(8072,908,'slider_5_slide','55'),(8073,908,'_slider_5_slide','field_60bf7688f46eb'),(8074,908,'slider_6_slide','56'),(8075,908,'_slider_6_slide','field_60bf7688f46eb'),(8076,908,'slider_7_slide','57'),(8077,908,'_slider_7_slide','field_60bf7688f46eb'),(8078,908,'s2-list_0_icon','61'),(8079,908,'_s2-list_0_icon','field_60bf76ecf46ef'),(8080,908,'s2-list_0_icon-hover','62'),(8081,908,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(8082,908,'s2-list_0_text','Лихоманка'),(8083,908,'_s2-list_0_text','field_60bf7712f46f1'),(8084,908,'s2-list_1_icon','63'),(8085,908,'_s2-list_1_icon','field_60bf76ecf46ef'),(8086,908,'s2-list_1_icon-hover','64'),(8087,908,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(8088,908,'s2-list_1_text','Похмільний синдром'),(8089,908,'_s2-list_1_text','field_60bf7712f46f1'),(8090,908,'s2-list_2_icon','65'),(8091,908,'_s2-list_2_icon','field_60bf76ecf46ef'),(8092,908,'s2-list_2_icon-hover','66'),(8093,908,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(8094,908,'s2-list_2_text','Діарея'),(8095,908,'_s2-list_2_text','field_60bf7712f46f1'),(8096,908,'s2-list_3_icon','67'),(8097,908,'_s2-list_3_icon','field_60bf76ecf46ef'),(8098,908,'s2-list_3_icon-hover','68'),(8099,908,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(8100,908,'s2-list_3_text','Блювота'),(8101,908,'_s2-list_3_text','field_60bf7712f46f1'),(8102,908,'s2-list_4_icon','69'),(8103,908,'_s2-list_4_icon','field_60bf76ecf46ef'),(8104,908,'s2-list_4_icon-hover','70'),(8105,908,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(8106,908,'s2-list_4_text','Інтенсивні фізичні навантаження'),(8107,908,'_s2-list_4_text','field_60bf7712f46f1'),(8108,908,'s2-list_5_icon','71'),(8109,908,'_s2-list_5_icon','field_60bf76ecf46ef'),(8110,908,'s2-list_5_icon-hover','72'),(8111,908,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(8112,908,'s2-list_5_text','Перегрівання в спекотну погоду'),(8113,908,'_s2-list_5_text','field_60bf7712f46f1'),(8114,908,'s1-slogan','Коли звичайної води замало!'),(8115,908,'_s1-slogan','field_60bf7ab4d9ba9'),(8116,908,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(8117,908,'_s3-text','field_60bf7bb5a7e2b'),(8118,908,'s4-ttl','РеО – вода для медичних цілей'),(8119,908,'_s4-ttl','field_60bf7c831f58c'),(8120,908,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(8121,908,'_s4-notes','field_60bf7ca31f58d'),(8122,908,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(8123,908,'_s5-video','field_60bf7ccfa01a5'),(8124,908,'s6-ttl','Коли звичайної води замало!'),(8125,908,'_s6-ttl','field_60bf7cfb10d31'),(8126,908,'s6-list','6'),(8127,908,'_s6-list','field_60bf7d0410d32'),(8128,908,'s6-list_0_icon','92'),(8129,908,'_s6-list_0_icon','field_60bf7d1810d33'),(8130,908,'s6-list_0_text','При підвищеній температурі'),(8131,908,'_s6-list_0_text','field_60bf7d2710d34'),(8132,908,'s6-list_1_icon','93'),(8133,908,'_s6-list_1_icon','field_60bf7d1810d33'),(8134,908,'s6-list_1_text','При харчових отруєннях'),(8135,908,'_s6-list_1_text','field_60bf7d2710d34'),(8136,908,'s6-list_2_icon','94'),(8137,908,'_s6-list_2_icon','field_60bf7d1810d33'),(8138,908,'s6-list_2_text','При кишкових інфекціях'),(8139,908,'_s6-list_2_text','field_60bf7d2710d34'),(8140,908,'s6-list_3_icon','95'),(8141,908,'_s6-list_3_icon','field_60bf7d1810d33'),(8142,908,'s6-list_3_text','Під час вагітності'),(8143,908,'_s6-list_3_text','field_60bf7d2710d34'),(8144,908,'s6-list_4_icon','96'),(8145,908,'_s6-list_4_icon','field_60bf7d1810d33'),(8146,908,'s6-list_4_text','Під час заняття спортом'),(8147,908,'_s6-list_4_text','field_60bf7d2710d34'),(8148,908,'s6-list_5_icon','97'),(8149,908,'_s6-list_5_icon','field_60bf7d1810d33'),(8150,908,'s6-list_5_text','При похмільному синдромі'),(8151,908,'_s6-list_5_text','field_60bf7d2710d34'),(8152,908,'s4-list_0_ttl','Натрій'),(8153,908,'_s4-list_0_ttl','field_60bf7fa95a92c'),(8154,908,'s4-list_0_formula','Na<sup>+</sup>'),(8155,908,'_s4-list_0_formula','field_60bf7fc65a92d'),(8156,908,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(8157,908,'_s4-list_0_text','field_60bf7fd35a92e'),(8158,908,'s4-list_1_ttl','Вода'),(8159,908,'_s4-list_1_ttl','field_60bf7fa95a92c'),(8160,908,'s4-list_1_formula','H<sub>2</sub>O'),(8161,908,'_s4-list_1_formula','field_60bf7fc65a92d'),(8162,908,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(8163,908,'_s4-list_1_text','field_60bf7fd35a92e'),(8164,908,'s4-list','9'),(8165,908,'_s4-list','field_60bf7f985a92b'),(8166,908,'s4-list_2_ttl','Калій'),(8167,908,'_s4-list_2_ttl','field_60bf7fa95a92c'),(8168,908,'s4-list_2_formula','K<sup>+</sup>'),(8169,908,'_s4-list_2_formula','field_60bf7fc65a92d'),(8170,908,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(8171,908,'_s4-list_2_text','field_60bf7fd35a92e'),(8172,908,'s4-list_3_ttl','Гідрокарбонати'),(8173,908,'_s4-list_3_ttl','field_60bf7fa95a92c'),(8174,908,'s4-list_3_formula','HCO<sup>3+</sup>'),(8175,908,'_s4-list_3_formula','field_60bf7fc65a92d'),(8176,908,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(8177,908,'_s4-list_3_text','field_60bf7fd35a92e'),(8178,908,'s4-list_4_ttl','Магній'),(8179,908,'_s4-list_4_ttl','field_60bf7fa95a92c'),(8180,908,'s4-list_4_formula','Mg<sup>2+</sup>'),(8181,908,'_s4-list_4_formula','field_60bf7fc65a92d'),(8182,908,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(8183,908,'_s4-list_4_text','field_60bf7fd35a92e'),(8184,908,'s4-list_5_ttl','Вуглекислий газ'),(8185,908,'_s4-list_5_ttl','field_60bf7fa95a92c'),(8186,908,'s4-list_5_formula','CO<sup>2</sup>+'),(8187,908,'_s4-list_5_formula','field_60bf7fc65a92d'),(8188,908,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(8189,908,'_s4-list_5_text','field_60bf7fd35a92e'),(8190,908,'s4-list_6_ttl','Кальцій'),(8191,908,'_s4-list_6_ttl','field_60bf7fa95a92c'),(8192,908,'s4-list_6_formula','Ca<sup>2+</sup>'),(8193,908,'_s4-list_6_formula','field_60bf7fc65a92d'),(8194,908,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(8195,908,'_s4-list_6_text','field_60bf7fd35a92e'),(8196,908,'s4-list_7_ttl','Сорбіт'),(8197,908,'_s4-list_7_ttl','field_60bf7fa95a92c'),(8198,908,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(8199,908,'_s4-list_7_formula','field_60bf7fc65a92d'),(8200,908,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(8201,908,'_s4-list_7_text','field_60bf7fd35a92e'),(8202,908,'s4-list_8_ttl','Хлор'),(8203,908,'_s4-list_8_ttl','field_60bf7fa95a92c'),(8204,908,'s4-list_8_formula','Cl'),(8205,908,'_s4-list_8_formula','field_60bf7fc65a92d'),(8206,908,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(8207,908,'_s4-list_8_text','field_60bf7fd35a92e'),(8208,908,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(8209,908,'_s4-feature1','field_60bf80ca480ea'),(8210,908,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(8211,908,'_s4-feature2','field_60bf80de480eb'),(8212,908,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(8213,908,'_s4-feature3','field_60bf80e2480ec'),(8214,908,'s4-feature4','Приємна на смак та легко п’єтьсянавіть при відчутті 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Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(8240,918,'_s1-text','field_60c069d69838b'),(8241,918,'s3-list','5'),(8242,918,'_s3-list','field_60c06d9298394'),(8243,918,'s3-list2','3'),(8244,918,'_s3-list2','field_60c06dd498396'),(8245,918,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(8246,918,'_s4-ttl','field_60c06ba39838e'),(8247,918,'s4-list','7'),(8248,918,'_s4-list','field_60c06bb39838f'),(8249,918,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(8250,918,'_s4-slogan','field_60c06d6d98392'),(8251,918,'s4-list_0_icon','127'),(8252,918,'_s4-list_0_icon','field_60c06bc298390'),(8253,918,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(8254,918,'_s4-list_0_text','field_60c06bce98391'),(8255,918,'s4-list_1_icon','128'),(8256,918,'_s4-list_1_icon','field_60c06bc298390'),(8257,918,'s4-list_1_text','<strong>головокружiння</strong>'),(8258,918,'_s4-list_1_text','field_60c06bce98391'),(8259,918,'s4-list_2_icon','68'),(8260,918,'_s4-list_2_icon','field_60c06bc298390'),(8261,918,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(8262,918,'_s4-list_2_text','field_60c06bce98391'),(8263,918,'s4-list_3_icon','64'),(8264,918,'_s4-list_3_icon','field_60c06bc298390'),(8265,918,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(8266,918,'_s4-list_3_text','field_60c06bce98391'),(8267,918,'s4-list_4_icon','129'),(8268,918,'_s4-list_4_icon','field_60c06bc298390'),(8269,918,'s4-list_4_text','<strong>дiарея</strong>'),(8270,918,'_s4-list_4_text','field_60c06bce98391'),(8271,918,'s4-list_5_icon','130'),(8272,918,'_s4-list_5_icon','field_60c06bc298390'),(8273,918,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(8274,918,'_s4-list_5_text','field_60c06bce98391'),(8275,918,'s4-list_6_icon','131'),(8276,918,'_s4-list_6_icon','field_60c06bc298390'),(8277,918,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(8278,918,'_s4-list_6_text','field_60c06bce98391'),(8279,918,'s3-list_0_li','має збалансований<br /> склад'),(8280,918,'_s3-list_0_li','field_60c06db098395'),(8281,918,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(8282,918,'_s3-list_1_li','field_60c06db098395'),(8283,918,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(8284,918,'_s3-list_2_li','field_60c06db098395'),(8285,918,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(8286,918,'_s3-list_3_li','field_60c06db098395'),(8287,918,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(8288,918,'_s3-list_4_li','field_60c06db098395'),(8289,918,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(8290,918,'_s3-list2_0_li','field_60c06dd498397'),(8291,918,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(8292,918,'_s3-list2_1_li','field_60c06dd498397'),(8293,918,'s3-list2_2_li','Допомагає підтримати водноелектролітний баланс під час лікування в стаціонарі та після виписки на дому'),(8294,918,'_s3-list2_2_li','field_60c06dd498397'),(8295,918,'s2-list_0_ttl','Вуглекислота'),(8296,918,'_s2-list_0_ttl','field_60c0745253144'),(8297,918,'s2-list_0_formula','Вуглекислота'),(8298,918,'_s2-list_0_formula','field_60c0747253145'),(8299,918,'s2-list_0_size','- 0,05-0,3%'),(8300,918,'_s2-list_0_size','field_60c0749553146'),(8301,918,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(8302,918,'_s2-list_0_text','field_60c0749d53147'),(8303,918,'s2-list','9'),(8304,918,'_s2-list','field_60c0743a53143'),(8305,918,'s2-list_1_ttl','Мiнералiзацiя'),(8306,918,'_s2-list_1_ttl','field_60c0745253144'),(8307,918,'s2-list_1_formula','Мiнералiзацiя'),(8308,918,'_s2-list_1_formula','field_60c0747253145'),(8309,918,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(8310,918,'_s2-list_1_size','field_60c0749553146'),(8311,918,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(8312,918,'_s2-list_1_text','field_60c0749d53147'),(8313,918,'s2-list_2_ttl','Сорбітол'),(8314,918,'_s2-list_2_ttl','field_60c0745253144'),(8315,918,'s2-list_2_formula','Сорбітол'),(8316,918,'_s2-list_2_formula','field_60c0747253145'),(8317,918,'s2-list_2_size','до 900 мл/г'),(8318,918,'_s2-list_2_size','field_60c0749553146'),(8319,918,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(8320,918,'_s2-list_2_text','field_60c0749d53147'),(8321,918,'s2-list_3_ttl','Натрій'),(8322,918,'_s2-list_3_ttl','field_60c0745253144'),(8323,918,'s2-list_3_formula','Na<sup>+</sup>'),(8324,918,'_s2-list_3_formula','field_60c0747253145'),(8325,918,'s2-list_3_size','- 900 мл/г'),(8326,918,'_s2-list_3_size','field_60c0749553146'),(8327,918,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(8328,918,'_s2-list_3_text','field_60c0749d53147'),(8329,918,'s2-list_4_ttl','Магній'),(8330,918,'_s2-list_4_ttl','field_60c0745253144'),(8331,918,'s2-list_4_formula','Mg<sup>2+</sup>'),(8332,918,'_s2-list_4_formula','field_60c0747253145'),(8333,918,'s2-list_4_size','- 50 мл/г'),(8334,918,'_s2-list_4_size','field_60c0749553146'),(8335,918,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(8336,918,'_s2-list_4_text','field_60c0749d53147'),(8337,918,'s2-list_5_ttl','Хлор'),(8338,918,'_s2-list_5_ttl','field_60c0745253144'),(8339,918,'s2-list_5_formula','Cl<sup>-</sup>'),(8340,918,'_s2-list_5_formula','field_60c0747253145'),(8341,918,'s2-list_5_size','- 600 мл/г'),(8342,918,'_s2-list_5_size','field_60c0749553146'),(8343,918,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(8344,918,'_s2-list_5_text','field_60c0749d53147'),(8345,918,'s2-list_6_ttl','Калій'),(8346,918,'_s2-list_6_ttl','field_60c0745253144'),(8347,918,'s2-list_6_formula','K<sup>+</sup>'),(8348,918,'_s2-list_6_formula','field_60c0747253145'),(8349,918,'s2-list_6_size','- 160 мл/г'),(8350,918,'_s2-list_6_size','field_60c0749553146'),(8351,918,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(8352,918,'_s2-list_6_text','field_60c0749d53147'),(8353,918,'s2-list_7_ttl','Кальцій'),(8354,918,'_s2-list_7_ttl','field_60c0745253144'),(8355,918,'s2-list_7_formula','Ca<sup>2+</sup>'),(8356,918,'_s2-list_7_formula','field_60c0747253145'),(8357,918,'s2-list_7_size','- 50 мл/г'),(8358,918,'_s2-list_7_size','field_60c0749553146'),(8359,918,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(8360,918,'_s2-list_7_text','field_60c0749d53147'),(8361,918,'s2-list_8_ttl','Гідрокарбонати'),(8362,918,'_s2-list_8_ttl','field_60c0745253144'),(8363,918,'s2-list_8_formula','HCO<sup>3+</sup>'),(8364,918,'_s2-list_8_formula','field_60c0747253145'),(8365,918,'s2-list_8_size','- 300 мл/г'),(8366,918,'_s2-list_8_size','field_60c0749553146'),(8367,918,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(8368,918,'_s2-list_8_text','field_60c0749d53147'),(8369,919,'slider','8'),(8370,919,'_slider','field_60bf767ef46ea'),(8371,919,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(8372,919,'_s2-ttl','field_60bf76d1f46ed'),(8373,919,'s2-list','6'),(8374,919,'_s2-list','field_60bf76e0f46ee'),(8375,919,'slider_0_slide','50'),(8376,919,'_slider_0_slide','field_60bf7688f46eb'),(8377,919,'slider_1_slide','51'),(8378,919,'_slider_1_slide','field_60bf7688f46eb'),(8379,919,'slider_2_slide','52'),(8380,919,'_slider_2_slide','field_60bf7688f46eb'),(8381,919,'slider_3_slide','53'),(8382,919,'_slider_3_slide','field_60bf7688f46eb'),(8383,919,'slider_4_slide','54'),(8384,919,'_slider_4_slide','field_60bf7688f46eb'),(8385,919,'slider_5_slide','55'),(8386,919,'_slider_5_slide','field_60bf7688f46eb'),(8387,919,'slider_6_slide','56'),(8388,919,'_slider_6_slide','field_60bf7688f46eb'),(8389,919,'slider_7_slide','57'),(8390,919,'_slider_7_slide','field_60bf7688f46eb'),(8391,919,'s2-list_0_icon','61'),(8392,919,'_s2-list_0_icon','field_60bf76ecf46ef'),(8393,919,'s2-list_0_icon-hover','62'),(8394,919,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(8395,919,'s2-list_0_text','Лихоманка'),(8396,919,'_s2-list_0_text','field_60bf7712f46f1'),(8397,919,'s2-list_1_icon','63'),(8398,919,'_s2-list_1_icon','field_60bf76ecf46ef'),(8399,919,'s2-list_1_icon-hover','64'),(8400,919,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(8401,919,'s2-list_1_text','Похмільний синдром'),(8402,919,'_s2-list_1_text','field_60bf7712f46f1'),(8403,919,'s2-list_2_icon','65'),(8404,919,'_s2-list_2_icon','field_60bf76ecf46ef'),(8405,919,'s2-list_2_icon-hover','66'),(8406,919,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(8407,919,'s2-list_2_text','Діарея'),(8408,919,'_s2-list_2_text','field_60bf7712f46f1'),(8409,919,'s2-list_3_icon','67'),(8410,919,'_s2-list_3_icon','field_60bf76ecf46ef'),(8411,919,'s2-list_3_icon-hover','68'),(8412,919,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(8413,919,'s2-list_3_text','Блювота'),(8414,919,'_s2-list_3_text','field_60bf7712f46f1'),(8415,919,'s2-list_4_icon','69'),(8416,919,'_s2-list_4_icon','field_60bf76ecf46ef'),(8417,919,'s2-list_4_icon-hover','70'),(8418,919,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(8419,919,'s2-list_4_text','Інтенсивні фізичні навантаження'),(8420,919,'_s2-list_4_text','field_60bf7712f46f1'),(8421,919,'s2-list_5_icon','71'),(8422,919,'_s2-list_5_icon','field_60bf76ecf46ef'),(8423,919,'s2-list_5_icon-hover','72'),(8424,919,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(8425,919,'s2-list_5_text','Перегрівання в спекотну погоду'),(8426,919,'_s2-list_5_text','field_60bf7712f46f1'),(8427,919,'s1-slogan','Коли звичайної води замало!'),(8428,919,'_s1-slogan','field_60bf7ab4d9ba9'),(8429,919,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(8430,919,'_s3-text','field_60bf7bb5a7e2b'),(8431,919,'s4-ttl','РеО – вода для медичних цілей'),(8432,919,'_s4-ttl','field_60bf7c831f58c'),(8433,919,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(8434,919,'_s4-notes','field_60bf7ca31f58d'),(8435,919,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(8436,919,'_s5-video','field_60bf7ccfa01a5'),(8437,919,'s6-ttl','Коли звичайної води замало!'),(8438,919,'_s6-ttl','field_60bf7cfb10d31'),(8439,919,'s6-list','6'),(8440,919,'_s6-list','field_60bf7d0410d32'),(8441,919,'s6-list_0_icon','92'),(8442,919,'_s6-list_0_icon','field_60bf7d1810d33'),(8443,919,'s6-list_0_text','При підвищеній температурі'),(8444,919,'_s6-list_0_text','field_60bf7d2710d34'),(8445,919,'s6-list_1_icon','93'),(8446,919,'_s6-list_1_icon','field_60bf7d1810d33'),(8447,919,'s6-list_1_text','При харчових отруєннях'),(8448,919,'_s6-list_1_text','field_60bf7d2710d34'),(8449,919,'s6-list_2_icon','94'),(8450,919,'_s6-list_2_icon','field_60bf7d1810d33'),(8451,919,'s6-list_2_text','При кишкових інфекціях'),(8452,919,'_s6-list_2_text','field_60bf7d2710d34'),(8453,919,'s6-list_3_icon','95'),(8454,919,'_s6-list_3_icon','field_60bf7d1810d33'),(8455,919,'s6-list_3_text','Під час вагітності'),(8456,919,'_s6-list_3_text','field_60bf7d2710d34'),(8457,919,'s6-list_4_icon','96'),(8458,919,'_s6-list_4_icon','field_60bf7d1810d33'),(8459,919,'s6-list_4_text','Під час заняття спортом'),(8460,919,'_s6-list_4_text','field_60bf7d2710d34'),(8461,919,'s6-list_5_icon','97'),(8462,919,'_s6-list_5_icon','field_60bf7d1810d33'),(8463,919,'s6-list_5_text','При похмільному синдромі'),(8464,919,'_s6-list_5_text','field_60bf7d2710d34'),(8465,919,'s4-list_0_ttl','Натрій'),(8466,919,'_s4-list_0_ttl','field_60bf7fa95a92c'),(8467,919,'s4-list_0_formula','Na<sup>+</sup>'),(8468,919,'_s4-list_0_formula','field_60bf7fc65a92d'),(8469,919,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(8470,919,'_s4-list_0_text','field_60bf7fd35a92e'),(8471,919,'s4-list_1_ttl','Вода'),(8472,919,'_s4-list_1_ttl','field_60bf7fa95a92c'),(8473,919,'s4-list_1_formula','H<sub>2</sub>O'),(8474,919,'_s4-list_1_formula','field_60bf7fc65a92d'),(8475,919,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(8476,919,'_s4-list_1_text','field_60bf7fd35a92e'),(8477,919,'s4-list','9'),(8478,919,'_s4-list','field_60bf7f985a92b'),(8479,919,'s4-list_2_ttl','Калій'),(8480,919,'_s4-list_2_ttl','field_60bf7fa95a92c'),(8481,919,'s4-list_2_formula','K<sup>+</sup>'),(8482,919,'_s4-list_2_formula','field_60bf7fc65a92d'),(8483,919,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(8484,919,'_s4-list_2_text','field_60bf7fd35a92e'),(8485,919,'s4-list_3_ttl','Гідрокарбонати'),(8486,919,'_s4-list_3_ttl','field_60bf7fa95a92c'),(8487,919,'s4-list_3_formula','HCO<sup>3+</sup>'),(8488,919,'_s4-list_3_formula','field_60bf7fc65a92d'),(8489,919,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(8490,919,'_s4-list_3_text','field_60bf7fd35a92e'),(8491,919,'s4-list_4_ttl','Магній'),(8492,919,'_s4-list_4_ttl','field_60bf7fa95a92c'),(8493,919,'s4-list_4_formula','Mg<sup>2+</sup>'),(8494,919,'_s4-list_4_formula','field_60bf7fc65a92d'),(8495,919,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(8496,919,'_s4-list_4_text','field_60bf7fd35a92e'),(8497,919,'s4-list_5_ttl','Вуглекислий газ'),(8498,919,'_s4-list_5_ttl','field_60bf7fa95a92c'),(8499,919,'s4-list_5_formula','CO<sup>2</sup>+'),(8500,919,'_s4-list_5_formula','field_60bf7fc65a92d'),(8501,919,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(8502,919,'_s4-list_5_text','field_60bf7fd35a92e'),(8503,919,'s4-list_6_ttl','Кальцій'),(8504,919,'_s4-list_6_ttl','field_60bf7fa95a92c'),(8505,919,'s4-list_6_formula','Ca<sup>2+</sup>'),(8506,919,'_s4-list_6_formula','field_60bf7fc65a92d'),(8507,919,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(8508,919,'_s4-list_6_text','field_60bf7fd35a92e'),(8509,919,'s4-list_7_ttl','Сорбіт'),(8510,919,'_s4-list_7_ttl','field_60bf7fa95a92c'),(8511,919,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(8512,919,'_s4-list_7_formula','field_60bf7fc65a92d'),(8513,919,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(8514,919,'_s4-list_7_text','field_60bf7fd35a92e'),(8515,919,'s4-list_8_ttl','Хлор'),(8516,919,'_s4-list_8_ttl','field_60bf7fa95a92c'),(8517,919,'s4-list_8_formula','Cl'),(8518,919,'_s4-list_8_formula','field_60bf7fc65a92d'),(8519,919,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(8520,919,'_s4-list_8_text','field_60bf7fd35a92e'),(8521,919,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(8522,919,'_s4-feature1','field_60bf80ca480ea'),(8523,919,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(8524,919,'_s4-feature2','field_60bf80de480eb'),(8525,919,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(8526,919,'_s4-feature3','field_60bf80e2480ec'),(8527,919,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(8528,919,'_s4-feature4','field_60bf80e5480ed'),(8529,920,'s1-text','<strong>ReO</strong> - це вода для Спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(8530,920,'_s1-text','field_60c069d69838b'),(8531,920,'s3-list','5'),(8532,920,'_s3-list','field_60c06d9298394'),(8533,920,'s3-list2','3'),(8534,920,'_s3-list2','field_60c06dd498396'),(8535,920,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(8536,920,'_s4-ttl','field_60c06ba39838e'),(8537,920,'s4-list','7'),(8538,920,'_s4-list','field_60c06bb39838f'),(8539,920,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(8540,920,'_s4-slogan','field_60c06d6d98392'),(8541,920,'s4-list_0_icon','127'),(8542,920,'_s4-list_0_icon','field_60c06bc298390'),(8543,920,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(8544,920,'_s4-list_0_text','field_60c06bce98391'),(8545,920,'s4-list_1_icon','128'),(8546,920,'_s4-list_1_icon','field_60c06bc298390'),(8547,920,'s4-list_1_text','<strong>головокружiння</strong>'),(8548,920,'_s4-list_1_text','field_60c06bce98391'),(8549,920,'s4-list_2_icon','68'),(8550,920,'_s4-list_2_icon','field_60c06bc298390'),(8551,920,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(8552,920,'_s4-list_2_text','field_60c06bce98391'),(8553,920,'s4-list_3_icon','64'),(8554,920,'_s4-list_3_icon','field_60c06bc298390'),(8555,920,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(8556,920,'_s4-list_3_text','field_60c06bce98391'),(8557,920,'s4-list_4_icon','129'),(8558,920,'_s4-list_4_icon','field_60c06bc298390'),(8559,920,'s4-list_4_text','<strong>дiарея</strong>'),(8560,920,'_s4-list_4_text','field_60c06bce98391'),(8561,920,'s4-list_5_icon','130'),(8562,920,'_s4-list_5_icon','field_60c06bc298390'),(8563,920,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(8564,920,'_s4-list_5_text','field_60c06bce98391'),(8565,920,'s4-list_6_icon','131'),(8566,920,'_s4-list_6_icon','field_60c06bc298390'),(8567,920,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(8568,920,'_s4-list_6_text','field_60c06bce98391'),(8569,920,'s3-list_0_li','має збалансований<br /> склад'),(8570,920,'_s3-list_0_li','field_60c06db098395'),(8571,920,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(8572,920,'_s3-list_1_li','field_60c06db098395'),(8573,920,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(8574,920,'_s3-list_2_li','field_60c06db098395'),(8575,920,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(8576,920,'_s3-list_3_li','field_60c06db098395'),(8577,920,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(8578,920,'_s3-list_4_li','field_60c06db098395'),(8579,920,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(8580,920,'_s3-list2_0_li','field_60c06dd498397'),(8581,920,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(8582,920,'_s3-list2_1_li','field_60c06dd498397'),(8583,920,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(8584,920,'_s3-list2_2_li','field_60c06dd498397'),(8585,920,'s2-list_0_ttl','Вуглекислота'),(8586,920,'_s2-list_0_ttl','field_60c0745253144'),(8587,920,'s2-list_0_formula','Вуглекислота'),(8588,920,'_s2-list_0_formula','field_60c0747253145'),(8589,920,'s2-list_0_size','- 0,05-0,3%'),(8590,920,'_s2-list_0_size','field_60c0749553146'),(8591,920,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(8592,920,'_s2-list_0_text','field_60c0749d53147'),(8593,920,'s2-list','9'),(8594,920,'_s2-list','field_60c0743a53143'),(8595,920,'s2-list_1_ttl','Мiнералiзацiя'),(8596,920,'_s2-list_1_ttl','field_60c0745253144'),(8597,920,'s2-list_1_formula','Мiнералiзацiя'),(8598,920,'_s2-list_1_formula','field_60c0747253145'),(8599,920,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(8600,920,'_s2-list_1_size','field_60c0749553146'),(8601,920,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(8602,920,'_s2-list_1_text','field_60c0749d53147'),(8603,920,'s2-list_2_ttl','Сорбітол'),(8604,920,'_s2-list_2_ttl','field_60c0745253144'),(8605,920,'s2-list_2_formula','Сорбітол'),(8606,920,'_s2-list_2_formula','field_60c0747253145'),(8607,920,'s2-list_2_size','до 900 мл/г'),(8608,920,'_s2-list_2_size','field_60c0749553146'),(8609,920,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(8610,920,'_s2-list_2_text','field_60c0749d53147'),(8611,920,'s2-list_3_ttl','Натрій'),(8612,920,'_s2-list_3_ttl','field_60c0745253144'),(8613,920,'s2-list_3_formula','Na<sup>+</sup>'),(8614,920,'_s2-list_3_formula','field_60c0747253145'),(8615,920,'s2-list_3_size','- 900 мл/г'),(8616,920,'_s2-list_3_size','field_60c0749553146'),(8617,920,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(8618,920,'_s2-list_3_text','field_60c0749d53147'),(8619,920,'s2-list_4_ttl','Магній'),(8620,920,'_s2-list_4_ttl','field_60c0745253144'),(8621,920,'s2-list_4_formula','Mg<sup>2+</sup>'),(8622,920,'_s2-list_4_formula','field_60c0747253145'),(8623,920,'s2-list_4_size','- 50 мл/г'),(8624,920,'_s2-list_4_size','field_60c0749553146'),(8625,920,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(8626,920,'_s2-list_4_text','field_60c0749d53147'),(8627,920,'s2-list_5_ttl','Хлор'),(8628,920,'_s2-list_5_ttl','field_60c0745253144'),(8629,920,'s2-list_5_formula','Cl<sup>-</sup>'),(8630,920,'_s2-list_5_formula','field_60c0747253145'),(8631,920,'s2-list_5_size','- 600 мл/г'),(8632,920,'_s2-list_5_size','field_60c0749553146'),(8633,920,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(8634,920,'_s2-list_5_text','field_60c0749d53147'),(8635,920,'s2-list_6_ttl','Калій'),(8636,920,'_s2-list_6_ttl','field_60c0745253144'),(8637,920,'s2-list_6_formula','K<sup>+</sup>'),(8638,920,'_s2-list_6_formula','field_60c0747253145'),(8639,920,'s2-list_6_size','- 160 мл/г'),(8640,920,'_s2-list_6_size','field_60c0749553146'),(8641,920,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(8642,920,'_s2-list_6_text','field_60c0749d53147'),(8643,920,'s2-list_7_ttl','Кальцій'),(8644,920,'_s2-list_7_ttl','field_60c0745253144'),(8645,920,'s2-list_7_formula','Ca<sup>2+</sup>'),(8646,920,'_s2-list_7_formula','field_60c0747253145'),(8647,920,'s2-list_7_size','- 50 мл/г'),(8648,920,'_s2-list_7_size','field_60c0749553146'),(8649,920,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(8650,920,'_s2-list_7_text','field_60c0749d53147'),(8651,920,'s2-list_8_ttl','Гідрокарбонати'),(8652,920,'_s2-list_8_ttl','field_60c0745253144'),(8653,920,'s2-list_8_formula','HCO<sup>3+</sup>'),(8654,920,'_s2-list_8_formula','field_60c0747253145'),(8655,920,'s2-list_8_size','- 300 мл/г'),(8656,920,'_s2-list_8_size','field_60c0749553146'),(8657,920,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(8658,920,'_s2-list_8_text','field_60c0749d53147'),(8660,921,'_s2-list','field_60bf76e0f46ee'),(8661,921,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(8662,921,'_s2-ttl','field_60bf76d1f46ed'),(8663,921,'slider','8'),(8664,921,'_slider','field_60bf767ef46ea'),(8665,921,'slider_0_slide','336'),(8666,921,'_slider_0_slide','field_60bf7688f46eb'),(8667,921,'slider_1_slide','346'),(8668,921,'_slider_1_slide','field_60bf7688f46eb'),(8669,921,'slider_2_slide','342'),(8670,921,'_slider_2_slide','field_60bf7688f46eb'),(8671,921,'slider_3_slide','340'),(8672,921,'_slider_3_slide','field_60bf7688f46eb'),(8673,921,'slider_4_slide','338'),(8674,921,'_slider_4_slide','field_60bf7688f46eb'),(8675,921,'slider_5_slide','334'),(8676,921,'_slider_5_slide','field_60bf7688f46eb'),(8677,921,'slider_6_slide','332'),(8678,921,'_slider_6_slide','field_60bf7688f46eb'),(8679,921,'slider_7_slide','344'),(8680,921,'_slider_7_slide','field_60bf7688f46eb'),(8681,921,'s2-list_0_icon','61'),(8682,921,'_s2-list_0_icon','field_60bf76ecf46ef'),(8683,921,'s2-list_0_icon-hover','62'),(8684,921,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(8685,921,'s2-list_0_text','Лихорадка'),(8686,921,'_s2-list_0_text','field_60bf7712f46f1'),(8687,921,'s2-list_1_icon','63'),(8688,921,'_s2-list_1_icon','field_60bf76ecf46ef'),(8689,921,'s2-list_1_icon-hover','64'),(8690,921,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(8691,921,'s2-list_1_text','Похмельный синдром'),(8692,921,'_s2-list_1_text','field_60bf7712f46f1'),(8693,921,'s2-list_2_icon','65'),(8694,921,'_s2-list_2_icon','field_60bf76ecf46ef'),(8695,921,'s2-list_2_icon-hover','66'),(8696,921,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(8697,921,'s2-list_2_text','Диарея'),(8698,921,'_s2-list_2_text','field_60bf7712f46f1'),(8699,921,'s2-list_3_icon','67'),(8700,921,'_s2-list_3_icon','field_60bf76ecf46ef'),(8701,921,'s2-list_3_icon-hover','68'),(8702,921,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(8703,921,'s2-list_3_text','Рвота'),(8704,921,'_s2-list_3_text','field_60bf7712f46f1'),(8705,921,'s2-list_4_icon','69'),(8706,921,'_s2-list_4_icon','field_60bf76ecf46ef'),(8707,921,'s2-list_4_icon-hover','70'),(8708,921,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(8709,921,'s2-list_4_text','Интенсивные физические нагрузки'),(8710,921,'_s2-list_4_text','field_60bf7712f46f1'),(8711,921,'s2-list_5_icon','71'),(8712,921,'_s2-list_5_icon','field_60bf76ecf46ef'),(8713,921,'s2-list_5_icon-hover','72'),(8714,921,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(8715,921,'s2-list_5_text','Перегрев в жаркую погоду'),(8716,921,'_s2-list_5_text','field_60bf7712f46f1'),(8717,921,'s1-slogan','Когда обычной воды недостаточно!'),(8718,921,'_s1-slogan','field_60bf7ab4d9ba9'),(8719,921,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(8720,921,'_s3-text','field_60bf7bb5a7e2b'),(8721,921,'s4-ttl','РеО – вода для медицинских целей!'),(8722,921,'_s4-ttl','field_60bf7c831f58c'),(8723,921,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(8724,921,'_s4-notes','field_60bf7ca31f58d'),(8725,921,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(8726,921,'_s5-video','field_60bf7ccfa01a5'),(8727,921,'s6-ttl','Когда обычной воды недостаточно!'),(8728,921,'_s6-ttl','field_60bf7cfb10d31'),(8729,921,'s6-list','6'),(8730,921,'_s6-list','field_60bf7d0410d32'),(8731,921,'s6-list_0_icon','92'),(8732,921,'_s6-list_0_icon','field_60bf7d1810d33'),(8733,921,'s6-list_0_text','При повышенной температуре'),(8734,921,'_s6-list_0_text','field_60bf7d2710d34'),(8735,921,'s6-list_1_icon','93'),(8736,921,'_s6-list_1_icon','field_60bf7d1810d33'),(8737,921,'s6-list_1_text','При пищевых отравлениях'),(8738,921,'_s6-list_1_text','field_60bf7d2710d34'),(8739,921,'s6-list_2_icon','94'),(8740,921,'_s6-list_2_icon','field_60bf7d1810d33'),(8741,921,'s6-list_2_text','При кишечных инфекциях'),(8742,921,'_s6-list_2_text','field_60bf7d2710d34'),(8743,921,'s6-list_3_icon','95'),(8744,921,'_s6-list_3_icon','field_60bf7d1810d33'),(8745,921,'s6-list_3_text','Во время беременности'),(8746,921,'_s6-list_3_text','field_60bf7d2710d34'),(8747,921,'s6-list_4_icon','96'),(8748,921,'_s6-list_4_icon','field_60bf7d1810d33'),(8749,921,'s6-list_4_text','Во время занятий спортом'),(8750,921,'_s6-list_4_text','field_60bf7d2710d34'),(8751,921,'s6-list_5_icon','97'),(8752,921,'_s6-list_5_icon','field_60bf7d1810d33'),(8753,921,'s6-list_5_text','При похмельном синдроме'),(8754,921,'_s6-list_5_text','field_60bf7d2710d34'),(8755,921,'s4-list_0_ttl','Натрий'),(8756,921,'_s4-list_0_ttl','field_60bf7fa95a92c'),(8757,921,'s4-list_0_formula','Na<sup>+</sup>'),(8758,921,'_s4-list_0_formula','field_60bf7fc65a92d'),(8759,921,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(8760,921,'_s4-list_0_text','field_60bf7fd35a92e'),(8761,921,'s4-list_1_ttl','Вода'),(8762,921,'_s4-list_1_ttl','field_60bf7fa95a92c'),(8763,921,'s4-list_1_formula','H<sub>2</sub>O'),(8764,921,'_s4-list_1_formula','field_60bf7fc65a92d'),(8765,921,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(8766,921,'_s4-list_1_text','field_60bf7fd35a92e'),(8767,921,'s4-list','9'),(8768,921,'_s4-list','field_60bf7f985a92b'),(8769,921,'s4-list_2_ttl','Калий'),(8770,921,'_s4-list_2_ttl','field_60bf7fa95a92c'),(8771,921,'s4-list_2_formula','K<sup>+</sup>'),(8772,921,'_s4-list_2_formula','field_60bf7fc65a92d'),(8773,921,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(8774,921,'_s4-list_2_text','field_60bf7fd35a92e'),(8775,921,'s4-list_3_ttl','Гидрокарбонаты'),(8776,921,'_s4-list_3_ttl','field_60bf7fa95a92c'),(8777,921,'s4-list_3_formula','HCO<sup>3+</sup>'),(8778,921,'_s4-list_3_formula','field_60bf7fc65a92d'),(8779,921,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(8780,921,'_s4-list_3_text','field_60bf7fd35a92e'),(8781,921,'s4-list_4_ttl','Магний'),(8782,921,'_s4-list_4_ttl','field_60bf7fa95a92c'),(8783,921,'s4-list_4_formula','Mg<sup>2+</sup>'),(8784,921,'_s4-list_4_formula','field_60bf7fc65a92d'),(8785,921,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(8786,921,'_s4-list_4_text','field_60bf7fd35a92e'),(8787,921,'s4-list_5_ttl','Углекислый газ'),(8788,921,'_s4-list_5_ttl','field_60bf7fa95a92c'),(8789,921,'s4-list_5_formula','CO<sup>2</sup>+'),(8790,921,'_s4-list_5_formula','field_60bf7fc65a92d'),(8791,921,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(8792,921,'_s4-list_5_text','field_60bf7fd35a92e'),(8793,921,'s4-list_6_ttl','Кальций'),(8794,921,'_s4-list_6_ttl','field_60bf7fa95a92c'),(8795,921,'s4-list_6_formula','Ca<sup>2+</sup>'),(8796,921,'_s4-list_6_formula','field_60bf7fc65a92d'),(8797,921,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(8798,921,'_s4-list_6_text','field_60bf7fd35a92e'),(8799,921,'s4-list_7_ttl','Сорбит'),(8800,921,'_s4-list_7_ttl','field_60bf7fa95a92c'),(8801,921,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(8802,921,'_s4-list_7_formula','field_60bf7fc65a92d'),(8803,921,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(8804,921,'_s4-list_7_text','field_60bf7fd35a92e'),(8805,921,'s4-list_8_ttl','Хлор'),(8806,921,'_s4-list_8_ttl','field_60bf7fa95a92c'),(8807,921,'s4-list_8_formula','Cl'),(8808,921,'_s4-list_8_formula','field_60bf7fc65a92d'),(8809,921,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(8810,921,'_s4-list_8_text','field_60bf7fd35a92e'),(8811,921,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(8812,921,'_s4-feature1','field_60bf80ca480ea'),(8813,921,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(8814,921,'_s4-feature2','field_60bf80de480eb'),(8815,921,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(8816,921,'_s4-feature3','field_60bf80e2480ec'),(8817,921,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(8818,921,'_s4-feature4','field_60bf80e5480ed'),(8820,922,'_s1-text','field_60c069d69838b'),(8821,922,'s3-list','5'),(8822,922,'_s3-list','field_60c06d9298394'),(8823,922,'s3-list2','3'),(8824,922,'_s3-list2','field_60c06dd498396'),(8825,922,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(8826,922,'_s4-ttl','field_60c06ba39838e'),(8827,922,'s4-list','7'),(8828,922,'_s4-list','field_60c06bb39838f'),(8829,922,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(8830,922,'_s4-slogan','field_60c06d6d98392'),(8831,922,'s4-list_0_icon','127'),(8832,922,'_s4-list_0_icon','field_60c06bc298390'),(8833,922,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(8834,922,'_s4-list_0_text','field_60c06bce98391'),(8835,922,'s4-list_1_icon','128'),(8836,922,'_s4-list_1_icon','field_60c06bc298390'),(8837,922,'s4-list_1_text','<strong>головокружение</strong>'),(8838,922,'_s4-list_1_text','field_60c06bce98391'),(8839,922,'s4-list_2_icon','68'),(8840,922,'_s4-list_2_icon','field_60c06bc298390'),(8841,922,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(8842,922,'_s4-list_2_text','field_60c06bce98391'),(8843,922,'s4-list_3_icon','64'),(8844,922,'_s4-list_3_icon','field_60c06bc298390'),(8845,922,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(8846,922,'_s4-list_3_text','field_60c06bce98391'),(8847,922,'s4-list_4_icon','129'),(8848,922,'_s4-list_4_icon','field_60c06bc298390'),(8849,922,'s4-list_4_text','<strong>диарея</strong>'),(8850,922,'_s4-list_4_text','field_60c06bce98391'),(8851,922,'s4-list_5_icon','130'),(8852,922,'_s4-list_5_icon','field_60c06bc298390'),(8853,922,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(8854,922,'_s4-list_5_text','field_60c06bce98391'),(8855,922,'s4-list_6_icon','131'),(8856,922,'_s4-list_6_icon','field_60c06bc298390'),(8857,922,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(8858,922,'_s4-list_6_text','field_60c06bce98391'),(8859,922,'s3-list_0_li','имеет сбалансированный<br /> состав'),(8860,922,'_s3-list_0_li','field_60c06db098395'),(8861,922,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(8862,922,'_s3-list_1_li','field_60c06db098395'),(8863,922,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(8864,922,'_s3-list_2_li','field_60c06db098395'),(8865,922,'s3-list_3_li','имеет приятный вкус и легко пьется даже при ощущении тошноты'),(8866,922,'_s3-list_3_li','field_60c06db098395'),(8867,922,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(8868,922,'_s3-list_4_li','field_60c06db098395'),(8869,922,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(8870,922,'_s3-list2_0_li','field_60c06dd498397'),(8871,922,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(8872,922,'_s3-list2_1_li','field_60c06dd498397'),(8873,922,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс в стационаре и после выписки на дом'),(8874,922,'_s3-list2_2_li','field_60c06dd498397'),(8875,922,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(8876,922,'_s2-list_3_text','field_60c0749d53147'),(8877,922,'s2-list_3_size','- 900 мл/г'),(8878,922,'_s2-list_3_size','field_60c0749553146'),(8879,922,'s2-list_3_formula','Na<sup>+</sup>'),(8880,922,'_s2-list_3_formula','field_60c0747253145'),(8881,922,'s2-list_3_ttl','Натрий'),(8882,922,'_s2-list_3_ttl','field_60c0745253144'),(8883,922,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(8884,922,'_s2-list_2_text','field_60c0749d53147'),(8885,922,'s2-list_2_size','до 900 мл/г'),(8886,922,'_s2-list_2_size','field_60c0749553146'),(8887,922,'s2-list_2_formula','Сорбитол'),(8888,922,'_s2-list_2_formula','field_60c0747253145'),(8889,922,'s2-list_2_ttl','Сорбитол'),(8890,922,'_s2-list_2_ttl','field_60c0745253144'),(8891,922,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(8892,922,'_s2-list_1_text','field_60c0749d53147'),(8893,922,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(8894,922,'_s2-list_1_size','field_60c0749553146'),(8895,922,'s2-list_1_formula','Минерализация'),(8896,922,'_s2-list_1_formula','field_60c0747253145'),(8897,922,'s2-list_1_ttl','Минерализация'),(8898,922,'_s2-list_1_ttl','field_60c0745253144'),(8899,922,'s2-list_0_ttl','Углекислота'),(8900,922,'_s2-list_0_ttl','field_60c0745253144'),(8901,922,'s2-list_0_formula','Углекислота'),(8902,922,'_s2-list_0_formula','field_60c0747253145'),(8903,922,'s2-list_0_size','- 0,05-0,3%'),(8904,922,'_s2-list_0_size','field_60c0749553146'),(8905,922,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(8906,922,'_s2-list_0_text','field_60c0749d53147'),(8907,922,'s2-list','9'),(8908,922,'_s2-list','field_60c0743a53143'),(8909,922,'s2-list_4_ttl','Магний'),(8910,922,'_s2-list_4_ttl','field_60c0745253144'),(8911,922,'s2-list_4_formula','Mg<sup>2+</sup>'),(8912,922,'_s2-list_4_formula','field_60c0747253145'),(8913,922,'s2-list_4_size','- 50 мл/г'),(8914,922,'_s2-list_4_size','field_60c0749553146'),(8915,922,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(8916,922,'_s2-list_4_text','field_60c0749d53147'),(8917,922,'s2-list_5_ttl','Хлор'),(8918,922,'_s2-list_5_ttl','field_60c0745253144'),(8919,922,'s2-list_5_formula','Cl<sup>-</sup>'),(8920,922,'_s2-list_5_formula','field_60c0747253145'),(8921,922,'s2-list_5_size','- 600 мл/г'),(8922,922,'_s2-list_5_size','field_60c0749553146'),(8923,922,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(8924,922,'_s2-list_5_text','field_60c0749d53147'),(8925,922,'s2-list_6_ttl','Калий'),(8926,922,'_s2-list_6_ttl','field_60c0745253144'),(8927,922,'s2-list_6_formula','K<sup>+</sup>'),(8928,922,'_s2-list_6_formula','field_60c0747253145'),(8929,922,'s2-list_6_size','- 160 мл/г'),(8930,922,'_s2-list_6_size','field_60c0749553146'),(8931,922,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(8932,922,'_s2-list_6_text','field_60c0749d53147'),(8933,922,'s2-list_7_ttl','Кальций'),(8934,922,'_s2-list_7_ttl','field_60c0745253144'),(8935,922,'s2-list_7_formula','Ca<sup>2+</sup>'),(8936,922,'_s2-list_7_formula','field_60c0747253145'),(8937,922,'s2-list_7_size','- 50 мл/г'),(8938,922,'_s2-list_7_size','field_60c0749553146'),(8939,922,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(8940,922,'_s2-list_7_text','field_60c0749d53147'),(8941,922,'s2-list_8_ttl','Гидрокарбонаты'),(8942,922,'_s2-list_8_ttl','field_60c0745253144'),(8943,922,'s2-list_8_formula','HCO<sup>3+</sup>'),(8944,922,'_s2-list_8_formula','field_60c0747253145'),(8945,922,'s2-list_8_size','- 300 мл/г'),(8946,922,'_s2-list_8_size','field_60c0749553146'),(8947,922,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(8948,922,'_s2-list_8_text','field_60c0749d53147'),(8949,923,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(8950,923,'_s1-text','field_60c069d69838b'),(8951,923,'s3-list','5'),(8952,923,'_s3-list','field_60c06d9298394'),(8953,923,'s3-list2','3'),(8954,923,'_s3-list2','field_60c06dd498396'),(8955,923,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(8956,923,'_s4-ttl','field_60c06ba39838e'),(8957,923,'s4-list','7'),(8958,923,'_s4-list','field_60c06bb39838f'),(8959,923,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(8960,923,'_s4-slogan','field_60c06d6d98392'),(8961,923,'s4-list_0_icon','127'),(8962,923,'_s4-list_0_icon','field_60c06bc298390'),(8963,923,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(8964,923,'_s4-list_0_text','field_60c06bce98391'),(8965,923,'s4-list_1_icon','128'),(8966,923,'_s4-list_1_icon','field_60c06bc298390'),(8967,923,'s4-list_1_text','<strong>головокружение</strong>'),(8968,923,'_s4-list_1_text','field_60c06bce98391'),(8969,923,'s4-list_2_icon','68'),(8970,923,'_s4-list_2_icon','field_60c06bc298390'),(8971,923,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(8972,923,'_s4-list_2_text','field_60c06bce98391'),(8973,923,'s4-list_3_icon','64'),(8974,923,'_s4-list_3_icon','field_60c06bc298390'),(8975,923,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(8976,923,'_s4-list_3_text','field_60c06bce98391'),(8977,923,'s4-list_4_icon','129'),(8978,923,'_s4-list_4_icon','field_60c06bc298390'),(8979,923,'s4-list_4_text','<strong>диарея</strong>'),(8980,923,'_s4-list_4_text','field_60c06bce98391'),(8981,923,'s4-list_5_icon','130'),(8982,923,'_s4-list_5_icon','field_60c06bc298390'),(8983,923,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(8984,923,'_s4-list_5_text','field_60c06bce98391'),(8985,923,'s4-list_6_icon','131'),(8986,923,'_s4-list_6_icon','field_60c06bc298390'),(8987,923,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(8988,923,'_s4-list_6_text','field_60c06bce98391'),(8989,923,'s3-list_0_li','имеет сбалансированный<br /> состав'),(8990,923,'_s3-list_0_li','field_60c06db098395'),(8991,923,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(8992,923,'_s3-list_1_li','field_60c06db098395'),(8993,923,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(8994,923,'_s3-list_2_li','field_60c06db098395'),(8995,923,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(8996,923,'_s3-list_3_li','field_60c06db098395'),(8997,923,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(8998,923,'_s3-list_4_li','field_60c06db098395'),(8999,923,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(9000,923,'_s3-list2_0_li','field_60c06dd498397'),(9001,923,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(9002,923,'_s3-list2_1_li','field_60c06dd498397'),(9003,923,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(9004,923,'_s3-list2_2_li','field_60c06dd498397'),(9005,923,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(9006,923,'_s2-list_3_text','field_60c0749d53147'),(9007,923,'s2-list_3_size','- 900 мл/г'),(9008,923,'_s2-list_3_size','field_60c0749553146'),(9009,923,'s2-list_3_formula','Na<sup>+</sup>'),(9010,923,'_s2-list_3_formula','field_60c0747253145'),(9011,923,'s2-list_3_ttl','Натрий'),(9012,923,'_s2-list_3_ttl','field_60c0745253144'),(9013,923,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. 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А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(9462,1057,'_s3-text','field_60bf7bb5a7e2b'),(9463,1057,'s4-ttl','РеО – вода для медичних цілей'),(9464,1057,'_s4-ttl','field_60bf7c831f58c'),(9465,1057,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(9466,1057,'_s4-notes','field_60bf7ca31f58d'),(9467,1057,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(9468,1057,'_s5-video','field_60bf7ccfa01a5'),(9469,1057,'s6-ttl','Коли звичайної води замало!'),(9470,1057,'_s6-ttl','field_60bf7cfb10d31'),(9471,1057,'s6-list','6'),(9472,1057,'_s6-list','field_60bf7d0410d32'),(9473,1057,'s6-list_0_icon','92'),(9474,1057,'_s6-list_0_icon','field_60bf7d1810d33'),(9475,1057,'s6-list_0_text','При підвищеній температурі'),(9476,1057,'_s6-list_0_text','field_60bf7d2710d34'),(9477,1057,'s6-list_1_icon','93'),(9478,1057,'_s6-list_1_icon','field_60bf7d1810d33'),(9479,1057,'s6-list_1_text','При харчових отруєннях'),(9480,1057,'_s6-list_1_text','field_60bf7d2710d34'),(9481,1057,'s6-list_2_icon','94'),(9482,1057,'_s6-list_2_icon','field_60bf7d1810d33'),(9483,1057,'s6-list_2_text','При кишкових інфекціях'),(9484,1057,'_s6-list_2_text','field_60bf7d2710d34'),(9485,1057,'s6-list_3_icon','95'),(9486,1057,'_s6-list_3_icon','field_60bf7d1810d33'),(9487,1057,'s6-list_3_text','Під час вагітності'),(9488,1057,'_s6-list_3_text','field_60bf7d2710d34'),(9489,1057,'s6-list_4_icon','96'),(9490,1057,'_s6-list_4_icon','field_60bf7d1810d33'),(9491,1057,'s6-list_4_text','Під час заняття спортом'),(9492,1057,'_s6-list_4_text','field_60bf7d2710d34'),(9493,1057,'s6-list_5_icon','97'),(9494,1057,'_s6-list_5_icon','field_60bf7d1810d33'),(9495,1057,'s6-list_5_text','При похмільному синдромі'),(9496,1057,'_s6-list_5_text','field_60bf7d2710d34'),(9497,1057,'s4-list_0_ttl','Натрій'),(9498,1057,'_s4-list_0_ttl','field_60bf7fa95a92c'),(9499,1057,'s4-list_0_formula','Na<sup>+</sup>'),(9500,1057,'_s4-list_0_formula','field_60bf7fc65a92d'),(9501,1057,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(9502,1057,'_s4-list_0_text','field_60bf7fd35a92e'),(9503,1057,'s4-list_1_ttl','Вода'),(9504,1057,'_s4-list_1_ttl','field_60bf7fa95a92c'),(9505,1057,'s4-list_1_formula','H<sub>2</sub>O'),(9506,1057,'_s4-list_1_formula','field_60bf7fc65a92d'),(9507,1057,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(9508,1057,'_s4-list_1_text','field_60bf7fd35a92e'),(9509,1057,'s4-list','9'),(9510,1057,'_s4-list','field_60bf7f985a92b'),(9511,1057,'s4-list_2_ttl','Калій'),(9512,1057,'_s4-list_2_ttl','field_60bf7fa95a92c'),(9513,1057,'s4-list_2_formula','K<sup>+</sup>'),(9514,1057,'_s4-list_2_formula','field_60bf7fc65a92d'),(9515,1057,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(9516,1057,'_s4-list_2_text','field_60bf7fd35a92e'),(9517,1057,'s4-list_3_ttl','Гідрокарбонати'),(9518,1057,'_s4-list_3_ttl','field_60bf7fa95a92c'),(9519,1057,'s4-list_3_formula','HCO<sup>3+</sup>'),(9520,1057,'_s4-list_3_formula','field_60bf7fc65a92d'),(9521,1057,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(9522,1057,'_s4-list_3_text','field_60bf7fd35a92e'),(9523,1057,'s4-list_4_ttl','Магній'),(9524,1057,'_s4-list_4_ttl','field_60bf7fa95a92c'),(9525,1057,'s4-list_4_formula','Mg<sup>2+</sup>'),(9526,1057,'_s4-list_4_formula','field_60bf7fc65a92d'),(9527,1057,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. 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- це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(9690,1109,'dwn-pdf',''),(9691,1109,'_dwn-pdf','field_60d5912c4d881'),(9693,1110,'_s1-text','field_60c069d69838b'),(9694,1110,'s3-list','5'),(9695,1110,'_s3-list','field_60c06d9298394'),(9696,1110,'s3-list2','3'),(9697,1110,'_s3-list2','field_60c06dd498396'),(9698,1110,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(9699,1110,'_s4-ttl','field_60c06ba39838e'),(9700,1110,'s4-list','7'),(9701,1110,'_s4-list','field_60c06bb39838f'),(9702,1110,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(9703,1110,'_s4-slogan','field_60c06d6d98392'),(9704,1110,'s4-list_0_icon','127'),(9705,1110,'_s4-list_0_icon','field_60c06bc298390'),(9706,1110,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(9707,1110,'_s4-list_0_text','field_60c06bce98391'),(9708,1110,'s4-list_1_icon','128'),(9709,1110,'_s4-list_1_icon','field_60c06bc298390'),(9710,1110,'s4-list_1_text','<strong>головокружiння</strong>'),(9711,1110,'_s4-list_1_text','field_60c06bce98391'),(9712,1110,'s4-list_2_icon','68'),(9713,1110,'_s4-list_2_icon','field_60c06bc298390'),(9714,1110,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(9715,1110,'_s4-list_2_text','field_60c06bce98391'),(9716,1110,'s4-list_3_icon','64'),(9717,1110,'_s4-list_3_icon','field_60c06bc298390'),(9718,1110,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(9719,1110,'_s4-list_3_text','field_60c06bce98391'),(9720,1110,'s4-list_4_icon','129'),(9721,1110,'_s4-list_4_icon','field_60c06bc298390'),(9722,1110,'s4-list_4_text','<strong>дiарея</strong>'),(9723,1110,'_s4-list_4_text','field_60c06bce98391'),(9724,1110,'s4-list_5_icon','130'),(9725,1110,'_s4-list_5_icon','field_60c06bc298390'),(9726,1110,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(9727,1110,'_s4-list_5_text','field_60c06bce98391'),(9728,1110,'s4-list_6_icon','131'),(9729,1110,'_s4-list_6_icon','field_60c06bc298390'),(9730,1110,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(9731,1110,'_s4-list_6_text','field_60c06bce98391'),(9732,1110,'s3-list_0_li','має збалансований<br /> склад'),(9733,1110,'_s3-list_0_li','field_60c06db098395'),(9734,1110,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(9735,1110,'_s3-list_1_li','field_60c06db098395'),(9736,1110,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(9737,1110,'_s3-list_2_li','field_60c06db098395'),(9738,1110,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(9739,1110,'_s3-list_3_li','field_60c06db098395'),(9740,1110,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(9741,1110,'_s3-list_4_li','field_60c06db098395'),(9742,1110,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(9743,1110,'_s3-list2_0_li','field_60c06dd498397'),(9744,1110,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(9745,1110,'_s3-list2_1_li','field_60c06dd498397'),(9746,1110,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(9747,1110,'_s3-list2_2_li','field_60c06dd498397'),(9748,1110,'s2-list_0_ttl','Вуглекислота'),(9749,1110,'_s2-list_0_ttl','field_60c0745253144'),(9750,1110,'s2-list_0_formula','Вуглекислота'),(9751,1110,'_s2-list_0_formula','field_60c0747253145'),(9752,1110,'s2-list_0_size','- 0,05-0,3%'),(9753,1110,'_s2-list_0_size','field_60c0749553146'),(9754,1110,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(9755,1110,'_s2-list_0_text','field_60c0749d53147'),(9756,1110,'s2-list','9'),(9757,1110,'_s2-list','field_60c0743a53143'),(9758,1110,'s2-list_1_ttl','Мiнералiзацiя'),(9759,1110,'_s2-list_1_ttl','field_60c0745253144'),(9760,1110,'s2-list_1_formula','Мiнералiзацiя'),(9761,1110,'_s2-list_1_formula','field_60c0747253145'),(9762,1110,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(9763,1110,'_s2-list_1_size','field_60c0749553146'),(9764,1110,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(9765,1110,'_s2-list_1_text','field_60c0749d53147'),(9766,1110,'s2-list_2_ttl','Сорбітол'),(9767,1110,'_s2-list_2_ttl','field_60c0745253144'),(9768,1110,'s2-list_2_formula','Сорбітол'),(9769,1110,'_s2-list_2_formula','field_60c0747253145'),(9770,1110,'s2-list_2_size','до 900 мл/г'),(9771,1110,'_s2-list_2_size','field_60c0749553146'),(9772,1110,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(9773,1110,'_s2-list_2_text','field_60c0749d53147'),(9774,1110,'s2-list_3_ttl','Натрій'),(9775,1110,'_s2-list_3_ttl','field_60c0745253144'),(9776,1110,'s2-list_3_formula','Na<sup>+</sup>'),(9777,1110,'_s2-list_3_formula','field_60c0747253145'),(9778,1110,'s2-list_3_size','- 900 мл/г'),(9779,1110,'_s2-list_3_size','field_60c0749553146'),(9780,1110,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(9781,1110,'_s2-list_3_text','field_60c0749d53147'),(9782,1110,'s2-list_4_ttl','Магній'),(9783,1110,'_s2-list_4_ttl','field_60c0745253144'),(9784,1110,'s2-list_4_formula','Mg<sup>2+</sup>'),(9785,1110,'_s2-list_4_formula','field_60c0747253145'),(9786,1110,'s2-list_4_size','- 50 мл/г'),(9787,1110,'_s2-list_4_size','field_60c0749553146'),(9788,1110,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(9789,1110,'_s2-list_4_text','field_60c0749d53147'),(9790,1110,'s2-list_5_ttl','Хлор'),(9791,1110,'_s2-list_5_ttl','field_60c0745253144'),(9792,1110,'s2-list_5_formula','Cl<sup>-</sup>'),(9793,1110,'_s2-list_5_formula','field_60c0747253145'),(9794,1110,'s2-list_5_size','- 600 мл/г'),(9795,1110,'_s2-list_5_size','field_60c0749553146'),(9796,1110,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(9797,1110,'_s2-list_5_text','field_60c0749d53147'),(9798,1110,'s2-list_6_ttl','Калій'),(9799,1110,'_s2-list_6_ttl','field_60c0745253144'),(9800,1110,'s2-list_6_formula','K<sup>+</sup>'),(9801,1110,'_s2-list_6_formula','field_60c0747253145'),(9802,1110,'s2-list_6_size','- 160 мл/г'),(9803,1110,'_s2-list_6_size','field_60c0749553146'),(9804,1110,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(9805,1110,'_s2-list_6_text','field_60c0749d53147'),(9806,1110,'s2-list_7_ttl','Кальцій'),(9807,1110,'_s2-list_7_ttl','field_60c0745253144'),(9808,1110,'s2-list_7_formula','Ca<sup>2+</sup>'),(9809,1110,'_s2-list_7_formula','field_60c0747253145'),(9810,1110,'s2-list_7_size','- 50 мл/г'),(9811,1110,'_s2-list_7_size','field_60c0749553146'),(9812,1110,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. 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навантаження'),(9993,1141,'_s2-list_4_text','field_60bf7712f46f1'),(9994,1141,'s2-list_5_icon','71'),(9995,1141,'_s2-list_5_icon','field_60bf76ecf46ef'),(9996,1141,'s2-list_5_icon-hover','72'),(9997,1141,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(9998,1141,'s2-list_5_text','Перегрівання в спекотну погоду'),(9999,1141,'_s2-list_5_text','field_60bf7712f46f1'),(10000,1141,'s1-slogan','Коли звичайної води замало!'),(10001,1141,'_s1-slogan','field_60bf7ab4d9ba9'),(10002,1141,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(10003,1141,'_s3-text','field_60bf7bb5a7e2b'),(10004,1141,'s4-ttl','РеО – вода для медичних цілей'),(10005,1141,'_s4-ttl','field_60bf7c831f58c'),(10006,1141,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(10007,1141,'_s4-notes','field_60bf7ca31f58d'),(10008,1141,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(10009,1141,'_s5-video','field_60bf7ccfa01a5'),(10010,1141,'s6-ttl','Коли звичайної води замало!'),(10011,1141,'_s6-ttl','field_60bf7cfb10d31'),(10012,1141,'s6-list','6'),(10013,1141,'_s6-list','field_60bf7d0410d32'),(10014,1141,'s6-list_0_icon','92'),(10015,1141,'_s6-list_0_icon','field_60bf7d1810d33'),(10016,1141,'s6-list_0_text','При підвищеній температурі'),(10017,1141,'_s6-list_0_text','field_60bf7d2710d34'),(10018,1141,'s6-list_1_icon','93'),(10019,1141,'_s6-list_1_icon','field_60bf7d1810d33'),(10020,1141,'s6-list_1_text','При харчових отруєннях'),(10021,1141,'_s6-list_1_text','field_60bf7d2710d34'),(10022,1141,'s6-list_2_icon','94'),(10023,1141,'_s6-list_2_icon','field_60bf7d1810d33'),(10024,1141,'s6-list_2_text','При кишкових інфекціях'),(10025,1141,'_s6-list_2_text','field_60bf7d2710d34'),(10026,1141,'s6-list_3_icon','95'),(10027,1141,'_s6-list_3_icon','field_60bf7d1810d33'),(10028,1141,'s6-list_3_text','Під час вагітності'),(10029,1141,'_s6-list_3_text','field_60bf7d2710d34'),(10030,1141,'s6-list_4_icon','96'),(10031,1141,'_s6-list_4_icon','field_60bf7d1810d33'),(10032,1141,'s6-list_4_text','Під час заняття спортом'),(10033,1141,'_s6-list_4_text','field_60bf7d2710d34'),(10034,1141,'s6-list_5_icon','97'),(10035,1141,'_s6-list_5_icon','field_60bf7d1810d33'),(10036,1141,'s6-list_5_text','При похмільному синдромі'),(10037,1141,'_s6-list_5_text','field_60bf7d2710d34'),(10038,1141,'s4-list_0_ttl','Натрій'),(10039,1141,'_s4-list_0_ttl','field_60bf7fa95a92c'),(10040,1141,'s4-list_0_formula','Na<sup>+</sup>'),(10041,1141,'_s4-list_0_formula','field_60bf7fc65a92d'),(10042,1141,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(10043,1141,'_s4-list_0_text','field_60bf7fd35a92e'),(10044,1141,'s4-list_1_ttl','Вода'),(10045,1141,'_s4-list_1_ttl','field_60bf7fa95a92c'),(10046,1141,'s4-list_1_formula','H<sub>2</sub>O'),(10047,1141,'_s4-list_1_formula','field_60bf7fc65a92d'),(10048,1141,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(10049,1141,'_s4-list_1_text','field_60bf7fd35a92e'),(10050,1141,'s4-list','9'),(10051,1141,'_s4-list','field_60bf7f985a92b'),(10052,1141,'s4-list_2_ttl','Калій'),(10053,1141,'_s4-list_2_ttl','field_60bf7fa95a92c'),(10054,1141,'s4-list_2_formula','K<sup>+</sup>'),(10055,1141,'_s4-list_2_formula','field_60bf7fc65a92d'),(10056,1141,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(10057,1141,'_s4-list_2_text','field_60bf7fd35a92e'),(10058,1141,'s4-list_3_ttl','Гідрокарбонати'),(10059,1141,'_s4-list_3_ttl','field_60bf7fa95a92c'),(10060,1141,'s4-list_3_formula','HCO<sup>3+</sup>'),(10061,1141,'_s4-list_3_formula','field_60bf7fc65a92d'),(10062,1141,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(10063,1141,'_s4-list_3_text','field_60bf7fd35a92e'),(10064,1141,'s4-list_4_ttl','Магній'),(10065,1141,'_s4-list_4_ttl','field_60bf7fa95a92c'),(10066,1141,'s4-list_4_formula','Mg<sup>2+</sup>'),(10067,1141,'_s4-list_4_formula','field_60bf7fc65a92d'),(10068,1141,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(10069,1141,'_s4-list_4_text','field_60bf7fd35a92e'),(10070,1141,'s4-list_5_ttl','Вуглекислий газ'),(10071,1141,'_s4-list_5_ttl','field_60bf7fa95a92c'),(10072,1141,'s4-list_5_formula','CO<sup>2</sup>+'),(10073,1141,'_s4-list_5_formula','field_60bf7fc65a92d'),(10074,1141,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(10075,1141,'_s4-list_5_text','field_60bf7fd35a92e'),(10076,1141,'s4-list_6_ttl','Кальцій'),(10077,1141,'_s4-list_6_ttl','field_60bf7fa95a92c'),(10078,1141,'s4-list_6_formula','Ca<sup>2+</sup>'),(10079,1141,'_s4-list_6_formula','field_60bf7fc65a92d'),(10080,1141,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(10081,1141,'_s4-list_6_text','field_60bf7fd35a92e'),(10082,1141,'s4-list_7_ttl','Сорбіт'),(10083,1141,'_s4-list_7_ttl','field_60bf7fa95a92c'),(10084,1141,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(10085,1141,'_s4-list_7_formula','field_60bf7fc65a92d'),(10086,1141,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(10087,1141,'_s4-list_7_text','field_60bf7fd35a92e'),(10088,1141,'s4-list_8_ttl','Хлор'),(10089,1141,'_s4-list_8_ttl','field_60bf7fa95a92c'),(10090,1141,'s4-list_8_formula','Cl'),(10091,1141,'_s4-list_8_formula','field_60bf7fc65a92d'),(10092,1141,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(10093,1141,'_s4-list_8_text','field_60bf7fd35a92e'),(10094,1141,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(10095,1141,'_s4-feature1','field_60bf80ca480ea'),(10096,1141,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(10097,1141,'_s4-feature2','field_60bf80de480eb'),(10098,1141,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(10099,1141,'_s4-feature3','field_60bf80e2480ec'),(10100,1141,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(10101,1141,'_s4-feature4','field_60bf80e5480ed'),(10102,1141,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(10103,1141,'_s2-list_0_link','field_60ee90d381a4e'),(10104,1141,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(10105,1141,'_s2-list_1_link','field_60ee90d381a4e'),(10106,1141,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(10107,1141,'_s2-list_2_link','field_60ee90d381a4e'),(10108,1141,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(10109,1141,'_s2-list_3_link','field_60ee90d381a4e'),(10110,1141,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(10111,1141,'_s2-list_4_link','field_60ee90d381a4e'),(10112,1141,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(10113,1141,'_s2-list_5_link','field_60ee90d381a4e'),(10114,1141,'s6-list_0_link',''),(10115,1141,'_s6-list_0_link','field_60ee916b04ace'),(10116,1141,'s6-list_1_link',''),(10117,1141,'_s6-list_1_link','field_60ee916b04ace'),(10118,1141,'s6-list_2_link',''),(10119,1141,'_s6-list_2_link','field_60ee916b04ace'),(10120,1141,'s6-list_3_link',''),(10121,1141,'_s6-list_3_link','field_60ee916b04ace'),(10122,1141,'s6-list_4_link',''),(10123,1141,'_s6-list_4_link','field_60ee916b04ace'),(10124,1141,'s6-list_5_link',''),(10125,1141,'_s6-list_5_link','field_60ee916b04ace'),(10126,1142,'slider','8'),(10127,1142,'_slider','field_60bf767ef46ea'),(10128,1142,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(10129,1142,'_s2-ttl','field_60bf76d1f46ed'),(10130,1142,'s2-list','6'),(10131,1142,'_s2-list','field_60bf76e0f46ee'),(10132,1142,'slider_0_slide','50'),(10133,1142,'_slider_0_slide','field_60bf7688f46eb'),(10134,1142,'slider_1_slide','51'),(10135,1142,'_slider_1_slide','field_60bf7688f46eb'),(10136,1142,'slider_2_slide','52'),(10137,1142,'_slider_2_slide','field_60bf7688f46eb'),(10138,1142,'slider_3_slide','53'),(10139,1142,'_slider_3_slide','field_60bf7688f46eb'),(10140,1142,'slider_4_slide','54'),(10141,1142,'_slider_4_slide','field_60bf7688f46eb'),(10142,1142,'slider_5_slide','55'),(10143,1142,'_slider_5_slide','field_60bf7688f46eb'),(10144,1142,'slider_6_slide','56'),(10145,1142,'_slider_6_slide','field_60bf7688f46eb'),(10146,1142,'slider_7_slide','57'),(10147,1142,'_slider_7_slide','field_60bf7688f46eb'),(10148,1142,'s2-list_0_icon','61'),(10149,1142,'_s2-list_0_icon','field_60bf76ecf46ef'),(10150,1142,'s2-list_0_icon-hover','62'),(10151,1142,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(10152,1142,'s2-list_0_text','Лихоманка'),(10153,1142,'_s2-list_0_text','field_60bf7712f46f1'),(10154,1142,'s2-list_1_icon','63'),(10155,1142,'_s2-list_1_icon','field_60bf76ecf46ef'),(10156,1142,'s2-list_1_icon-hover','64'),(10157,1142,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(10158,1142,'s2-list_1_text','Похмільний синдром'),(10159,1142,'_s2-list_1_text','field_60bf7712f46f1'),(10160,1142,'s2-list_2_icon','65'),(10161,1142,'_s2-list_2_icon','field_60bf76ecf46ef'),(10162,1142,'s2-list_2_icon-hover','66'),(10163,1142,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(10164,1142,'s2-list_2_text','Діарея'),(10165,1142,'_s2-list_2_text','field_60bf7712f46f1'),(10166,1142,'s2-list_3_icon','67'),(10167,1142,'_s2-list_3_icon','field_60bf76ecf46ef'),(10168,1142,'s2-list_3_icon-hover','68'),(10169,1142,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(10170,1142,'s2-list_3_text','Блювота'),(10171,1142,'_s2-list_3_text','field_60bf7712f46f1'),(10172,1142,'s2-list_4_icon','69'),(10173,1142,'_s2-list_4_icon','field_60bf76ecf46ef'),(10174,1142,'s2-list_4_icon-hover','70'),(10175,1142,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(10176,1142,'s2-list_4_text','Інтенсивні фізичні навантаження'),(10177,1142,'_s2-list_4_text','field_60bf7712f46f1'),(10178,1142,'s2-list_5_icon','71'),(10179,1142,'_s2-list_5_icon','field_60bf76ecf46ef'),(10180,1142,'s2-list_5_icon-hover','72'),(10181,1142,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(10182,1142,'s2-list_5_text','Перегрівання в спекотну погоду'),(10183,1142,'_s2-list_5_text','field_60bf7712f46f1'),(10184,1142,'s1-slogan','Коли звичайної води замало!'),(10185,1142,'_s1-slogan','field_60bf7ab4d9ba9'),(10186,1142,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(10187,1142,'_s3-text','field_60bf7bb5a7e2b'),(10188,1142,'s4-ttl','РеО – вода для медичних цілей'),(10189,1142,'_s4-ttl','field_60bf7c831f58c'),(10190,1142,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(10191,1142,'_s4-notes','field_60bf7ca31f58d'),(10192,1142,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(10193,1142,'_s5-video','field_60bf7ccfa01a5'),(10194,1142,'s6-ttl','Коли звичайної води замало!'),(10195,1142,'_s6-ttl','field_60bf7cfb10d31'),(10196,1142,'s6-list','6'),(10197,1142,'_s6-list','field_60bf7d0410d32'),(10198,1142,'s6-list_0_icon','92'),(10199,1142,'_s6-list_0_icon','field_60bf7d1810d33'),(10200,1142,'s6-list_0_text','При підвищеній температурі'),(10201,1142,'_s6-list_0_text','field_60bf7d2710d34'),(10202,1142,'s6-list_1_icon','93'),(10203,1142,'_s6-list_1_icon','field_60bf7d1810d33'),(10204,1142,'s6-list_1_text','При харчових отруєннях'),(10205,1142,'_s6-list_1_text','field_60bf7d2710d34'),(10206,1142,'s6-list_2_icon','94'),(10207,1142,'_s6-list_2_icon','field_60bf7d1810d33'),(10208,1142,'s6-list_2_text','При кишкових інфекціях'),(10209,1142,'_s6-list_2_text','field_60bf7d2710d34'),(10210,1142,'s6-list_3_icon','95'),(10211,1142,'_s6-list_3_icon','field_60bf7d1810d33'),(10212,1142,'s6-list_3_text','Під час вагітності'),(10213,1142,'_s6-list_3_text','field_60bf7d2710d34'),(10214,1142,'s6-list_4_icon','96'),(10215,1142,'_s6-list_4_icon','field_60bf7d1810d33'),(10216,1142,'s6-list_4_text','Під час заняття спортом'),(10217,1142,'_s6-list_4_text','field_60bf7d2710d34'),(10218,1142,'s6-list_5_icon','97'),(10219,1142,'_s6-list_5_icon','field_60bf7d1810d33'),(10220,1142,'s6-list_5_text','При похмільному синдромі'),(10221,1142,'_s6-list_5_text','field_60bf7d2710d34'),(10222,1142,'s4-list_0_ttl','Натрій'),(10223,1142,'_s4-list_0_ttl','field_60bf7fa95a92c'),(10224,1142,'s4-list_0_formula','Na<sup>+</sup>'),(10225,1142,'_s4-list_0_formula','field_60bf7fc65a92d'),(10226,1142,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(10227,1142,'_s4-list_0_text','field_60bf7fd35a92e'),(10228,1142,'s4-list_1_ttl','Вода'),(10229,1142,'_s4-list_1_ttl','field_60bf7fa95a92c'),(10230,1142,'s4-list_1_formula','H<sub>2</sub>O'),(10231,1142,'_s4-list_1_formula','field_60bf7fc65a92d'),(10232,1142,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(10233,1142,'_s4-list_1_text','field_60bf7fd35a92e'),(10234,1142,'s4-list','9'),(10235,1142,'_s4-list','field_60bf7f985a92b'),(10236,1142,'s4-list_2_ttl','Калій'),(10237,1142,'_s4-list_2_ttl','field_60bf7fa95a92c'),(10238,1142,'s4-list_2_formula','K<sup>+</sup>'),(10239,1142,'_s4-list_2_formula','field_60bf7fc65a92d'),(10240,1142,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(10241,1142,'_s4-list_2_text','field_60bf7fd35a92e'),(10242,1142,'s4-list_3_ttl','Гідрокарбонати'),(10243,1142,'_s4-list_3_ttl','field_60bf7fa95a92c'),(10244,1142,'s4-list_3_formula','HCO<sup>3+</sup>'),(10245,1142,'_s4-list_3_formula','field_60bf7fc65a92d'),(10246,1142,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(10247,1142,'_s4-list_3_text','field_60bf7fd35a92e'),(10248,1142,'s4-list_4_ttl','Магній'),(10249,1142,'_s4-list_4_ttl','field_60bf7fa95a92c'),(10250,1142,'s4-list_4_formula','Mg<sup>2+</sup>'),(10251,1142,'_s4-list_4_formula','field_60bf7fc65a92d'),(10252,1142,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(10253,1142,'_s4-list_4_text','field_60bf7fd35a92e'),(10254,1142,'s4-list_5_ttl','Вуглекислий газ'),(10255,1142,'_s4-list_5_ttl','field_60bf7fa95a92c'),(10256,1142,'s4-list_5_formula','CO<sup>2</sup>+'),(10257,1142,'_s4-list_5_formula','field_60bf7fc65a92d'),(10258,1142,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(10259,1142,'_s4-list_5_text','field_60bf7fd35a92e'),(10260,1142,'s4-list_6_ttl','Кальцій'),(10261,1142,'_s4-list_6_ttl','field_60bf7fa95a92c'),(10262,1142,'s4-list_6_formula','Ca<sup>2+</sup>'),(10263,1142,'_s4-list_6_formula','field_60bf7fc65a92d'),(10264,1142,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(10265,1142,'_s4-list_6_text','field_60bf7fd35a92e'),(10266,1142,'s4-list_7_ttl','Сорбіт'),(10267,1142,'_s4-list_7_ttl','field_60bf7fa95a92c'),(10268,1142,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(10269,1142,'_s4-list_7_formula','field_60bf7fc65a92d'),(10270,1142,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(10271,1142,'_s4-list_7_text','field_60bf7fd35a92e'),(10272,1142,'s4-list_8_ttl','Хлор'),(10273,1142,'_s4-list_8_ttl','field_60bf7fa95a92c'),(10274,1142,'s4-list_8_formula','Cl'),(10275,1142,'_s4-list_8_formula','field_60bf7fc65a92d'),(10276,1142,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(10277,1142,'_s4-list_8_text','field_60bf7fd35a92e'),(10278,1142,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(10279,1142,'_s4-feature1','field_60bf80ca480ea'),(10280,1142,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(10281,1142,'_s4-feature2','field_60bf80de480eb'),(10282,1142,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(10283,1142,'_s4-feature3','field_60bf80e2480ec'),(10284,1142,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(10285,1142,'_s4-feature4','field_60bf80e5480ed'),(10286,1142,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(10287,1142,'_s2-list_0_link','field_60ee90d381a4e'),(10288,1142,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(10289,1142,'_s2-list_1_link','field_60ee90d381a4e'),(10290,1142,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(10291,1142,'_s2-list_2_link','field_60ee90d381a4e'),(10292,1142,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(10293,1142,'_s2-list_3_link','field_60ee90d381a4e'),(10294,1142,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(10295,1142,'_s2-list_4_link','field_60ee90d381a4e'),(10296,1142,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(10297,1142,'_s2-list_5_link','field_60ee90d381a4e'),(10298,1142,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(10299,1142,'_s6-list_0_link','field_60ee916b04ace'),(10300,1142,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(10301,1142,'_s6-list_1_link','field_60ee916b04ace'),(10302,1142,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(10303,1142,'_s6-list_2_link','field_60ee916b04ace'),(10304,1142,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(10305,1142,'_s6-list_3_link','field_60ee916b04ace'),(10306,1142,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(10307,1142,'_s6-list_4_link','field_60ee916b04ace'),(10308,1142,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(10309,1142,'_s6-list_5_link','field_60ee916b04ace'),(10310,176,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(10311,176,'_s2-list_0_link','field_60ee90d381a4e'),(10312,176,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(10313,176,'_s2-list_1_link','field_60ee90d381a4e'),(10314,176,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(10315,176,'_s2-list_2_link','field_60ee90d381a4e'),(10316,176,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(10317,176,'_s2-list_3_link','field_60ee90d381a4e'),(10318,176,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(10319,176,'_s2-list_4_link','field_60ee90d381a4e'),(10320,176,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(10321,176,'_s2-list_5_link','field_60ee90d381a4e'),(10322,176,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(10323,176,'_s6-list_0_link','field_60ee916b04ace'),(10324,176,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(10325,176,'_s6-list_1_link','field_60ee916b04ace'),(10326,176,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(10327,176,'_s6-list_2_link','field_60ee916b04ace'),(10328,176,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(10329,176,'_s6-list_3_link','field_60ee916b04ace'),(10330,176,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(10331,176,'_s6-list_4_link','field_60ee916b04ace'),(10332,176,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(10333,176,'_s6-list_5_link','field_60ee916b04ace'),(10334,1143,'s2-list','6'),(10335,1143,'_s2-list','field_60bf76e0f46ee'),(10336,1143,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(10337,1143,'_s2-ttl','field_60bf76d1f46ed'),(10338,1143,'slider','8'),(10339,1143,'_slider','field_60bf767ef46ea'),(10340,1143,'slider_0_slide','336'),(10341,1143,'_slider_0_slide','field_60bf7688f46eb'),(10342,1143,'slider_1_slide','346'),(10343,1143,'_slider_1_slide','field_60bf7688f46eb'),(10344,1143,'slider_2_slide','342'),(10345,1143,'_slider_2_slide','field_60bf7688f46eb'),(10346,1143,'slider_3_slide','340'),(10347,1143,'_slider_3_slide','field_60bf7688f46eb'),(10348,1143,'slider_4_slide','338'),(10349,1143,'_slider_4_slide','field_60bf7688f46eb'),(10350,1143,'slider_5_slide','334'),(10351,1143,'_slider_5_slide','field_60bf7688f46eb'),(10352,1143,'slider_6_slide','332'),(10353,1143,'_slider_6_slide','field_60bf7688f46eb'),(10354,1143,'slider_7_slide','344'),(10355,1143,'_slider_7_slide','field_60bf7688f46eb'),(10356,1143,'s2-list_0_icon','61'),(10357,1143,'_s2-list_0_icon','field_60bf76ecf46ef'),(10358,1143,'s2-list_0_icon-hover','62'),(10359,1143,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(10360,1143,'s2-list_0_text','Лихорадка'),(10361,1143,'_s2-list_0_text','field_60bf7712f46f1'),(10362,1143,'s2-list_1_icon','63'),(10363,1143,'_s2-list_1_icon','field_60bf76ecf46ef'),(10364,1143,'s2-list_1_icon-hover','64'),(10365,1143,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(10366,1143,'s2-list_1_text','Похмельный синдром'),(10367,1143,'_s2-list_1_text','field_60bf7712f46f1'),(10368,1143,'s2-list_2_icon','65'),(10369,1143,'_s2-list_2_icon','field_60bf76ecf46ef'),(10370,1143,'s2-list_2_icon-hover','66'),(10371,1143,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(10372,1143,'s2-list_2_text','Диарея'),(10373,1143,'_s2-list_2_text','field_60bf7712f46f1'),(10374,1143,'s2-list_3_icon','67'),(10375,1143,'_s2-list_3_icon','field_60bf76ecf46ef'),(10376,1143,'s2-list_3_icon-hover','68'),(10377,1143,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(10378,1143,'s2-list_3_text','Рвота'),(10379,1143,'_s2-list_3_text','field_60bf7712f46f1'),(10380,1143,'s2-list_4_icon','69'),(10381,1143,'_s2-list_4_icon','field_60bf76ecf46ef'),(10382,1143,'s2-list_4_icon-hover','70'),(10383,1143,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(10384,1143,'s2-list_4_text','Интенсивные физические нагрузки'),(10385,1143,'_s2-list_4_text','field_60bf7712f46f1'),(10386,1143,'s2-list_5_icon','71'),(10387,1143,'_s2-list_5_icon','field_60bf76ecf46ef'),(10388,1143,'s2-list_5_icon-hover','72'),(10389,1143,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(10390,1143,'s2-list_5_text','Перегрев в жаркую погоду'),(10391,1143,'_s2-list_5_text','field_60bf7712f46f1'),(10392,1143,'s1-slogan','Когда обычной воды недостаточно!'),(10393,1143,'_s1-slogan','field_60bf7ab4d9ba9'),(10394,1143,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(10395,1143,'_s3-text','field_60bf7bb5a7e2b'),(10396,1143,'s4-ttl','РеО – вода для медицинских целей!'),(10397,1143,'_s4-ttl','field_60bf7c831f58c'),(10398,1143,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(10399,1143,'_s4-notes','field_60bf7ca31f58d'),(10400,1143,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(10401,1143,'_s5-video','field_60bf7ccfa01a5'),(10402,1143,'s6-ttl','Когда обычной воды недостаточно!'),(10403,1143,'_s6-ttl','field_60bf7cfb10d31'),(10404,1143,'s6-list','6'),(10405,1143,'_s6-list','field_60bf7d0410d32'),(10406,1143,'s6-list_0_icon','92'),(10407,1143,'_s6-list_0_icon','field_60bf7d1810d33'),(10408,1143,'s6-list_0_text','При повышенной температуре'),(10409,1143,'_s6-list_0_text','field_60bf7d2710d34'),(10410,1143,'s6-list_1_icon','93'),(10411,1143,'_s6-list_1_icon','field_60bf7d1810d33'),(10412,1143,'s6-list_1_text','При пищевых отравлениях'),(10413,1143,'_s6-list_1_text','field_60bf7d2710d34'),(10414,1143,'s6-list_2_icon','94'),(10415,1143,'_s6-list_2_icon','field_60bf7d1810d33'),(10416,1143,'s6-list_2_text','При кишечных инфекциях'),(10417,1143,'_s6-list_2_text','field_60bf7d2710d34'),(10418,1143,'s6-list_3_icon','95'),(10419,1143,'_s6-list_3_icon','field_60bf7d1810d33'),(10420,1143,'s6-list_3_text','Во время беременности'),(10421,1143,'_s6-list_3_text','field_60bf7d2710d34'),(10422,1143,'s6-list_4_icon','96'),(10423,1143,'_s6-list_4_icon','field_60bf7d1810d33'),(10424,1143,'s6-list_4_text','Во время занятий спортом'),(10425,1143,'_s6-list_4_text','field_60bf7d2710d34'),(10426,1143,'s6-list_5_icon','97'),(10427,1143,'_s6-list_5_icon','field_60bf7d1810d33'),(10428,1143,'s6-list_5_text','При похмельном синдроме'),(10429,1143,'_s6-list_5_text','field_60bf7d2710d34'),(10430,1143,'s4-list_0_ttl','Натрий'),(10431,1143,'_s4-list_0_ttl','field_60bf7fa95a92c'),(10432,1143,'s4-list_0_formula','Na<sup>+</sup>'),(10433,1143,'_s4-list_0_formula','field_60bf7fc65a92d'),(10434,1143,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(10435,1143,'_s4-list_0_text','field_60bf7fd35a92e'),(10436,1143,'s4-list_1_ttl','Вода'),(10437,1143,'_s4-list_1_ttl','field_60bf7fa95a92c'),(10438,1143,'s4-list_1_formula','H<sub>2</sub>O'),(10439,1143,'_s4-list_1_formula','field_60bf7fc65a92d'),(10440,1143,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(10441,1143,'_s4-list_1_text','field_60bf7fd35a92e'),(10442,1143,'s4-list','9'),(10443,1143,'_s4-list','field_60bf7f985a92b'),(10444,1143,'s4-list_2_ttl','Калий'),(10445,1143,'_s4-list_2_ttl','field_60bf7fa95a92c'),(10446,1143,'s4-list_2_formula','K<sup>+</sup>'),(10447,1143,'_s4-list_2_formula','field_60bf7fc65a92d'),(10448,1143,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(10449,1143,'_s4-list_2_text','field_60bf7fd35a92e'),(10450,1143,'s4-list_3_ttl','Гидрокарбонаты'),(10451,1143,'_s4-list_3_ttl','field_60bf7fa95a92c'),(10452,1143,'s4-list_3_formula','HCO<sup>3+</sup>'),(10453,1143,'_s4-list_3_formula','field_60bf7fc65a92d'),(10454,1143,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(10455,1143,'_s4-list_3_text','field_60bf7fd35a92e'),(10456,1143,'s4-list_4_ttl','Магний'),(10457,1143,'_s4-list_4_ttl','field_60bf7fa95a92c'),(10458,1143,'s4-list_4_formula','Mg<sup>2+</sup>'),(10459,1143,'_s4-list_4_formula','field_60bf7fc65a92d'),(10460,1143,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(10461,1143,'_s4-list_4_text','field_60bf7fd35a92e'),(10462,1143,'s4-list_5_ttl','Углекислый газ'),(10463,1143,'_s4-list_5_ttl','field_60bf7fa95a92c'),(10464,1143,'s4-list_5_formula','CO<sup>2</sup>+'),(10465,1143,'_s4-list_5_formula','field_60bf7fc65a92d'),(10466,1143,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(10467,1143,'_s4-list_5_text','field_60bf7fd35a92e'),(10468,1143,'s4-list_6_ttl','Кальций'),(10469,1143,'_s4-list_6_ttl','field_60bf7fa95a92c'),(10470,1143,'s4-list_6_formula','Ca<sup>2+</sup>'),(10471,1143,'_s4-list_6_formula','field_60bf7fc65a92d'),(10472,1143,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(10473,1143,'_s4-list_6_text','field_60bf7fd35a92e'),(10474,1143,'s4-list_7_ttl','Сорбит'),(10475,1143,'_s4-list_7_ttl','field_60bf7fa95a92c'),(10476,1143,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(10477,1143,'_s4-list_7_formula','field_60bf7fc65a92d'),(10478,1143,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(10479,1143,'_s4-list_7_text','field_60bf7fd35a92e'),(10480,1143,'s4-list_8_ttl','Хлор'),(10481,1143,'_s4-list_8_ttl','field_60bf7fa95a92c'),(10482,1143,'s4-list_8_formula','Cl'),(10483,1143,'_s4-list_8_formula','field_60bf7fc65a92d'),(10484,1143,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. 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Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(11080,1273,'_s4-notes','field_60bf7ca31f58d'),(11081,1273,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(11082,1273,'_s5-video','field_60bf7ccfa01a5'),(11083,1273,'s6-ttl','Коли звичайної води замало!'),(11084,1273,'_s6-ttl','field_60bf7cfb10d31'),(11085,1273,'s6-list','6'),(11086,1273,'_s6-list','field_60bf7d0410d32'),(11087,1273,'s6-list_0_icon','92'),(11088,1273,'_s6-list_0_icon','field_60bf7d1810d33'),(11089,1273,'s6-list_0_text','При підвищеній температурі'),(11090,1273,'_s6-list_0_text','field_60bf7d2710d34'),(11091,1273,'s6-list_1_icon','93'),(11092,1273,'_s6-list_1_icon','field_60bf7d1810d33'),(11093,1273,'s6-list_1_text','При харчових отруєннях'),(11094,1273,'_s6-list_1_text','field_60bf7d2710d34'),(11095,1273,'s6-list_2_icon','94'),(11096,1273,'_s6-list_2_icon','field_60bf7d1810d33'),(11097,1273,'s6-list_2_text','При кишкових інфекціях'),(11098,1273,'_s6-list_2_text','field_60bf7d2710d34'),(11099,1273,'s6-list_3_icon','95'),(11100,1273,'_s6-list_3_icon','field_60bf7d1810d33'),(11101,1273,'s6-list_3_text','Під час вагітності'),(11102,1273,'_s6-list_3_text','field_60bf7d2710d34'),(11103,1273,'s6-list_4_icon','96'),(11104,1273,'_s6-list_4_icon','field_60bf7d1810d33'),(11105,1273,'s6-list_4_text','Під час заняття спортом'),(11106,1273,'_s6-list_4_text','field_60bf7d2710d34'),(11107,1273,'s6-list_5_icon','97'),(11108,1273,'_s6-list_5_icon','field_60bf7d1810d33'),(11109,1273,'s6-list_5_text','При похмільному синдромі'),(11110,1273,'_s6-list_5_text','field_60bf7d2710d34'),(11111,1273,'s4-list_0_ttl','Натрій'),(11112,1273,'_s4-list_0_ttl','field_60bf7fa95a92c'),(11113,1273,'s4-list_0_formula','Na<sup>+</sup>'),(11114,1273,'_s4-list_0_formula','field_60bf7fc65a92d'),(11115,1273,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(11116,1273,'_s4-list_0_text','field_60bf7fd35a92e'),(11117,1273,'s4-list_1_ttl','Вода'),(11118,1273,'_s4-list_1_ttl','field_60bf7fa95a92c'),(11119,1273,'s4-list_1_formula','H<sub>2</sub>O'),(11120,1273,'_s4-list_1_formula','field_60bf7fc65a92d'),(11121,1273,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(11122,1273,'_s4-list_1_text','field_60bf7fd35a92e'),(11123,1273,'s4-list','9'),(11124,1273,'_s4-list','field_60bf7f985a92b'),(11125,1273,'s4-list_2_ttl','Калій'),(11126,1273,'_s4-list_2_ttl','field_60bf7fa95a92c'),(11127,1273,'s4-list_2_formula','K<sup>+</sup>'),(11128,1273,'_s4-list_2_formula','field_60bf7fc65a92d'),(11129,1273,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(11130,1273,'_s4-list_2_text','field_60bf7fd35a92e'),(11131,1273,'s4-list_3_ttl','Гідрокарбонати'),(11132,1273,'_s4-list_3_ttl','field_60bf7fa95a92c'),(11133,1273,'s4-list_3_formula','HCO<sup>3+</sup>'),(11134,1273,'_s4-list_3_formula','field_60bf7fc65a92d'),(11135,1273,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(11136,1273,'_s4-list_3_text','field_60bf7fd35a92e'),(11137,1273,'s4-list_4_ttl','Магній'),(11138,1273,'_s4-list_4_ttl','field_60bf7fa95a92c'),(11139,1273,'s4-list_4_formula','Mg<sup>2+</sup>'),(11140,1273,'_s4-list_4_formula','field_60bf7fc65a92d'),(11141,1273,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(11142,1273,'_s4-list_4_text','field_60bf7fd35a92e'),(11143,1273,'s4-list_5_ttl','Вуглекислий газ'),(11144,1273,'_s4-list_5_ttl','field_60bf7fa95a92c'),(11145,1273,'s4-list_5_formula','CO<sup>2</sup>+'),(11146,1273,'_s4-list_5_formula','field_60bf7fc65a92d'),(11147,1273,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(11148,1273,'_s4-list_5_text','field_60bf7fd35a92e'),(11149,1273,'s4-list_6_ttl','Кальцій'),(11150,1273,'_s4-list_6_ttl','field_60bf7fa95a92c'),(11151,1273,'s4-list_6_formula','Ca<sup>2+</sup>'),(11152,1273,'_s4-list_6_formula','field_60bf7fc65a92d'),(11153,1273,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(11154,1273,'_s4-list_6_text','field_60bf7fd35a92e'),(11155,1273,'s4-list_7_ttl','Сорбіт'),(11156,1273,'_s4-list_7_ttl','field_60bf7fa95a92c'),(11157,1273,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(11158,1273,'_s4-list_7_formula','field_60bf7fc65a92d'),(11159,1273,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(11160,1273,'_s4-list_7_text','field_60bf7fd35a92e'),(11161,1273,'s4-list_8_ttl','Хлор'),(11162,1273,'_s4-list_8_ttl','field_60bf7fa95a92c'),(11163,1273,'s4-list_8_formula','Cl'),(11164,1273,'_s4-list_8_formula','field_60bf7fc65a92d'),(11165,1273,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(11166,1273,'_s4-list_8_text','field_60bf7fd35a92e'),(11167,1273,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(11168,1273,'_s4-feature1','field_60bf80ca480ea'),(11169,1273,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(11170,1273,'_s4-feature2','field_60bf80de480eb'),(11171,1273,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(11172,1273,'_s4-feature3','field_60bf80e2480ec'),(11173,1273,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(11174,1273,'_s4-feature4','field_60bf80e5480ed'),(11175,1273,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11176,1273,'_s2-list_0_link','field_60ee90d381a4e'),(11177,1273,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11178,1273,'_s2-list_1_link','field_60ee90d381a4e'),(11179,1273,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11180,1273,'_s2-list_2_link','field_60ee90d381a4e'),(11181,1273,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(11182,1273,'_s2-list_3_link','field_60ee90d381a4e'),(11183,1273,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11184,1273,'_s2-list_4_link','field_60ee90d381a4e'),(11185,1273,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(11186,1273,'_s2-list_5_link','field_60ee90d381a4e'),(11187,1273,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11188,1273,'_s6-list_0_link','field_60ee916b04ace'),(11189,1273,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(11190,1273,'_s6-list_1_link','field_60ee916b04ace'),(11191,1273,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11192,1273,'_s6-list_2_link','field_60ee916b04ace'),(11193,1273,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(11194,1273,'_s6-list_3_link','field_60ee916b04ace'),(11195,1273,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11196,1273,'_s6-list_4_link','field_60ee916b04ace'),(11197,1273,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11198,1273,'_s6-list_5_link','field_60ee916b04ace'),(11199,1273,'slider_8_slide',''),(11200,1273,'_slider_8_slide','field_60bf7688f46eb'),(11201,8,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(11202,8,'_slider_0_webplink','field_60fa70c989e88'),(11203,8,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(11204,8,'_slider_1_webplink','field_60fa70c989e88'),(11205,8,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(11206,8,'_slider_2_webplink','field_60fa70c989e88'),(11207,8,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(11208,8,'_slider_3_webplink','field_60fa70c989e88'),(11209,8,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(11210,8,'_slider_4_webplink','field_60fa70c989e88'),(11211,8,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(11212,8,'_slider_5_webplink','field_60fa70c989e88'),(11213,8,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(11214,8,'_slider_6_webplink','field_60fa70c989e88'),(11215,8,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(11216,8,'_slider_7_webplink','field_60fa70c989e88'),(11424,1275,'_slider','field_60bf767ef46ea'),(11423,1275,'slider','8'),(11219,1274,'slider','9'),(11220,1274,'_slider','field_60bf767ef46ea'),(11221,1274,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(11222,1274,'_s2-ttl','field_60bf76d1f46ed'),(11223,1274,'s2-list','6'),(11224,1274,'_s2-list','field_60bf76e0f46ee'),(11225,1274,'slider_0_slide','50'),(11226,1274,'_slider_0_slide','field_60bf7688f46eb'),(11227,1274,'slider_1_slide','51'),(11228,1274,'_slider_1_slide','field_60bf7688f46eb'),(11229,1274,'slider_2_slide','52'),(11230,1274,'_slider_2_slide','field_60bf7688f46eb'),(11231,1274,'slider_3_slide','53'),(11232,1274,'_slider_3_slide','field_60bf7688f46eb'),(11233,1274,'slider_4_slide','54'),(11234,1274,'_slider_4_slide','field_60bf7688f46eb'),(11235,1274,'slider_5_slide','55'),(11236,1274,'_slider_5_slide','field_60bf7688f46eb'),(11237,1274,'slider_6_slide','56'),(11238,1274,'_slider_6_slide','field_60bf7688f46eb'),(11239,1274,'slider_7_slide','57'),(11240,1274,'_slider_7_slide','field_60bf7688f46eb'),(11241,1274,'s2-list_0_icon','61'),(11242,1274,'_s2-list_0_icon','field_60bf76ecf46ef'),(11243,1274,'s2-list_0_icon-hover','62'),(11244,1274,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(11245,1274,'s2-list_0_text','Лихоманка'),(11246,1274,'_s2-list_0_text','field_60bf7712f46f1'),(11247,1274,'s2-list_1_icon','63'),(11248,1274,'_s2-list_1_icon','field_60bf76ecf46ef'),(11249,1274,'s2-list_1_icon-hover','64'),(11250,1274,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(11251,1274,'s2-list_1_text','Похмільний синдром'),(11252,1274,'_s2-list_1_text','field_60bf7712f46f1'),(11253,1274,'s2-list_2_icon','65'),(11254,1274,'_s2-list_2_icon','field_60bf76ecf46ef'),(11255,1274,'s2-list_2_icon-hover','66'),(11256,1274,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(11257,1274,'s2-list_2_text','Діарея'),(11258,1274,'_s2-list_2_text','field_60bf7712f46f1'),(11259,1274,'s2-list_3_icon','67'),(11260,1274,'_s2-list_3_icon','field_60bf76ecf46ef'),(11261,1274,'s2-list_3_icon-hover','68'),(11262,1274,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(11263,1274,'s2-list_3_text','Блювота'),(11264,1274,'_s2-list_3_text','field_60bf7712f46f1'),(11265,1274,'s2-list_4_icon','69'),(11266,1274,'_s2-list_4_icon','field_60bf76ecf46ef'),(11267,1274,'s2-list_4_icon-hover','70'),(11268,1274,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(11269,1274,'s2-list_4_text','Інтенсивні фізичні навантаження'),(11270,1274,'_s2-list_4_text','field_60bf7712f46f1'),(11271,1274,'s2-list_5_icon','71'),(11272,1274,'_s2-list_5_icon','field_60bf76ecf46ef'),(11273,1274,'s2-list_5_icon-hover','72'),(11274,1274,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(11275,1274,'s2-list_5_text','Перегрівання в спекотну погоду'),(11276,1274,'_s2-list_5_text','field_60bf7712f46f1'),(11277,1274,'s1-slogan','Коли звичайної води замало!'),(11278,1274,'_s1-slogan','field_60bf7ab4d9ba9'),(11279,1274,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(11280,1274,'_s3-text','field_60bf7bb5a7e2b'),(11281,1274,'s4-ttl','РеО – вода для медичних цілей'),(11282,1274,'_s4-ttl','field_60bf7c831f58c'),(11283,1274,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(11284,1274,'_s4-notes','field_60bf7ca31f58d'),(11285,1274,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(11286,1274,'_s5-video','field_60bf7ccfa01a5'),(11287,1274,'s6-ttl','Коли звичайної води замало!'),(11288,1274,'_s6-ttl','field_60bf7cfb10d31'),(11289,1274,'s6-list','6'),(11290,1274,'_s6-list','field_60bf7d0410d32'),(11291,1274,'s6-list_0_icon','92'),(11292,1274,'_s6-list_0_icon','field_60bf7d1810d33'),(11293,1274,'s6-list_0_text','При підвищеній температурі'),(11294,1274,'_s6-list_0_text','field_60bf7d2710d34'),(11295,1274,'s6-list_1_icon','93'),(11296,1274,'_s6-list_1_icon','field_60bf7d1810d33'),(11297,1274,'s6-list_1_text','При харчових отруєннях'),(11298,1274,'_s6-list_1_text','field_60bf7d2710d34'),(11299,1274,'s6-list_2_icon','94'),(11300,1274,'_s6-list_2_icon','field_60bf7d1810d33'),(11301,1274,'s6-list_2_text','При кишкових інфекціях'),(11302,1274,'_s6-list_2_text','field_60bf7d2710d34'),(11303,1274,'s6-list_3_icon','95'),(11304,1274,'_s6-list_3_icon','field_60bf7d1810d33'),(11305,1274,'s6-list_3_text','Під час вагітності'),(11306,1274,'_s6-list_3_text','field_60bf7d2710d34'),(11307,1274,'s6-list_4_icon','96'),(11308,1274,'_s6-list_4_icon','field_60bf7d1810d33'),(11309,1274,'s6-list_4_text','Під час заняття спортом'),(11310,1274,'_s6-list_4_text','field_60bf7d2710d34'),(11311,1274,'s6-list_5_icon','97'),(11312,1274,'_s6-list_5_icon','field_60bf7d1810d33'),(11313,1274,'s6-list_5_text','При похмільному синдромі'),(11314,1274,'_s6-list_5_text','field_60bf7d2710d34'),(11315,1274,'s4-list_0_ttl','Натрій'),(11316,1274,'_s4-list_0_ttl','field_60bf7fa95a92c'),(11317,1274,'s4-list_0_formula','Na<sup>+</sup>'),(11318,1274,'_s4-list_0_formula','field_60bf7fc65a92d'),(11319,1274,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(11320,1274,'_s4-list_0_text','field_60bf7fd35a92e'),(11321,1274,'s4-list_1_ttl','Вода'),(11322,1274,'_s4-list_1_ttl','field_60bf7fa95a92c'),(11323,1274,'s4-list_1_formula','H<sub>2</sub>O'),(11324,1274,'_s4-list_1_formula','field_60bf7fc65a92d'),(11325,1274,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(11326,1274,'_s4-list_1_text','field_60bf7fd35a92e'),(11327,1274,'s4-list','9'),(11328,1274,'_s4-list','field_60bf7f985a92b'),(11329,1274,'s4-list_2_ttl','Калій'),(11330,1274,'_s4-list_2_ttl','field_60bf7fa95a92c'),(11331,1274,'s4-list_2_formula','K<sup>+</sup>'),(11332,1274,'_s4-list_2_formula','field_60bf7fc65a92d'),(11333,1274,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(11334,1274,'_s4-list_2_text','field_60bf7fd35a92e'),(11335,1274,'s4-list_3_ttl','Гідрокарбонати'),(11336,1274,'_s4-list_3_ttl','field_60bf7fa95a92c'),(11337,1274,'s4-list_3_formula','HCO<sup>3+</sup>'),(11338,1274,'_s4-list_3_formula','field_60bf7fc65a92d'),(11339,1274,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(11340,1274,'_s4-list_3_text','field_60bf7fd35a92e'),(11341,1274,'s4-list_4_ttl','Магній'),(11342,1274,'_s4-list_4_ttl','field_60bf7fa95a92c'),(11343,1274,'s4-list_4_formula','Mg<sup>2+</sup>'),(11344,1274,'_s4-list_4_formula','field_60bf7fc65a92d'),(11345,1274,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(11346,1274,'_s4-list_4_text','field_60bf7fd35a92e'),(11347,1274,'s4-list_5_ttl','Вуглекислий газ'),(11348,1274,'_s4-list_5_ttl','field_60bf7fa95a92c'),(11349,1274,'s4-list_5_formula','CO<sup>2</sup>+'),(11350,1274,'_s4-list_5_formula','field_60bf7fc65a92d'),(11351,1274,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(11352,1274,'_s4-list_5_text','field_60bf7fd35a92e'),(11353,1274,'s4-list_6_ttl','Кальцій'),(11354,1274,'_s4-list_6_ttl','field_60bf7fa95a92c'),(11355,1274,'s4-list_6_formula','Ca<sup>2+</sup>'),(11356,1274,'_s4-list_6_formula','field_60bf7fc65a92d'),(11357,1274,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(11358,1274,'_s4-list_6_text','field_60bf7fd35a92e'),(11359,1274,'s4-list_7_ttl','Сорбіт'),(11360,1274,'_s4-list_7_ttl','field_60bf7fa95a92c'),(11361,1274,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(11362,1274,'_s4-list_7_formula','field_60bf7fc65a92d'),(11363,1274,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(11364,1274,'_s4-list_7_text','field_60bf7fd35a92e'),(11365,1274,'s4-list_8_ttl','Хлор'),(11366,1274,'_s4-list_8_ttl','field_60bf7fa95a92c'),(11367,1274,'s4-list_8_formula','Cl'),(11368,1274,'_s4-list_8_formula','field_60bf7fc65a92d'),(11369,1274,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(11370,1274,'_s4-list_8_text','field_60bf7fd35a92e'),(11371,1274,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(11372,1274,'_s4-feature1','field_60bf80ca480ea'),(11373,1274,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(11374,1274,'_s4-feature2','field_60bf80de480eb'),(11375,1274,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(11376,1274,'_s4-feature3','field_60bf80e2480ec'),(11377,1274,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(11378,1274,'_s4-feature4','field_60bf80e5480ed'),(11379,1274,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11380,1274,'_s2-list_0_link','field_60ee90d381a4e'),(11381,1274,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11382,1274,'_s2-list_1_link','field_60ee90d381a4e'),(11383,1274,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11384,1274,'_s2-list_2_link','field_60ee90d381a4e'),(11385,1274,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(11386,1274,'_s2-list_3_link','field_60ee90d381a4e'),(11387,1274,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11388,1274,'_s2-list_4_link','field_60ee90d381a4e'),(11389,1274,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(11390,1274,'_s2-list_5_link','field_60ee90d381a4e'),(11391,1274,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11392,1274,'_s6-list_0_link','field_60ee916b04ace'),(11393,1274,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(11394,1274,'_s6-list_1_link','field_60ee916b04ace'),(11395,1274,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11396,1274,'_s6-list_2_link','field_60ee916b04ace'),(11397,1274,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(11398,1274,'_s6-list_3_link','field_60ee916b04ace'),(11399,1274,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11400,1274,'_s6-list_4_link','field_60ee916b04ace'),(11401,1274,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11402,1274,'_s6-list_5_link','field_60ee916b04ace'),(11403,1274,'slider_8_slide',''),(11404,1274,'_slider_8_slide','field_60bf7688f46eb'),(11405,1274,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(11406,1274,'_slider_0_webplink','field_60fa70c989e88'),(11407,1274,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(11408,1274,'_slider_1_webplink','field_60fa70c989e88'),(11409,1274,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(11410,1274,'_slider_2_webplink','field_60fa70c989e88'),(11411,1274,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(11412,1274,'_slider_3_webplink','field_60fa70c989e88'),(11413,1274,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(11414,1274,'_slider_4_webplink','field_60fa70c989e88'),(11415,1274,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(11416,1274,'_slider_5_webplink','field_60fa70c989e88'),(11417,1274,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(11418,1274,'_slider_6_webplink','field_60fa70c989e88'),(11419,1274,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(11420,1274,'_slider_7_webplink','field_60fa70c989e88'),(11421,1274,'slider_8_webplink','/wp-content/themes/reo/images/webp/slide-9.webp'),(11422,1274,'_slider_8_webplink','field_60fa70c989e88'),(11426,1275,'_s2-ttl','field_60bf76d1f46ed'),(11427,1275,'s2-list','6'),(11428,1275,'_s2-list','field_60bf76e0f46ee'),(11429,1275,'slider_0_slide','50'),(11430,1275,'_slider_0_slide','field_60bf7688f46eb'),(11431,1275,'slider_1_slide','51'),(11432,1275,'_slider_1_slide','field_60bf7688f46eb'),(11433,1275,'slider_2_slide','52'),(11434,1275,'_slider_2_slide','field_60bf7688f46eb'),(11435,1275,'slider_3_slide','53'),(11436,1275,'_slider_3_slide','field_60bf7688f46eb'),(11437,1275,'slider_4_slide','54'),(11438,1275,'_slider_4_slide','field_60bf7688f46eb'),(11439,1275,'slider_5_slide','55'),(11440,1275,'_slider_5_slide','field_60bf7688f46eb'),(11441,1275,'slider_6_slide','56'),(11442,1275,'_slider_6_slide','field_60bf7688f46eb'),(11443,1275,'slider_7_slide','57'),(11444,1275,'_slider_7_slide','field_60bf7688f46eb'),(11445,1275,'s2-list_0_icon','61'),(11446,1275,'_s2-list_0_icon','field_60bf76ecf46ef'),(11447,1275,'s2-list_0_icon-hover','62'),(11448,1275,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(11449,1275,'s2-list_0_text','Лихоманка'),(11450,1275,'_s2-list_0_text','field_60bf7712f46f1'),(11451,1275,'s2-list_1_icon','63'),(11452,1275,'_s2-list_1_icon','field_60bf76ecf46ef'),(11453,1275,'s2-list_1_icon-hover','64'),(11454,1275,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(11455,1275,'s2-list_1_text','Похмільний синдром'),(11456,1275,'_s2-list_1_text','field_60bf7712f46f1'),(11457,1275,'s2-list_2_icon','65'),(11458,1275,'_s2-list_2_icon','field_60bf76ecf46ef'),(11459,1275,'s2-list_2_icon-hover','66'),(11460,1275,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(11461,1275,'s2-list_2_text','Діарея'),(11462,1275,'_s2-list_2_text','field_60bf7712f46f1'),(11463,1275,'s2-list_3_icon','67'),(11464,1275,'_s2-list_3_icon','field_60bf76ecf46ef'),(11465,1275,'s2-list_3_icon-hover','68'),(11466,1275,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(11467,1275,'s2-list_3_text','Блювота'),(11468,1275,'_s2-list_3_text','field_60bf7712f46f1'),(11469,1275,'s2-list_4_icon','69'),(11470,1275,'_s2-list_4_icon','field_60bf76ecf46ef'),(11471,1275,'s2-list_4_icon-hover','70'),(11472,1275,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(11473,1275,'s2-list_4_text','Інтенсивні фізичні навантаження'),(11474,1275,'_s2-list_4_text','field_60bf7712f46f1'),(11475,1275,'s2-list_5_icon','71'),(11476,1275,'_s2-list_5_icon','field_60bf76ecf46ef'),(11477,1275,'s2-list_5_icon-hover','72'),(11478,1275,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(11479,1275,'s2-list_5_text','Перегрівання в спекотну погоду'),(11480,1275,'_s2-list_5_text','field_60bf7712f46f1'),(11481,1275,'s1-slogan','Коли звичайної води замало!'),(11482,1275,'_s1-slogan','field_60bf7ab4d9ba9'),(11483,1275,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(11484,1275,'_s3-text','field_60bf7bb5a7e2b'),(11485,1275,'s4-ttl','РеО – вода для медичних цілей'),(11486,1275,'_s4-ttl','field_60bf7c831f58c'),(11487,1275,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(11488,1275,'_s4-notes','field_60bf7ca31f58d'),(11489,1275,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(11490,1275,'_s5-video','field_60bf7ccfa01a5'),(11491,1275,'s6-ttl','Коли звичайної води замало!'),(11492,1275,'_s6-ttl','field_60bf7cfb10d31'),(11493,1275,'s6-list','6'),(11494,1275,'_s6-list','field_60bf7d0410d32'),(11495,1275,'s6-list_0_icon','92'),(11496,1275,'_s6-list_0_icon','field_60bf7d1810d33'),(11497,1275,'s6-list_0_text','При підвищеній температурі'),(11498,1275,'_s6-list_0_text','field_60bf7d2710d34'),(11499,1275,'s6-list_1_icon','93'),(11500,1275,'_s6-list_1_icon','field_60bf7d1810d33'),(11501,1275,'s6-list_1_text','При харчових отруєннях'),(11502,1275,'_s6-list_1_text','field_60bf7d2710d34'),(11503,1275,'s6-list_2_icon','94'),(11504,1275,'_s6-list_2_icon','field_60bf7d1810d33'),(11505,1275,'s6-list_2_text','При кишкових інфекціях'),(11506,1275,'_s6-list_2_text','field_60bf7d2710d34'),(11507,1275,'s6-list_3_icon','95'),(11508,1275,'_s6-list_3_icon','field_60bf7d1810d33'),(11509,1275,'s6-list_3_text','Під час вагітності'),(11510,1275,'_s6-list_3_text','field_60bf7d2710d34'),(11511,1275,'s6-list_4_icon','96'),(11512,1275,'_s6-list_4_icon','field_60bf7d1810d33'),(11513,1275,'s6-list_4_text','Під час заняття спортом'),(11514,1275,'_s6-list_4_text','field_60bf7d2710d34'),(11515,1275,'s6-list_5_icon','97'),(11516,1275,'_s6-list_5_icon','field_60bf7d1810d33'),(11517,1275,'s6-list_5_text','При похмільному синдромі'),(11518,1275,'_s6-list_5_text','field_60bf7d2710d34'),(11519,1275,'s4-list_0_ttl','Натрій'),(11520,1275,'_s4-list_0_ttl','field_60bf7fa95a92c'),(11521,1275,'s4-list_0_formula','Na<sup>+</sup>'),(11522,1275,'_s4-list_0_formula','field_60bf7fc65a92d'),(11523,1275,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(11524,1275,'_s4-list_0_text','field_60bf7fd35a92e'),(11525,1275,'s4-list_1_ttl','Вода'),(11526,1275,'_s4-list_1_ttl','field_60bf7fa95a92c'),(11527,1275,'s4-list_1_formula','H<sub>2</sub>O'),(11528,1275,'_s4-list_1_formula','field_60bf7fc65a92d'),(11529,1275,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(11530,1275,'_s4-list_1_text','field_60bf7fd35a92e'),(11531,1275,'s4-list','9'),(11532,1275,'_s4-list','field_60bf7f985a92b'),(11533,1275,'s4-list_2_ttl','Калій'),(11534,1275,'_s4-list_2_ttl','field_60bf7fa95a92c'),(11535,1275,'s4-list_2_formula','K<sup>+</sup>'),(11536,1275,'_s4-list_2_formula','field_60bf7fc65a92d'),(11537,1275,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(11538,1275,'_s4-list_2_text','field_60bf7fd35a92e'),(11539,1275,'s4-list_3_ttl','Гідрокарбонати'),(11540,1275,'_s4-list_3_ttl','field_60bf7fa95a92c'),(11541,1275,'s4-list_3_formula','HCO<sup>3+</sup>'),(11542,1275,'_s4-list_3_formula','field_60bf7fc65a92d'),(11543,1275,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(11544,1275,'_s4-list_3_text','field_60bf7fd35a92e'),(11545,1275,'s4-list_4_ttl','Магній'),(11546,1275,'_s4-list_4_ttl','field_60bf7fa95a92c'),(11547,1275,'s4-list_4_formula','Mg<sup>2+</sup>'),(11548,1275,'_s4-list_4_formula','field_60bf7fc65a92d'),(11549,1275,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(11550,1275,'_s4-list_4_text','field_60bf7fd35a92e'),(11551,1275,'s4-list_5_ttl','Вуглекислий газ'),(11552,1275,'_s4-list_5_ttl','field_60bf7fa95a92c'),(11553,1275,'s4-list_5_formula','CO<sup>2</sup>+'),(11554,1275,'_s4-list_5_formula','field_60bf7fc65a92d'),(11555,1275,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(11556,1275,'_s4-list_5_text','field_60bf7fd35a92e'),(11557,1275,'s4-list_6_ttl','Кальцій'),(11558,1275,'_s4-list_6_ttl','field_60bf7fa95a92c'),(11559,1275,'s4-list_6_formula','Ca<sup>2+</sup>'),(11560,1275,'_s4-list_6_formula','field_60bf7fc65a92d'),(11561,1275,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(11562,1275,'_s4-list_6_text','field_60bf7fd35a92e'),(11563,1275,'s4-list_7_ttl','Сорбіт'),(11564,1275,'_s4-list_7_ttl','field_60bf7fa95a92c'),(11565,1275,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(11566,1275,'_s4-list_7_formula','field_60bf7fc65a92d'),(11567,1275,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(11568,1275,'_s4-list_7_text','field_60bf7fd35a92e'),(11569,1275,'s4-list_8_ttl','Хлор'),(11570,1275,'_s4-list_8_ttl','field_60bf7fa95a92c'),(11571,1275,'s4-list_8_formula','Cl'),(11572,1275,'_s4-list_8_formula','field_60bf7fc65a92d'),(11573,1275,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(11574,1275,'_s4-list_8_text','field_60bf7fd35a92e'),(11575,1275,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(11576,1275,'_s4-feature1','field_60bf80ca480ea'),(11577,1275,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(11578,1275,'_s4-feature2','field_60bf80de480eb'),(11579,1275,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(11580,1275,'_s4-feature3','field_60bf80e2480ec'),(11581,1275,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(11582,1275,'_s4-feature4','field_60bf80e5480ed'),(11583,1275,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11584,1275,'_s2-list_0_link','field_60ee90d381a4e'),(11585,1275,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11586,1275,'_s2-list_1_link','field_60ee90d381a4e'),(11587,1275,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11588,1275,'_s2-list_2_link','field_60ee90d381a4e'),(11589,1275,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(11590,1275,'_s2-list_3_link','field_60ee90d381a4e'),(11591,1275,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11592,1275,'_s2-list_4_link','field_60ee90d381a4e'),(11593,1275,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(11594,1275,'_s2-list_5_link','field_60ee90d381a4e'),(11595,1275,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(11596,1275,'_s6-list_0_link','field_60ee916b04ace'),(11597,1275,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(11598,1275,'_s6-list_1_link','field_60ee916b04ace'),(11599,1275,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(11600,1275,'_s6-list_2_link','field_60ee916b04ace'),(11601,1275,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(11602,1275,'_s6-list_3_link','field_60ee916b04ace'),(11603,1275,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(11604,1275,'_s6-list_4_link','field_60ee916b04ace'),(11605,1275,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(11606,1275,'_s6-list_5_link','field_60ee916b04ace'),(11607,1275,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(11608,1275,'_slider_0_webplink','field_60fa70c989e88'),(11609,1275,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(11610,1275,'_slider_1_webplink','field_60fa70c989e88'),(11611,1275,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(11612,1275,'_slider_2_webplink','field_60fa70c989e88'),(11613,1275,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(11614,1275,'_slider_3_webplink','field_60fa70c989e88'),(11615,1275,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(11616,1275,'_slider_4_webplink','field_60fa70c989e88'),(11617,1275,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(11618,1275,'_slider_5_webplink','field_60fa70c989e88'),(11619,1275,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(11620,1275,'_slider_6_webplink','field_60fa70c989e88'),(11621,1275,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(11622,1275,'_slider_7_webplink','field_60fa70c989e88'),(11623,176,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(11624,176,'_slider_0_webplink','field_60fa70c989e88'),(11625,176,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(11626,176,'_slider_1_webplink','field_60fa70c989e88'),(11627,176,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(11628,176,'_slider_2_webplink','field_60fa70c989e88'),(11629,176,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(11630,176,'_slider_3_webplink','field_60fa70c989e88'),(11631,176,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(11632,176,'_slider_4_webplink','field_60fa70c989e88'),(11633,176,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(11634,176,'_slider_5_webplink','field_60fa70c989e88'),(11635,176,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(11636,176,'_slider_6_webplink','field_60fa70c989e88'),(11637,176,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(11638,176,'_slider_7_webplink','field_60fa70c989e88'),(11639,1276,'s2-list','6'),(11640,1276,'_s2-list','field_60bf76e0f46ee'),(11641,1276,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(11642,1276,'_s2-ttl','field_60bf76d1f46ed'),(11643,1276,'slider','8'),(11644,1276,'_slider','field_60bf767ef46ea'),(11645,1276,'slider_0_slide','336'),(11646,1276,'_slider_0_slide','field_60bf7688f46eb'),(11647,1276,'slider_1_slide','346'),(11648,1276,'_slider_1_slide','field_60bf7688f46eb'),(11649,1276,'slider_2_slide','342'),(11650,1276,'_slider_2_slide','field_60bf7688f46eb'),(11651,1276,'slider_3_slide','340'),(11652,1276,'_slider_3_slide','field_60bf7688f46eb'),(11653,1276,'slider_4_slide','338'),(11654,1276,'_slider_4_slide','field_60bf7688f46eb'),(11655,1276,'slider_5_slide','334'),(11656,1276,'_slider_5_slide','field_60bf7688f46eb'),(11657,1276,'slider_6_slide','332'),(11658,1276,'_slider_6_slide','field_60bf7688f46eb'),(11659,1276,'slider_7_slide','344'),(11660,1276,'_slider_7_slide','field_60bf7688f46eb'),(11661,1276,'s2-list_0_icon','61'),(11662,1276,'_s2-list_0_icon','field_60bf76ecf46ef'),(11663,1276,'s2-list_0_icon-hover','62'),(11664,1276,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(11665,1276,'s2-list_0_text','Лихорадка'),(11666,1276,'_s2-list_0_text','field_60bf7712f46f1'),(11667,1276,'s2-list_1_icon','63'),(11668,1276,'_s2-list_1_icon','field_60bf76ecf46ef'),(11669,1276,'s2-list_1_icon-hover','64'),(11670,1276,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(11671,1276,'s2-list_1_text','Похмельный синдром'),(11672,1276,'_s2-list_1_text','field_60bf7712f46f1'),(11673,1276,'s2-list_2_icon','65'),(11674,1276,'_s2-list_2_icon','field_60bf76ecf46ef'),(11675,1276,'s2-list_2_icon-hover','66'),(11676,1276,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(11677,1276,'s2-list_2_text','Диарея'),(11678,1276,'_s2-list_2_text','field_60bf7712f46f1'),(11679,1276,'s2-list_3_icon','67'),(11680,1276,'_s2-list_3_icon','field_60bf76ecf46ef'),(11681,1276,'s2-list_3_icon-hover','68'),(11682,1276,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(11683,1276,'s2-list_3_text','Рвота'),(11684,1276,'_s2-list_3_text','field_60bf7712f46f1'),(11685,1276,'s2-list_4_icon','69'),(11686,1276,'_s2-list_4_icon','field_60bf76ecf46ef'),(11687,1276,'s2-list_4_icon-hover','70'),(11688,1276,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(11689,1276,'s2-list_4_text','Интенсивные физические нагрузки'),(11690,1276,'_s2-list_4_text','field_60bf7712f46f1'),(11691,1276,'s2-list_5_icon','71'),(11692,1276,'_s2-list_5_icon','field_60bf76ecf46ef'),(11693,1276,'s2-list_5_icon-hover','72'),(11694,1276,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(11695,1276,'s2-list_5_text','Перегрев в жаркую погоду'),(11696,1276,'_s2-list_5_text','field_60bf7712f46f1'),(11697,1276,'s1-slogan','Когда обычной воды недостаточно!'),(11698,1276,'_s1-slogan','field_60bf7ab4d9ba9'),(11699,1276,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(11700,1276,'_s3-text','field_60bf7bb5a7e2b'),(11701,1276,'s4-ttl','РеО – вода для медицинских целей!'),(11702,1276,'_s4-ttl','field_60bf7c831f58c'),(11703,1276,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(11704,1276,'_s4-notes','field_60bf7ca31f58d'),(11705,1276,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(11706,1276,'_s5-video','field_60bf7ccfa01a5'),(11707,1276,'s6-ttl','Когда обычной воды недостаточно!'),(11708,1276,'_s6-ttl','field_60bf7cfb10d31'),(11709,1276,'s6-list','6'),(11710,1276,'_s6-list','field_60bf7d0410d32'),(11711,1276,'s6-list_0_icon','92'),(11712,1276,'_s6-list_0_icon','field_60bf7d1810d33'),(11713,1276,'s6-list_0_text','При повышенной температуре'),(11714,1276,'_s6-list_0_text','field_60bf7d2710d34'),(11715,1276,'s6-list_1_icon','93'),(11716,1276,'_s6-list_1_icon','field_60bf7d1810d33'),(11717,1276,'s6-list_1_text','При пищевых отравлениях'),(11718,1276,'_s6-list_1_text','field_60bf7d2710d34'),(11719,1276,'s6-list_2_icon','94'),(11720,1276,'_s6-list_2_icon','field_60bf7d1810d33'),(11721,1276,'s6-list_2_text','При кишечных инфекциях'),(11722,1276,'_s6-list_2_text','field_60bf7d2710d34'),(11723,1276,'s6-list_3_icon','95'),(11724,1276,'_s6-list_3_icon','field_60bf7d1810d33'),(11725,1276,'s6-list_3_text','Во время беременности'),(11726,1276,'_s6-list_3_text','field_60bf7d2710d34'),(11727,1276,'s6-list_4_icon','96'),(11728,1276,'_s6-list_4_icon','field_60bf7d1810d33'),(11729,1276,'s6-list_4_text','Во время занятий спортом'),(11730,1276,'_s6-list_4_text','field_60bf7d2710d34'),(11731,1276,'s6-list_5_icon','97'),(11732,1276,'_s6-list_5_icon','field_60bf7d1810d33'),(11733,1276,'s6-list_5_text','При похмельном синдроме'),(11734,1276,'_s6-list_5_text','field_60bf7d2710d34'),(11735,1276,'s4-list_0_ttl','Натрий'),(11736,1276,'_s4-list_0_ttl','field_60bf7fa95a92c'),(11737,1276,'s4-list_0_formula','Na<sup>+</sup>'),(11738,1276,'_s4-list_0_formula','field_60bf7fc65a92d'),(11739,1276,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(11740,1276,'_s4-list_0_text','field_60bf7fd35a92e'),(11741,1276,'s4-list_1_ttl','Вода'),(11742,1276,'_s4-list_1_ttl','field_60bf7fa95a92c'),(11743,1276,'s4-list_1_formula','H<sub>2</sub>O'),(11744,1276,'_s4-list_1_formula','field_60bf7fc65a92d'),(11745,1276,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(11746,1276,'_s4-list_1_text','field_60bf7fd35a92e'),(11747,1276,'s4-list','9'),(11748,1276,'_s4-list','field_60bf7f985a92b'),(11749,1276,'s4-list_2_ttl','Калий'),(11750,1276,'_s4-list_2_ttl','field_60bf7fa95a92c'),(11751,1276,'s4-list_2_formula','K<sup>+</sup>'),(11752,1276,'_s4-list_2_formula','field_60bf7fc65a92d'),(11753,1276,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(11754,1276,'_s4-list_2_text','field_60bf7fd35a92e'),(11755,1276,'s4-list_3_ttl','Гидрокарбонаты'),(11756,1276,'_s4-list_3_ttl','field_60bf7fa95a92c'),(11757,1276,'s4-list_3_formula','HCO<sup>3+</sup>'),(11758,1276,'_s4-list_3_formula','field_60bf7fc65a92d'),(11759,1276,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(11760,1276,'_s4-list_3_text','field_60bf7fd35a92e'),(11761,1276,'s4-list_4_ttl','Магний'),(11762,1276,'_s4-list_4_ttl','field_60bf7fa95a92c'),(11763,1276,'s4-list_4_formula','Mg<sup>2+</sup>'),(11764,1276,'_s4-list_4_formula','field_60bf7fc65a92d'),(11765,1276,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(11766,1276,'_s4-list_4_text','field_60bf7fd35a92e'),(11767,1276,'s4-list_5_ttl','Углекислый газ'),(11768,1276,'_s4-list_5_ttl','field_60bf7fa95a92c'),(11769,1276,'s4-list_5_formula','CO<sup>2</sup>+'),(11770,1276,'_s4-list_5_formula','field_60bf7fc65a92d'),(11771,1276,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(11772,1276,'_s4-list_5_text','field_60bf7fd35a92e'),(11773,1276,'s4-list_6_ttl','Кальций'),(11774,1276,'_s4-list_6_ttl','field_60bf7fa95a92c'),(11775,1276,'s4-list_6_formula','Ca<sup>2+</sup>'),(11776,1276,'_s4-list_6_formula','field_60bf7fc65a92d'),(11777,1276,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(11778,1276,'_s4-list_6_text','field_60bf7fd35a92e'),(11779,1276,'s4-list_7_ttl','Сорбит'),(11780,1276,'_s4-list_7_ttl','field_60bf7fa95a92c'),(11781,1276,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(11782,1276,'_s4-list_7_formula','field_60bf7fc65a92d'),(11783,1276,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(11784,1276,'_s4-list_7_text','field_60bf7fd35a92e'),(11785,1276,'s4-list_8_ttl','Хлор'),(11786,1276,'_s4-list_8_ttl','field_60bf7fa95a92c'),(11787,1276,'s4-list_8_formula','Cl'),(11788,1276,'_s4-list_8_formula','field_60bf7fc65a92d'),(11789,1276,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(11790,1276,'_s4-list_8_text','field_60bf7fd35a92e'),(11791,1276,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(11792,1276,'_s4-feature1','field_60bf80ca480ea'),(11793,1276,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(11794,1276,'_s4-feature2','field_60bf80de480eb'),(11795,1276,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(11796,1276,'_s4-feature3','field_60bf80e2480ec'),(11797,1276,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве 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навантаження'),(11938,1289,'_s2-list_4_text','field_60bf7712f46f1'),(11939,1289,'s2-list_5_icon','71'),(11940,1289,'_s2-list_5_icon','field_60bf76ecf46ef'),(11941,1289,'s2-list_5_icon-hover','72'),(11942,1289,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(11943,1289,'s2-list_5_text','Перегрівання в спекотну погоду'),(11944,1289,'_s2-list_5_text','field_60bf7712f46f1'),(11945,1289,'s1-slogan','Коли звичайної води замало!'),(11946,1289,'_s1-slogan','field_60bf7ab4d9ba9'),(11947,1289,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(11948,1289,'_s3-text','field_60bf7bb5a7e2b'),(11949,1289,'s4-ttl','РеО – вода для медичних цілей'),(11950,1289,'_s4-ttl','field_60bf7c831f58c'),(11951,1289,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(11952,1289,'_s4-notes','field_60bf7ca31f58d'),(11953,1289,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(11954,1289,'_s5-video','field_60bf7ccfa01a5'),(11955,1289,'s6-ttl','Коли звичайної води замало!'),(11956,1289,'_s6-ttl','field_60bf7cfb10d31'),(11957,1289,'s6-list','6'),(11958,1289,'_s6-list','field_60bf7d0410d32'),(11959,1289,'s6-list_0_icon','92'),(11960,1289,'_s6-list_0_icon','field_60bf7d1810d33'),(11961,1289,'s6-list_0_text','При підвищеній температурі'),(11962,1289,'_s6-list_0_text','field_60bf7d2710d34'),(11963,1289,'s6-list_1_icon','93'),(11964,1289,'_s6-list_1_icon','field_60bf7d1810d33'),(11965,1289,'s6-list_1_text','При харчових отруєннях'),(11966,1289,'_s6-list_1_text','field_60bf7d2710d34'),(11967,1289,'s6-list_2_icon','94'),(11968,1289,'_s6-list_2_icon','field_60bf7d1810d33'),(11969,1289,'s6-list_2_text','При кишкових інфекціях'),(11970,1289,'_s6-list_2_text','field_60bf7d2710d34'),(11971,1289,'s6-list_3_icon','95'),(11972,1289,'_s6-list_3_icon','field_60bf7d1810d33'),(11973,1289,'s6-list_3_text','Під час вагітності'),(11974,1289,'_s6-list_3_text','field_60bf7d2710d34'),(11975,1289,'s6-list_4_icon','96'),(11976,1289,'_s6-list_4_icon','field_60bf7d1810d33'),(11977,1289,'s6-list_4_text','Під час заняття спортом'),(11978,1289,'_s6-list_4_text','field_60bf7d2710d34'),(11979,1289,'s6-list_5_icon','97'),(11980,1289,'_s6-list_5_icon','field_60bf7d1810d33'),(11981,1289,'s6-list_5_text','При похмільному синдромі'),(11982,1289,'_s6-list_5_text','field_60bf7d2710d34'),(11983,1289,'s4-list_0_ttl','Натрій'),(11984,1289,'_s4-list_0_ttl','field_60bf7fa95a92c'),(11985,1289,'s4-list_0_formula','Na<sup>+</sup>'),(11986,1289,'_s4-list_0_formula','field_60bf7fc65a92d'),(11987,1289,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(11988,1289,'_s4-list_0_text','field_60bf7fd35a92e'),(11989,1289,'s4-list_1_ttl','Вода'),(11990,1289,'_s4-list_1_ttl','field_60bf7fa95a92c'),(11991,1289,'s4-list_1_formula','H<sub>2</sub>O'),(11992,1289,'_s4-list_1_formula','field_60bf7fc65a92d'),(11993,1289,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(11994,1289,'_s4-list_1_text','field_60bf7fd35a92e'),(11995,1289,'s4-list','9'),(11996,1289,'_s4-list','field_60bf7f985a92b'),(11997,1289,'s4-list_2_ttl','Калій'),(11998,1289,'_s4-list_2_ttl','field_60bf7fa95a92c'),(11999,1289,'s4-list_2_formula','K<sup>+</sup>'),(12000,1289,'_s4-list_2_formula','field_60bf7fc65a92d'),(12001,1289,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(12002,1289,'_s4-list_2_text','field_60bf7fd35a92e'),(12003,1289,'s4-list_3_ttl','Гідрокарбонати'),(12004,1289,'_s4-list_3_ttl','field_60bf7fa95a92c'),(12005,1289,'s4-list_3_formula','HCO<sup>3+</sup>'),(12006,1289,'_s4-list_3_formula','field_60bf7fc65a92d'),(12007,1289,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(12008,1289,'_s4-list_3_text','field_60bf7fd35a92e'),(12009,1289,'s4-list_4_ttl','Магній'),(12010,1289,'_s4-list_4_ttl','field_60bf7fa95a92c'),(12011,1289,'s4-list_4_formula','Mg<sup>2+</sup>'),(12012,1289,'_s4-list_4_formula','field_60bf7fc65a92d'),(12013,1289,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(12014,1289,'_s4-list_4_text','field_60bf7fd35a92e'),(12015,1289,'s4-list_5_ttl','Вуглекислий газ'),(12016,1289,'_s4-list_5_ttl','field_60bf7fa95a92c'),(12017,1289,'s4-list_5_formula','CO<sup>2</sup>+'),(12018,1289,'_s4-list_5_formula','field_60bf7fc65a92d'),(12019,1289,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(12020,1289,'_s4-list_5_text','field_60bf7fd35a92e'),(12021,1289,'s4-list_6_ttl','Кальцій'),(12022,1289,'_s4-list_6_ttl','field_60bf7fa95a92c'),(12023,1289,'s4-list_6_formula','Ca<sup>2+</sup>'),(12024,1289,'_s4-list_6_formula','field_60bf7fc65a92d'),(12025,1289,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(12026,1289,'_s4-list_6_text','field_60bf7fd35a92e'),(12027,1289,'s4-list_7_ttl','Сорбіт'),(12028,1289,'_s4-list_7_ttl','field_60bf7fa95a92c'),(12029,1289,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(12030,1289,'_s4-list_7_formula','field_60bf7fc65a92d'),(12031,1289,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(12032,1289,'_s4-list_7_text','field_60bf7fd35a92e'),(12033,1289,'s4-list_8_ttl','Хлор'),(12034,1289,'_s4-list_8_ttl','field_60bf7fa95a92c'),(12035,1289,'s4-list_8_formula','Cl'),(12036,1289,'_s4-list_8_formula','field_60bf7fc65a92d'),(12037,1289,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(12038,1289,'_s4-list_8_text','field_60bf7fd35a92e'),(12039,1289,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(12040,1289,'_s4-feature1','field_60bf80ca480ea'),(12041,1289,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(12042,1289,'_s4-feature2','field_60bf80de480eb'),(12043,1289,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(12044,1289,'_s4-feature3','field_60bf80e2480ec'),(12045,1289,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(12046,1289,'_s4-feature4','field_60bf80e5480ed'),(12047,1289,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12048,1289,'_s2-list_0_link','field_60ee90d381a4e'),(12049,1289,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12050,1289,'_s2-list_1_link','field_60ee90d381a4e'),(12051,1289,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12052,1289,'_s2-list_2_link','field_60ee90d381a4e'),(12053,1289,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(12054,1289,'_s2-list_3_link','field_60ee90d381a4e'),(12055,1289,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12056,1289,'_s2-list_4_link','field_60ee90d381a4e'),(12057,1289,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(12058,1289,'_s2-list_5_link','field_60ee90d381a4e'),(12059,1289,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12060,1289,'_s6-list_0_link','field_60ee916b04ace'),(12061,1289,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(12062,1289,'_s6-list_1_link','field_60ee916b04ace'),(12063,1289,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12064,1289,'_s6-list_2_link','field_60ee916b04ace'),(12065,1289,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(12066,1289,'_s6-list_3_link','field_60ee916b04ace'),(12067,1289,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12068,1289,'_s6-list_4_link','field_60ee916b04ace'),(12069,1289,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12070,1289,'_s6-list_5_link','field_60ee916b04ace'),(12071,1289,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(12072,1289,'_slider_0_webplink','field_60fa70c989e88'),(12073,1289,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(12074,1289,'_slider_1_webplink','field_60fa70c989e88'),(12075,1289,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(12076,1289,'_slider_2_webplink','field_60fa70c989e88'),(12077,1289,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(12078,1289,'_slider_3_webplink','field_60fa70c989e88'),(12079,1289,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(12080,1289,'_slider_4_webplink','field_60fa70c989e88'),(12081,1289,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(12082,1289,'_slider_5_webplink','field_60fa70c989e88'),(12083,1289,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(12084,1289,'_slider_6_webplink','field_60fa70c989e88'),(12085,1289,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(12086,1289,'_slider_7_webplink','field_60fa70c989e88'),(12087,1290,'_wp_attached_file','2021/07/slide-1.webp'),(12088,1291,'_wp_attachment_metadata','a:0:{}'),(12089,1291,'_wp_attached_file','2021/07/slide-1.webp'),(12090,1291,'wpml_media_processed','1'),(12091,1292,'_wp_attached_file','2021/07/slide-2.webp'),(12092,1293,'_wp_attachment_metadata','a:0:{}'),(12093,1293,'_wp_attached_file','2021/07/slide-2.webp'),(12094,1293,'wpml_media_processed','1'),(12095,1294,'_wp_attached_file','2021/07/slide-3.webp'),(12096,1295,'_wp_attachment_metadata','a:0:{}'),(12097,1295,'_wp_attached_file','2021/07/slide-3.webp'),(12098,1295,'wpml_media_processed','1'),(12099,1296,'_wp_attached_file','2021/07/slide-4.webp'),(12100,1297,'_wp_attachment_metadata','a:0:{}'),(12101,1297,'_wp_attached_file','2021/07/slide-4.webp'),(12102,1297,'wpml_media_processed','1'),(12103,1298,'_wp_attached_file','2021/07/slide-5.webp'),(12104,1299,'_wp_attachment_metadata','a:0:{}'),(12105,1299,'_wp_attached_file','2021/07/slide-5.webp'),(12106,1299,'wpml_media_processed','1'),(12107,1300,'_wp_attached_file','2021/07/slide-6.webp'),(12108,1301,'_wp_attachment_metadata','a:0:{}'),(12109,1301,'_wp_attached_file','2021/07/slide-6.webp'),(12110,1301,'wpml_media_processed','1'),(12111,1302,'_wp_attached_file','2021/07/slide-7.webp'),(12112,1303,'_wp_attachment_metadata','a:0:{}'),(12113,1303,'_wp_attached_file','2021/07/slide-7.webp'),(12114,1303,'wpml_media_processed','1'),(12115,1304,'_wp_attached_file','2021/07/slide-8.webp'),(12116,1305,'_wp_attachment_metadata','a:0:{}'),(12117,1305,'_wp_attached_file','2021/07/slide-8.webp'),(12118,1305,'wpml_media_processed','1'),(12119,8,'slider_0_slide','1787'),(12120,8,'_slider_0_slide','field_60bf7688f46eb'),(12121,8,'slider_1_slide','1767'),(12122,8,'_slider_1_slide','field_60bf7688f46eb'),(12123,8,'slider_2_slide','50'),(12124,8,'_slider_2_slide','field_60bf7688f46eb'),(12125,8,'slider_3_slide','51'),(12126,8,'_slider_3_slide','field_60bf7688f46eb'),(12127,8,'slider_4_slide','52'),(12128,8,'_slider_4_slide','field_60bf7688f46eb'),(12129,8,'slider_5_slide','53'),(12130,8,'_slider_5_slide','field_60bf7688f46eb'),(12131,8,'slider_6_slide','54'),(12132,8,'_slider_6_slide','field_60bf7688f46eb'),(12133,8,'slider_7_slide','55'),(12134,8,'_slider_7_slide','field_60bf7688f46eb'),(12135,1306,'slider','8'),(12136,1306,'_slider','field_60bf767ef46ea'),(12137,1306,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(12138,1306,'_s2-ttl','field_60bf76d1f46ed'),(12139,1306,'s2-list','6'),(12140,1306,'_s2-list','field_60bf76e0f46ee'),(12141,1306,'s2-list_0_icon','61'),(12142,1306,'_s2-list_0_icon','field_60bf76ecf46ef'),(12143,1306,'s2-list_0_icon-hover','62'),(12144,1306,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(12145,1306,'s2-list_0_text','Лихоманка'),(12146,1306,'_s2-list_0_text','field_60bf7712f46f1'),(12147,1306,'s2-list_1_icon','63'),(12148,1306,'_s2-list_1_icon','field_60bf76ecf46ef'),(12149,1306,'s2-list_1_icon-hover','64'),(12150,1306,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(12151,1306,'s2-list_1_text','Похмільний синдром'),(12152,1306,'_s2-list_1_text','field_60bf7712f46f1'),(12153,1306,'s2-list_2_icon','65'),(12154,1306,'_s2-list_2_icon','field_60bf76ecf46ef'),(12155,1306,'s2-list_2_icon-hover','66'),(12156,1306,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(12157,1306,'s2-list_2_text','Діарея'),(12158,1306,'_s2-list_2_text','field_60bf7712f46f1'),(12159,1306,'s2-list_3_icon','67'),(12160,1306,'_s2-list_3_icon','field_60bf76ecf46ef'),(12161,1306,'s2-list_3_icon-hover','68'),(12162,1306,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(12163,1306,'s2-list_3_text','Блювота'),(12164,1306,'_s2-list_3_text','field_60bf7712f46f1'),(12165,1306,'s2-list_4_icon','69'),(12166,1306,'_s2-list_4_icon','field_60bf76ecf46ef'),(12167,1306,'s2-list_4_icon-hover','70'),(12168,1306,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(12169,1306,'s2-list_4_text','Інтенсивні фізичні навантаження'),(12170,1306,'_s2-list_4_text','field_60bf7712f46f1'),(12171,1306,'s2-list_5_icon','71'),(12172,1306,'_s2-list_5_icon','field_60bf76ecf46ef'),(12173,1306,'s2-list_5_icon-hover','72'),(12174,1306,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(12175,1306,'s2-list_5_text','Перегрівання в спекотну погоду'),(12176,1306,'_s2-list_5_text','field_60bf7712f46f1'),(12177,1306,'s1-slogan','Коли звичайної води замало!'),(12178,1306,'_s1-slogan','field_60bf7ab4d9ba9'),(12179,1306,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(12180,1306,'_s3-text','field_60bf7bb5a7e2b'),(12181,1306,'s4-ttl','РеО – вода для медичних цілей'),(12182,1306,'_s4-ttl','field_60bf7c831f58c'),(12183,1306,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(12184,1306,'_s4-notes','field_60bf7ca31f58d'),(12185,1306,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(12186,1306,'_s5-video','field_60bf7ccfa01a5'),(12187,1306,'s6-ttl','Коли звичайної води замало!'),(12188,1306,'_s6-ttl','field_60bf7cfb10d31'),(12189,1306,'s6-list','6'),(12190,1306,'_s6-list','field_60bf7d0410d32'),(12191,1306,'s6-list_0_icon','92'),(12192,1306,'_s6-list_0_icon','field_60bf7d1810d33'),(12193,1306,'s6-list_0_text','При підвищеній температурі'),(12194,1306,'_s6-list_0_text','field_60bf7d2710d34'),(12195,1306,'s6-list_1_icon','93'),(12196,1306,'_s6-list_1_icon','field_60bf7d1810d33'),(12197,1306,'s6-list_1_text','При харчових отруєннях'),(12198,1306,'_s6-list_1_text','field_60bf7d2710d34'),(12199,1306,'s6-list_2_icon','94'),(12200,1306,'_s6-list_2_icon','field_60bf7d1810d33'),(12201,1306,'s6-list_2_text','При кишкових інфекціях'),(12202,1306,'_s6-list_2_text','field_60bf7d2710d34'),(12203,1306,'s6-list_3_icon','95'),(12204,1306,'_s6-list_3_icon','field_60bf7d1810d33'),(12205,1306,'s6-list_3_text','Під час вагітності'),(12206,1306,'_s6-list_3_text','field_60bf7d2710d34'),(12207,1306,'s6-list_4_icon','96'),(12208,1306,'_s6-list_4_icon','field_60bf7d1810d33'),(12209,1306,'s6-list_4_text','Під час заняття спортом'),(12210,1306,'_s6-list_4_text','field_60bf7d2710d34'),(12211,1306,'s6-list_5_icon','97'),(12212,1306,'_s6-list_5_icon','field_60bf7d1810d33'),(12213,1306,'s6-list_5_text','При похмільному синдромі'),(12214,1306,'_s6-list_5_text','field_60bf7d2710d34'),(12215,1306,'s4-list_0_ttl','Натрій'),(12216,1306,'_s4-list_0_ttl','field_60bf7fa95a92c'),(12217,1306,'s4-list_0_formula','Na<sup>+</sup>'),(12218,1306,'_s4-list_0_formula','field_60bf7fc65a92d'),(12219,1306,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(12220,1306,'_s4-list_0_text','field_60bf7fd35a92e'),(12221,1306,'s4-list_1_ttl','Вода'),(12222,1306,'_s4-list_1_ttl','field_60bf7fa95a92c'),(12223,1306,'s4-list_1_formula','H<sub>2</sub>O'),(12224,1306,'_s4-list_1_formula','field_60bf7fc65a92d'),(12225,1306,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(12226,1306,'_s4-list_1_text','field_60bf7fd35a92e'),(12227,1306,'s4-list','9'),(12228,1306,'_s4-list','field_60bf7f985a92b'),(12229,1306,'s4-list_2_ttl','Калій'),(12230,1306,'_s4-list_2_ttl','field_60bf7fa95a92c'),(12231,1306,'s4-list_2_formula','K<sup>+</sup>'),(12232,1306,'_s4-list_2_formula','field_60bf7fc65a92d'),(12233,1306,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(12234,1306,'_s4-list_2_text','field_60bf7fd35a92e'),(12235,1306,'s4-list_3_ttl','Гідрокарбонати'),(12236,1306,'_s4-list_3_ttl','field_60bf7fa95a92c'),(12237,1306,'s4-list_3_formula','HCO<sup>3+</sup>'),(12238,1306,'_s4-list_3_formula','field_60bf7fc65a92d'),(12239,1306,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(12240,1306,'_s4-list_3_text','field_60bf7fd35a92e'),(12241,1306,'s4-list_4_ttl','Магній'),(12242,1306,'_s4-list_4_ttl','field_60bf7fa95a92c'),(12243,1306,'s4-list_4_formula','Mg<sup>2+</sup>'),(12244,1306,'_s4-list_4_formula','field_60bf7fc65a92d'),(12245,1306,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(12246,1306,'_s4-list_4_text','field_60bf7fd35a92e'),(12247,1306,'s4-list_5_ttl','Вуглекислий газ'),(12248,1306,'_s4-list_5_ttl','field_60bf7fa95a92c'),(12249,1306,'s4-list_5_formula','CO<sup>2</sup>+'),(12250,1306,'_s4-list_5_formula','field_60bf7fc65a92d'),(12251,1306,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(12252,1306,'_s4-list_5_text','field_60bf7fd35a92e'),(12253,1306,'s4-list_6_ttl','Кальцій'),(12254,1306,'_s4-list_6_ttl','field_60bf7fa95a92c'),(12255,1306,'s4-list_6_formula','Ca<sup>2+</sup>'),(12256,1306,'_s4-list_6_formula','field_60bf7fc65a92d'),(12257,1306,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(12258,1306,'_s4-list_6_text','field_60bf7fd35a92e'),(12259,1306,'s4-list_7_ttl','Сорбіт'),(12260,1306,'_s4-list_7_ttl','field_60bf7fa95a92c'),(12261,1306,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(12262,1306,'_s4-list_7_formula','field_60bf7fc65a92d'),(12263,1306,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(12264,1306,'_s4-list_7_text','field_60bf7fd35a92e'),(12265,1306,'s4-list_8_ttl','Хлор'),(12266,1306,'_s4-list_8_ttl','field_60bf7fa95a92c'),(12267,1306,'s4-list_8_formula','Cl'),(12268,1306,'_s4-list_8_formula','field_60bf7fc65a92d'),(12269,1306,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(12270,1306,'_s4-list_8_text','field_60bf7fd35a92e'),(12271,1306,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(12272,1306,'_s4-feature1','field_60bf80ca480ea'),(12273,1306,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(12274,1306,'_s4-feature2','field_60bf80de480eb'),(12275,1306,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(12276,1306,'_s4-feature3','field_60bf80e2480ec'),(12277,1306,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(12278,1306,'_s4-feature4','field_60bf80e5480ed'),(12279,1306,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12280,1306,'_s2-list_0_link','field_60ee90d381a4e'),(12281,1306,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12282,1306,'_s2-list_1_link','field_60ee90d381a4e'),(12283,1306,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12284,1306,'_s2-list_2_link','field_60ee90d381a4e'),(12285,1306,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(12286,1306,'_s2-list_3_link','field_60ee90d381a4e'),(12287,1306,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12288,1306,'_s2-list_4_link','field_60ee90d381a4e'),(12289,1306,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(12290,1306,'_s2-list_5_link','field_60ee90d381a4e'),(12291,1306,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12292,1306,'_s6-list_0_link','field_60ee916b04ace'),(12293,1306,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(12294,1306,'_s6-list_1_link','field_60ee916b04ace'),(12295,1306,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12296,1306,'_s6-list_2_link','field_60ee916b04ace'),(12297,1306,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(12298,1306,'_s6-list_3_link','field_60ee916b04ace'),(12299,1306,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12300,1306,'_s6-list_4_link','field_60ee916b04ace'),(12301,1306,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12302,1306,'_s6-list_5_link','field_60ee916b04ace'),(12303,1306,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(12304,1306,'_slider_0_webplink','field_60fa70c989e88'),(12305,1306,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(12306,1306,'_slider_1_webplink','field_60fa70c989e88'),(12307,1306,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(12308,1306,'_slider_2_webplink','field_60fa70c989e88'),(12309,1306,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(12310,1306,'_slider_3_webplink','field_60fa70c989e88'),(12311,1306,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(12312,1306,'_slider_4_webplink','field_60fa70c989e88'),(12313,1306,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(12314,1306,'_slider_5_webplink','field_60fa70c989e88'),(12315,1306,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(12316,1306,'_slider_6_webplink','field_60fa70c989e88'),(12317,1306,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(12318,1306,'_slider_7_webplink','field_60fa70c989e88'),(12319,1306,'slider_0_slide','1290'),(12320,1306,'_slider_0_slide','field_60bf7688f46eb'),(12321,1306,'slider_1_slide','1292'),(12322,1306,'_slider_1_slide','field_60bf7688f46eb'),(12323,1306,'slider_2_slide','1294'),(12324,1306,'_slider_2_slide','field_60bf7688f46eb'),(12325,1306,'slider_3_slide','1296'),(12326,1306,'_slider_3_slide','field_60bf7688f46eb'),(12327,1306,'slider_4_slide','1298'),(12328,1306,'_slider_4_slide','field_60bf7688f46eb'),(12329,1306,'slider_5_slide','1300'),(12330,1306,'_slider_5_slide','field_60bf7688f46eb'),(12331,1306,'slider_6_slide','1302'),(12332,1306,'_slider_6_slide','field_60bf7688f46eb'),(12333,1306,'slider_7_slide','1304'),(12334,1306,'_slider_7_slide','field_60bf7688f46eb'),(12335,1307,'s2-list','6'),(12336,1307,'_s2-list','field_60bf76e0f46ee'),(12337,1307,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(12338,1307,'_s2-ttl','field_60bf76d1f46ed'),(12339,1307,'slider','8'),(12340,1307,'_slider','field_60bf767ef46ea'),(12341,1307,'slider_0_slide','1291'),(12342,1307,'_slider_0_slide','field_60bf7688f46eb'),(12343,1307,'slider_1_slide','1293'),(12344,1307,'_slider_1_slide','field_60bf7688f46eb'),(12345,1307,'slider_2_slide','1295'),(12346,1307,'_slider_2_slide','field_60bf7688f46eb'),(12347,1307,'slider_3_slide','1297'),(12348,1307,'_slider_3_slide','field_60bf7688f46eb'),(12349,1307,'slider_4_slide','1299'),(12350,1307,'_slider_4_slide','field_60bf7688f46eb'),(12351,1307,'slider_5_slide','1301'),(12352,1307,'_slider_5_slide','field_60bf7688f46eb'),(12353,1307,'slider_6_slide','1303'),(12354,1307,'_slider_6_slide','field_60bf7688f46eb'),(12355,1307,'slider_7_slide','1305'),(12356,1307,'_slider_7_slide','field_60bf7688f46eb'),(12357,1307,'s2-list_0_icon','61'),(12358,1307,'_s2-list_0_icon','field_60bf76ecf46ef'),(12359,1307,'s2-list_0_icon-hover','62'),(12360,1307,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(12361,1307,'s2-list_0_text','Лихорадка'),(12362,1307,'_s2-list_0_text','field_60bf7712f46f1'),(12363,1307,'s2-list_1_icon','63'),(12364,1307,'_s2-list_1_icon','field_60bf76ecf46ef'),(12365,1307,'s2-list_1_icon-hover','64'),(12366,1307,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(12367,1307,'s2-list_1_text','Похмельный синдром'),(12368,1307,'_s2-list_1_text','field_60bf7712f46f1'),(12369,1307,'s2-list_2_icon','65'),(12370,1307,'_s2-list_2_icon','field_60bf76ecf46ef'),(12371,1307,'s2-list_2_icon-hover','66'),(12372,1307,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(12373,1307,'s2-list_2_text','Диарея'),(12374,1307,'_s2-list_2_text','field_60bf7712f46f1'),(12375,1307,'s2-list_3_icon','67'),(12376,1307,'_s2-list_3_icon','field_60bf76ecf46ef'),(12377,1307,'s2-list_3_icon-hover','68'),(12378,1307,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(12379,1307,'s2-list_3_text','Рвота'),(12380,1307,'_s2-list_3_text','field_60bf7712f46f1'),(12381,1307,'s2-list_4_icon','69'),(12382,1307,'_s2-list_4_icon','field_60bf76ecf46ef'),(12383,1307,'s2-list_4_icon-hover','70'),(12384,1307,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(12385,1307,'s2-list_4_text','Интенсивные физические нагрузки'),(12386,1307,'_s2-list_4_text','field_60bf7712f46f1'),(12387,1307,'s2-list_5_icon','71'),(12388,1307,'_s2-list_5_icon','field_60bf76ecf46ef'),(12389,1307,'s2-list_5_icon-hover','72'),(12390,1307,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(12391,1307,'s2-list_5_text','Перегрев в жаркую погоду'),(12392,1307,'_s2-list_5_text','field_60bf7712f46f1'),(12393,1307,'s1-slogan','Когда обычной воды недостаточно!'),(12394,1307,'_s1-slogan','field_60bf7ab4d9ba9'),(12395,1307,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(12396,1307,'_s3-text','field_60bf7bb5a7e2b'),(12397,1307,'s4-ttl','РеО – вода для медицинских целей!'),(12398,1307,'_s4-ttl','field_60bf7c831f58c'),(12399,1307,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(12400,1307,'_s4-notes','field_60bf7ca31f58d'),(12401,1307,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(12402,1307,'_s5-video','field_60bf7ccfa01a5'),(12403,1307,'s6-ttl','Когда обычной воды недостаточно!'),(12404,1307,'_s6-ttl','field_60bf7cfb10d31'),(12405,1307,'s6-list','6'),(12406,1307,'_s6-list','field_60bf7d0410d32'),(12407,1307,'s6-list_0_icon','92'),(12408,1307,'_s6-list_0_icon','field_60bf7d1810d33'),(12409,1307,'s6-list_0_text','При повышенной температуре'),(12410,1307,'_s6-list_0_text','field_60bf7d2710d34'),(12411,1307,'s6-list_1_icon','93'),(12412,1307,'_s6-list_1_icon','field_60bf7d1810d33'),(12413,1307,'s6-list_1_text','При пищевых отравлениях'),(12414,1307,'_s6-list_1_text','field_60bf7d2710d34'),(12415,1307,'s6-list_2_icon','94'),(12416,1307,'_s6-list_2_icon','field_60bf7d1810d33'),(12417,1307,'s6-list_2_text','При кишечных инфекциях'),(12418,1307,'_s6-list_2_text','field_60bf7d2710d34'),(12419,1307,'s6-list_3_icon','95'),(12420,1307,'_s6-list_3_icon','field_60bf7d1810d33'),(12421,1307,'s6-list_3_text','Во время беременности'),(12422,1307,'_s6-list_3_text','field_60bf7d2710d34'),(12423,1307,'s6-list_4_icon','96'),(12424,1307,'_s6-list_4_icon','field_60bf7d1810d33'),(12425,1307,'s6-list_4_text','Во время занятий спортом'),(12426,1307,'_s6-list_4_text','field_60bf7d2710d34'),(12427,1307,'s6-list_5_icon','97'),(12428,1307,'_s6-list_5_icon','field_60bf7d1810d33'),(12429,1307,'s6-list_5_text','При похмельном синдроме'),(12430,1307,'_s6-list_5_text','field_60bf7d2710d34'),(12431,1307,'s4-list_0_ttl','Натрий'),(12432,1307,'_s4-list_0_ttl','field_60bf7fa95a92c'),(12433,1307,'s4-list_0_formula','Na<sup>+</sup>'),(12434,1307,'_s4-list_0_formula','field_60bf7fc65a92d'),(12435,1307,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(12436,1307,'_s4-list_0_text','field_60bf7fd35a92e'),(12437,1307,'s4-list_1_ttl','Вода'),(12438,1307,'_s4-list_1_ttl','field_60bf7fa95a92c'),(12439,1307,'s4-list_1_formula','H<sub>2</sub>O'),(12440,1307,'_s4-list_1_formula','field_60bf7fc65a92d'),(12441,1307,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(12442,1307,'_s4-list_1_text','field_60bf7fd35a92e'),(12443,1307,'s4-list','9'),(12444,1307,'_s4-list','field_60bf7f985a92b'),(12445,1307,'s4-list_2_ttl','Калий'),(12446,1307,'_s4-list_2_ttl','field_60bf7fa95a92c'),(12447,1307,'s4-list_2_formula','K<sup>+</sup>'),(12448,1307,'_s4-list_2_formula','field_60bf7fc65a92d'),(12449,1307,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(12450,1307,'_s4-list_2_text','field_60bf7fd35a92e'),(12451,1307,'s4-list_3_ttl','Гидрокарбонаты'),(12452,1307,'_s4-list_3_ttl','field_60bf7fa95a92c'),(12453,1307,'s4-list_3_formula','HCO<sup>3+</sup>'),(12454,1307,'_s4-list_3_formula','field_60bf7fc65a92d'),(12455,1307,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(12456,1307,'_s4-list_3_text','field_60bf7fd35a92e'),(12457,1307,'s4-list_4_ttl','Магний'),(12458,1307,'_s4-list_4_ttl','field_60bf7fa95a92c'),(12459,1307,'s4-list_4_formula','Mg<sup>2+</sup>'),(12460,1307,'_s4-list_4_formula','field_60bf7fc65a92d'),(12461,1307,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(12462,1307,'_s4-list_4_text','field_60bf7fd35a92e'),(12463,1307,'s4-list_5_ttl','Углекислый газ'),(12464,1307,'_s4-list_5_ttl','field_60bf7fa95a92c'),(12465,1307,'s4-list_5_formula','CO<sup>2</sup>+'),(12466,1307,'_s4-list_5_formula','field_60bf7fc65a92d'),(12467,1307,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(12468,1307,'_s4-list_5_text','field_60bf7fd35a92e'),(12469,1307,'s4-list_6_ttl','Кальций'),(12470,1307,'_s4-list_6_ttl','field_60bf7fa95a92c'),(12471,1307,'s4-list_6_formula','Ca<sup>2+</sup>'),(12472,1307,'_s4-list_6_formula','field_60bf7fc65a92d'),(12473,1307,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(12474,1307,'_s4-list_6_text','field_60bf7fd35a92e'),(12475,1307,'s4-list_7_ttl','Сорбит'),(12476,1307,'_s4-list_7_ttl','field_60bf7fa95a92c'),(12477,1307,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(12478,1307,'_s4-list_7_formula','field_60bf7fc65a92d'),(12479,1307,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(12480,1307,'_s4-list_7_text','field_60bf7fd35a92e'),(12481,1307,'s4-list_8_ttl','Хлор'),(12482,1307,'_s4-list_8_ttl','field_60bf7fa95a92c'),(12483,1307,'s4-list_8_formula','Cl'),(12484,1307,'_s4-list_8_formula','field_60bf7fc65a92d'),(12485,1307,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(12486,1307,'_s4-list_8_text','field_60bf7fd35a92e'),(12487,1307,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(12488,1307,'_s4-feature1','field_60bf80ca480ea'),(12489,1307,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(12490,1307,'_s4-feature2','field_60bf80de480eb'),(12491,1307,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(12492,1307,'_s4-feature3','field_60bf80e2480ec'),(12493,1307,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(12494,1307,'_s4-feature4','field_60bf80e5480ed'),(12495,1307,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(12496,1307,'_s2-list_0_link','field_60ee90d381a4e'),(12497,1307,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(12498,1307,'_s2-list_1_link','field_60ee90d381a4e'),(12499,1307,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(12500,1307,'_s2-list_2_link','field_60ee90d381a4e'),(12501,1307,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(12502,1307,'_s2-list_3_link','field_60ee90d381a4e'),(12503,1307,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(12504,1307,'_s2-list_4_link','field_60ee90d381a4e'),(12505,1307,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(12506,1307,'_s2-list_5_link','field_60ee90d381a4e'),(12507,1307,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(12508,1307,'_s6-list_0_link','field_60ee916b04ace'),(12509,1307,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(12510,1307,'_s6-list_1_link','field_60ee916b04ace'),(12511,1307,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(12512,1307,'_s6-list_2_link','field_60ee916b04ace'),(12513,1307,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(12514,1307,'_s6-list_3_link','field_60ee916b04ace'),(12515,1307,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(12516,1307,'_s6-list_4_link','field_60ee916b04ace'),(12517,1307,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(12518,1307,'_s6-list_5_link','field_60ee916b04ace'),(12519,1307,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(12520,1307,'_slider_0_webplink','field_60fa70c989e88'),(12521,1307,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(12522,1307,'_slider_1_webplink','field_60fa70c989e88'),(12523,1307,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(12524,1307,'_slider_2_webplink','field_60fa70c989e88'),(12525,1307,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(12526,1307,'_slider_3_webplink','field_60fa70c989e88'),(12527,1307,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(12528,1307,'_slider_4_webplink','field_60fa70c989e88'),(12529,1307,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(12530,1307,'_slider_5_webplink','field_60fa70c989e88'),(12531,1307,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(12532,1307,'_slider_6_webplink','field_60fa70c989e88'),(12533,1307,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(12534,1307,'_slider_7_webplink','field_60fa70c989e88'),(12540,1308,'_s2-list','field_60bf76e0f46ee'),(12541,1308,'s2-list_0_icon','61'),(12542,1308,'_s2-list_0_icon','field_60bf76ecf46ef'),(12543,1308,'s2-list_0_icon-hover','62'),(12544,1308,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(12545,1308,'s2-list_0_text','Лихоманка'),(12546,1308,'_s2-list_0_text','field_60bf7712f46f1'),(12547,1308,'s2-list_1_icon','63'),(12548,1308,'_s2-list_1_icon','field_60bf76ecf46ef'),(12549,1308,'s2-list_1_icon-hover','64'),(12550,1308,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(12551,1308,'s2-list_1_text','Похмільний синдром'),(12552,1308,'_s2-list_1_text','field_60bf7712f46f1'),(12553,1308,'s2-list_2_icon','65'),(12554,1308,'_s2-list_2_icon','field_60bf76ecf46ef'),(12555,1308,'s2-list_2_icon-hover','66'),(12556,1308,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(12557,1308,'s2-list_2_text','Діарея'),(12558,1308,'_s2-list_2_text','field_60bf7712f46f1'),(12559,1308,'s2-list_3_icon','67'),(12560,1308,'_s2-list_3_icon','field_60bf76ecf46ef'),(12561,1308,'s2-list_3_icon-hover','68'),(12562,1308,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(12563,1308,'s2-list_3_text','Блювота'),(12564,1308,'_s2-list_3_text','field_60bf7712f46f1'),(12565,1308,'s2-list_4_icon','69'),(12566,1308,'_s2-list_4_icon','field_60bf76ecf46ef'),(12567,1308,'s2-list_4_icon-hover','70'),(12568,1308,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(12569,1308,'s2-list_4_text','Інтенсивні фізичні навантаження'),(12570,1308,'_s2-list_4_text','field_60bf7712f46f1'),(12571,1308,'s2-list_5_icon','71'),(12572,1308,'_s2-list_5_icon','field_60bf76ecf46ef'),(12573,1308,'s2-list_5_icon-hover','72'),(12574,1308,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(12575,1308,'s2-list_5_text','Перегрівання в спекотну погоду'),(12576,1308,'_s2-list_5_text','field_60bf7712f46f1'),(12577,1308,'s1-slogan','Коли звичайної води замало!'),(12578,1308,'_s1-slogan','field_60bf7ab4d9ba9'),(12579,1308,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(12580,1308,'_s3-text','field_60bf7bb5a7e2b'),(12581,1308,'s4-ttl','РеО – вода для медичних цілей'),(12582,1308,'_s4-ttl','field_60bf7c831f58c'),(12583,1308,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(12584,1308,'_s4-notes','field_60bf7ca31f58d'),(12585,1308,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(12586,1308,'_s5-video','field_60bf7ccfa01a5'),(12587,1308,'s6-ttl','Коли звичайної води замало!'),(12588,1308,'_s6-ttl','field_60bf7cfb10d31'),(12589,1308,'s6-list','6'),(12590,1308,'_s6-list','field_60bf7d0410d32'),(12591,1308,'s6-list_0_icon','92'),(12592,1308,'_s6-list_0_icon','field_60bf7d1810d33'),(12593,1308,'s6-list_0_text','При підвищеній температурі'),(12594,1308,'_s6-list_0_text','field_60bf7d2710d34'),(12595,1308,'s6-list_1_icon','93'),(12596,1308,'_s6-list_1_icon','field_60bf7d1810d33'),(12597,1308,'s6-list_1_text','При харчових отруєннях'),(12598,1308,'_s6-list_1_text','field_60bf7d2710d34'),(12599,1308,'s6-list_2_icon','94'),(12600,1308,'_s6-list_2_icon','field_60bf7d1810d33'),(12601,1308,'s6-list_2_text','При кишкових інфекціях'),(12602,1308,'_s6-list_2_text','field_60bf7d2710d34'),(12603,1308,'s6-list_3_icon','95'),(12604,1308,'_s6-list_3_icon','field_60bf7d1810d33'),(12605,1308,'s6-list_3_text','Під час вагітності'),(12606,1308,'_s6-list_3_text','field_60bf7d2710d34'),(12607,1308,'s6-list_4_icon','96'),(12608,1308,'_s6-list_4_icon','field_60bf7d1810d33'),(12609,1308,'s6-list_4_text','Під час заняття спортом'),(12610,1308,'_s6-list_4_text','field_60bf7d2710d34'),(12611,1308,'s6-list_5_icon','97'),(12612,1308,'_s6-list_5_icon','field_60bf7d1810d33'),(12613,1308,'s6-list_5_text','При похмільному синдромі'),(12614,1308,'_s6-list_5_text','field_60bf7d2710d34'),(12615,1308,'s4-list_0_ttl','Натрій'),(12616,1308,'_s4-list_0_ttl','field_60bf7fa95a92c'),(12617,1308,'s4-list_0_formula','Na<sup>+</sup>'),(12618,1308,'_s4-list_0_formula','field_60bf7fc65a92d'),(12619,1308,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(12620,1308,'_s4-list_0_text','field_60bf7fd35a92e'),(12621,1308,'s4-list_1_ttl','Вода'),(12622,1308,'_s4-list_1_ttl','field_60bf7fa95a92c'),(12623,1308,'s4-list_1_formula','H<sub>2</sub>O'),(12624,1308,'_s4-list_1_formula','field_60bf7fc65a92d'),(12625,1308,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(12626,1308,'_s4-list_1_text','field_60bf7fd35a92e'),(12627,1308,'s4-list','9'),(12628,1308,'_s4-list','field_60bf7f985a92b'),(12629,1308,'s4-list_2_ttl','Калій'),(12630,1308,'_s4-list_2_ttl','field_60bf7fa95a92c'),(12631,1308,'s4-list_2_formula','K<sup>+</sup>'),(12632,1308,'_s4-list_2_formula','field_60bf7fc65a92d'),(12633,1308,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(12634,1308,'_s4-list_2_text','field_60bf7fd35a92e'),(12635,1308,'s4-list_3_ttl','Гідрокарбонати'),(12636,1308,'_s4-list_3_ttl','field_60bf7fa95a92c'),(12637,1308,'s4-list_3_formula','HCO<sup>3+</sup>'),(12638,1308,'_s4-list_3_formula','field_60bf7fc65a92d'),(12639,1308,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(12640,1308,'_s4-list_3_text','field_60bf7fd35a92e'),(12641,1308,'s4-list_4_ttl','Магній'),(12642,1308,'_s4-list_4_ttl','field_60bf7fa95a92c'),(12643,1308,'s4-list_4_formula','Mg<sup>2+</sup>'),(12644,1308,'_s4-list_4_formula','field_60bf7fc65a92d'),(12645,1308,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(12646,1308,'_s4-list_4_text','field_60bf7fd35a92e'),(12647,1308,'s4-list_5_ttl','Вуглекислий газ'),(12648,1308,'_s4-list_5_ttl','field_60bf7fa95a92c'),(12649,1308,'s4-list_5_formula','CO<sup>2</sup>+'),(12650,1308,'_s4-list_5_formula','field_60bf7fc65a92d'),(12651,1308,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(12652,1308,'_s4-list_5_text','field_60bf7fd35a92e'),(12653,1308,'s4-list_6_ttl','Кальцій'),(12654,1308,'_s4-list_6_ttl','field_60bf7fa95a92c'),(12655,1308,'s4-list_6_formula','Ca<sup>2+</sup>'),(12656,1308,'_s4-list_6_formula','field_60bf7fc65a92d'),(12657,1308,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(12658,1308,'_s4-list_6_text','field_60bf7fd35a92e'),(12659,1308,'s4-list_7_ttl','Сорбіт'),(12660,1308,'_s4-list_7_ttl','field_60bf7fa95a92c'),(12661,1308,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(12662,1308,'_s4-list_7_formula','field_60bf7fc65a92d'),(12663,1308,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(12664,1308,'_s4-list_7_text','field_60bf7fd35a92e'),(12665,1308,'s4-list_8_ttl','Хлор'),(12666,1308,'_s4-list_8_ttl','field_60bf7fa95a92c'),(12667,1308,'s4-list_8_formula','Cl'),(12668,1308,'_s4-list_8_formula','field_60bf7fc65a92d'),(12669,1308,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(12670,1308,'_s4-list_8_text','field_60bf7fd35a92e'),(12671,1308,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(12672,1308,'_s4-feature1','field_60bf80ca480ea'),(12673,1308,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(12674,1308,'_s4-feature2','field_60bf80de480eb'),(12675,1308,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(12676,1308,'_s4-feature3','field_60bf80e2480ec'),(12677,1308,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(12678,1308,'_s4-feature4','field_60bf80e5480ed'),(12679,1308,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12680,1308,'_s2-list_0_link','field_60ee90d381a4e'),(12681,1308,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12682,1308,'_s2-list_1_link','field_60ee90d381a4e'),(12683,1308,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12684,1308,'_s2-list_2_link','field_60ee90d381a4e'),(12685,1308,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(12686,1308,'_s2-list_3_link','field_60ee90d381a4e'),(12687,1308,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12688,1308,'_s2-list_4_link','field_60ee90d381a4e'),(12689,1308,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(12690,1308,'_s2-list_5_link','field_60ee90d381a4e'),(12691,1308,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(12692,1308,'_s6-list_0_link','field_60ee916b04ace'),(12693,1308,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(12694,1308,'_s6-list_1_link','field_60ee916b04ace'),(12695,1308,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(12696,1308,'_s6-list_2_link','field_60ee916b04ace'),(12697,1308,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(12698,1308,'_s6-list_3_link','field_60ee916b04ace'),(12699,1308,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(12700,1308,'_s6-list_4_link','field_60ee916b04ace'),(12701,1308,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(12702,1308,'_s6-list_5_link','field_60ee916b04ace'),(12703,1308,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(12704,1308,'_slider_0_webplink','field_60fa70c989e88'),(12705,1308,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(12706,1308,'_slider_1_webplink','field_60fa70c989e88'),(12707,1308,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(12708,1308,'_slider_2_webplink','field_60fa70c989e88'),(12709,1308,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(12710,1308,'_slider_3_webplink','field_60fa70c989e88'),(12711,1308,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(12712,1308,'_slider_4_webplink','field_60fa70c989e88'),(12713,1308,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(12714,1308,'_slider_5_webplink','field_60fa70c989e88'),(12715,1308,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(12716,1308,'_slider_6_webplink','field_60fa70c989e88'),(12717,1308,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(12718,1308,'_slider_7_webplink','field_60fa70c989e88'),(12719,1308,'slider_0_slide','50'),(12720,1308,'_slider_0_slide','field_60bf7688f46eb'),(12721,1308,'slider_1_slide','51'),(12722,1308,'_slider_1_slide','field_60bf7688f46eb'),(12723,1308,'slider_2_slide','52'),(12724,1308,'_slider_2_slide','field_60bf7688f46eb'),(12725,1308,'slider_3_slide','53'),(12726,1308,'_slider_3_slide','field_60bf7688f46eb'),(12727,1308,'slider_4_slide','54'),(12728,1308,'_slider_4_slide','field_60bf7688f46eb'),(12729,1308,'slider_5_slide','55'),(12730,1308,'_slider_5_slide','field_60bf7688f46eb'),(12731,1308,'slider_6_slide','56'),(12732,1308,'_slider_6_slide','field_60bf7688f46eb'),(12733,1308,'slider_7_slide','57'),(12734,1308,'_slider_7_slide','field_60bf7688f46eb'),(12735,1310,'s2-list','6'),(12736,1310,'_s2-list','field_60bf76e0f46ee'),(12737,1310,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(12738,1310,'_s2-ttl','field_60bf76d1f46ed'),(12739,1310,'slider','8'),(12740,1310,'_slider','field_60bf767ef46ea'),(12741,1310,'slider_0_slide','145'),(12742,1310,'_slider_0_slide','field_60bf7688f46eb'),(12743,1310,'slider_1_slide','146'),(12744,1310,'_slider_1_slide','field_60bf7688f46eb'),(12745,1310,'slider_2_slide','147'),(12746,1310,'_slider_2_slide','field_60bf7688f46eb'),(12747,1310,'slider_3_slide','148'),(12748,1310,'_slider_3_slide','field_60bf7688f46eb'),(12749,1310,'slider_4_slide','149'),(12750,1310,'_slider_4_slide','field_60bf7688f46eb'),(12751,1310,'slider_5_slide','150'),(12752,1310,'_slider_5_slide','field_60bf7688f46eb'),(12753,1310,'slider_6_slide','151'),(12754,1310,'_slider_6_slide','field_60bf7688f46eb'),(12755,1310,'slider_7_slide','152'),(12756,1310,'_slider_7_slide','field_60bf7688f46eb'),(12757,1310,'s2-list_0_icon','61'),(12758,1310,'_s2-list_0_icon','field_60bf76ecf46ef'),(12759,1310,'s2-list_0_icon-hover','62'),(12760,1310,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(12761,1310,'s2-list_0_text','Лихорадка'),(12762,1310,'_s2-list_0_text','field_60bf7712f46f1'),(12763,1310,'s2-list_1_icon','63'),(12764,1310,'_s2-list_1_icon','field_60bf76ecf46ef'),(12765,1310,'s2-list_1_icon-hover','64'),(12766,1310,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(12767,1310,'s2-list_1_text','Похмельный синдром'),(12768,1310,'_s2-list_1_text','field_60bf7712f46f1'),(12769,1310,'s2-list_2_icon','65'),(12770,1310,'_s2-list_2_icon','field_60bf76ecf46ef'),(12771,1310,'s2-list_2_icon-hover','66'),(12772,1310,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(12773,1310,'s2-list_2_text','Диарея'),(12774,1310,'_s2-list_2_text','field_60bf7712f46f1'),(12775,1310,'s2-list_3_icon','67'),(12776,1310,'_s2-list_3_icon','field_60bf76ecf46ef'),(12777,1310,'s2-list_3_icon-hover','68'),(12778,1310,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(12779,1310,'s2-list_3_text','Рвота'),(12780,1310,'_s2-list_3_text','field_60bf7712f46f1'),(12781,1310,'s2-list_4_icon','69'),(12782,1310,'_s2-list_4_icon','field_60bf76ecf46ef'),(12783,1310,'s2-list_4_icon-hover','70'),(12784,1310,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(12785,1310,'s2-list_4_text','Интенсивные физические нагрузки'),(12786,1310,'_s2-list_4_text','field_60bf7712f46f1'),(12787,1310,'s2-list_5_icon','71'),(12788,1310,'_s2-list_5_icon','field_60bf76ecf46ef'),(12789,1310,'s2-list_5_icon-hover','72'),(12790,1310,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(12791,1310,'s2-list_5_text','Перегрев в жаркую погоду'),(12792,1310,'_s2-list_5_text','field_60bf7712f46f1'),(12793,1310,'s1-slogan','Когда обычной воды недостаточно!'),(12794,1310,'_s1-slogan','field_60bf7ab4d9ba9'),(12795,1310,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(12796,1310,'_s3-text','field_60bf7bb5a7e2b'),(12797,1310,'s4-ttl','РеО – вода для медицинских целей!'),(12798,1310,'_s4-ttl','field_60bf7c831f58c'),(12799,1310,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(12800,1310,'_s4-notes','field_60bf7ca31f58d'),(12801,1310,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(12802,1310,'_s5-video','field_60bf7ccfa01a5'),(12803,1310,'s6-ttl','Когда обычной воды недостаточно!'),(12804,1310,'_s6-ttl','field_60bf7cfb10d31'),(12805,1310,'s6-list','6'),(12806,1310,'_s6-list','field_60bf7d0410d32'),(12807,1310,'s6-list_0_icon','92'),(12808,1310,'_s6-list_0_icon','field_60bf7d1810d33'),(12809,1310,'s6-list_0_text','При повышенной температуре'),(12810,1310,'_s6-list_0_text','field_60bf7d2710d34'),(12811,1310,'s6-list_1_icon','93'),(12812,1310,'_s6-list_1_icon','field_60bf7d1810d33'),(12813,1310,'s6-list_1_text','При пищевых отравлениях'),(12814,1310,'_s6-list_1_text','field_60bf7d2710d34'),(12815,1310,'s6-list_2_icon','94'),(12816,1310,'_s6-list_2_icon','field_60bf7d1810d33'),(12817,1310,'s6-list_2_text','При кишечных инфекциях'),(12818,1310,'_s6-list_2_text','field_60bf7d2710d34'),(12819,1310,'s6-list_3_icon','95'),(12820,1310,'_s6-list_3_icon','field_60bf7d1810d33'),(12821,1310,'s6-list_3_text','Во время беременности'),(12822,1310,'_s6-list_3_text','field_60bf7d2710d34'),(12823,1310,'s6-list_4_icon','96'),(12824,1310,'_s6-list_4_icon','field_60bf7d1810d33'),(12825,1310,'s6-list_4_text','Во время занятий спортом'),(12826,1310,'_s6-list_4_text','field_60bf7d2710d34'),(12827,1310,'s6-list_5_icon','97'),(12828,1310,'_s6-list_5_icon','field_60bf7d1810d33'),(12829,1310,'s6-list_5_text','При похмельном синдроме'),(12830,1310,'_s6-list_5_text','field_60bf7d2710d34'),(12831,1310,'s4-list_0_ttl','Натрий'),(12832,1310,'_s4-list_0_ttl','field_60bf7fa95a92c'),(12833,1310,'s4-list_0_formula','Na<sup>+</sup>'),(12834,1310,'_s4-list_0_formula','field_60bf7fc65a92d'),(12835,1310,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(12836,1310,'_s4-list_0_text','field_60bf7fd35a92e'),(12837,1310,'s4-list_1_ttl','Вода'),(12838,1310,'_s4-list_1_ttl','field_60bf7fa95a92c'),(12839,1310,'s4-list_1_formula','H<sub>2</sub>O'),(12840,1310,'_s4-list_1_formula','field_60bf7fc65a92d'),(12841,1310,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(12842,1310,'_s4-list_1_text','field_60bf7fd35a92e'),(12843,1310,'s4-list','9'),(12844,1310,'_s4-list','field_60bf7f985a92b'),(12845,1310,'s4-list_2_ttl','Калий'),(12846,1310,'_s4-list_2_ttl','field_60bf7fa95a92c'),(12847,1310,'s4-list_2_formula','K<sup>+</sup>'),(12848,1310,'_s4-list_2_formula','field_60bf7fc65a92d'),(12849,1310,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(12850,1310,'_s4-list_2_text','field_60bf7fd35a92e'),(12851,1310,'s4-list_3_ttl','Гидрокарбонаты'),(12852,1310,'_s4-list_3_ttl','field_60bf7fa95a92c'),(12853,1310,'s4-list_3_formula','HCO<sup>3+</sup>'),(12854,1310,'_s4-list_3_formula','field_60bf7fc65a92d'),(12855,1310,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(12856,1310,'_s4-list_3_text','field_60bf7fd35a92e'),(12857,1310,'s4-list_4_ttl','Магний'),(12858,1310,'_s4-list_4_ttl','field_60bf7fa95a92c'),(12859,1310,'s4-list_4_formula','Mg<sup>2+</sup>'),(12860,1310,'_s4-list_4_formula','field_60bf7fc65a92d'),(12861,1310,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(12862,1310,'_s4-list_4_text','field_60bf7fd35a92e'),(12863,1310,'s4-list_5_ttl','Углекислый газ'),(12864,1310,'_s4-list_5_ttl','field_60bf7fa95a92c'),(12865,1310,'s4-list_5_formula','CO<sup>2</sup>+'),(12866,1310,'_s4-list_5_formula','field_60bf7fc65a92d'),(12867,1310,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(12868,1310,'_s4-list_5_text','field_60bf7fd35a92e'),(12869,1310,'s4-list_6_ttl','Кальций'),(12870,1310,'_s4-list_6_ttl','field_60bf7fa95a92c'),(12871,1310,'s4-list_6_formula','Ca<sup>2+</sup>'),(12872,1310,'_s4-list_6_formula','field_60bf7fc65a92d'),(12873,1310,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(12874,1310,'_s4-list_6_text','field_60bf7fd35a92e'),(12875,1310,'s4-list_7_ttl','Сорбит'),(12876,1310,'_s4-list_7_ttl','field_60bf7fa95a92c'),(12877,1310,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(12878,1310,'_s4-list_7_formula','field_60bf7fc65a92d'),(12879,1310,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(12880,1310,'_s4-list_7_text','field_60bf7fd35a92e'),(12881,1310,'s4-list_8_ttl','Хлор'),(12882,1310,'_s4-list_8_ttl','field_60bf7fa95a92c'),(12883,1310,'s4-list_8_formula','Cl'),(12884,1310,'_s4-list_8_formula','field_60bf7fc65a92d'),(12885,1310,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(12886,1310,'_s4-list_8_text','field_60bf7fd35a92e'),(12887,1310,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(12888,1310,'_s4-feature1','field_60bf80ca480ea'),(12889,1310,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(12890,1310,'_s4-feature2','field_60bf80de480eb'),(12891,1310,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(12892,1310,'_s4-feature3','field_60bf80e2480ec'),(12893,1310,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве 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5,1312,'logos_4_link',''),(12976,1312,'_logos_4_link','field_60defad65a9bc'),(12977,1312,'logos','5'),(12978,1312,'_logos','field_60defabb5a9ba'),(12979,1313,'logos_0_logo','765'),(12980,1313,'_logos_0_logo','field_60defacd5a9bb'),(12981,1313,'logos_0_link','https://tabletki.ua/uk/%D0%A0%D0%B5%D0%BE/1007865/'),(12982,1313,'_logos_0_link','field_60defad65a9bc'),(12983,1313,'logos_1_logo','759'),(12984,1313,'_logos_1_logo','field_60defacd5a9bb'),(12985,1313,'logos_1_link','https://liki24.com/uk/p/pishevoj-produkt-dlya-specialnyh-medicinskih-celej-reo-950-ml-yuriya-farm-ooo/'),(12986,1313,'_logos_1_link','field_60defad65a9bc'),(12987,1313,'logos_2_logo','761'),(12988,1313,'_logos_2_logo','field_60defacd5a9bb'),(12989,1313,'logos_2_link',''),(12990,1313,'_logos_2_link','field_60defad65a9bc'),(12991,1313,'logos_3_logo','763'),(12992,1313,'_logos_3_logo','field_60defacd5a9bb'),(12993,1313,'logos_3_link',''),(12994,1313,'_logos_3_link','field_60defad65a9bc'),(12995,1313,'logos_4_logo','767'),(12996,1313,'_logos_4_logo','field_60defacd5a9bb'),(12997,1313,'logos_4_link',''),(12998,1313,'_logos_4_link','field_60defad65a9bc'),(12999,1313,'logos','5'),(13000,1313,'_logos','field_60defabb5a9ba'),(13003,1315,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(13004,1315,'_s2-ttl','field_60bf76d1f46ed'),(13005,1315,'s2-list','6'),(13006,1315,'_s2-list','field_60bf76e0f46ee'),(13007,1315,'s2-list_0_icon','61'),(13008,1315,'_s2-list_0_icon','field_60bf76ecf46ef'),(13009,1315,'s2-list_0_icon-hover','62'),(13010,1315,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(13011,1315,'s2-list_0_text','Лихоманка'),(13012,1315,'_s2-list_0_text','field_60bf7712f46f1'),(13013,1315,'s2-list_1_icon','63'),(13014,1315,'_s2-list_1_icon','field_60bf76ecf46ef'),(13015,1315,'s2-list_1_icon-hover','64'),(13016,1315,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(13017,1315,'s2-list_1_text','Похмільний синдром'),(13018,1315,'_s2-list_1_text','field_60bf7712f46f1'),(13019,1315,'s2-list_2_icon','65'),(13020,1315,'_s2-list_2_icon','field_60bf76ecf46ef'),(13021,1315,'s2-list_2_icon-hover','66'),(13022,1315,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(13023,1315,'s2-list_2_text','Діарея'),(13024,1315,'_s2-list_2_text','field_60bf7712f46f1'),(13025,1315,'s2-list_3_icon','67'),(13026,1315,'_s2-list_3_icon','field_60bf76ecf46ef'),(13027,1315,'s2-list_3_icon-hover','68'),(13028,1315,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(13029,1315,'s2-list_3_text','Блювота'),(13030,1315,'_s2-list_3_text','field_60bf7712f46f1'),(13031,1315,'s2-list_4_icon','69'),(13032,1315,'_s2-list_4_icon','field_60bf76ecf46ef'),(13033,1315,'s2-list_4_icon-hover','70'),(13034,1315,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(13035,1315,'s2-list_4_text','Інтенсивні фізичні навантаження'),(13036,1315,'_s2-list_4_text','field_60bf7712f46f1'),(13037,1315,'s2-list_5_icon','71'),(13038,1315,'_s2-list_5_icon','field_60bf76ecf46ef'),(13039,1315,'s2-list_5_icon-hover','72'),(13040,1315,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(13041,1315,'s2-list_5_text','Перегрівання в спекотну погоду'),(13042,1315,'_s2-list_5_text','field_60bf7712f46f1'),(13043,1315,'s1-slogan','Коли звичайної води замало!'),(13044,1315,'_s1-slogan','field_60bf7ab4d9ba9'),(13045,1315,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(13046,1315,'_s3-text','field_60bf7bb5a7e2b'),(13047,1315,'s4-ttl','РеО – вода для медичних цілей'),(13048,1315,'_s4-ttl','field_60bf7c831f58c'),(13049,1315,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(13050,1315,'_s4-notes','field_60bf7ca31f58d'),(13051,1315,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(13052,1315,'_s5-video','field_60bf7ccfa01a5'),(13053,1315,'s6-ttl','Коли звичайної води замало!'),(13054,1315,'_s6-ttl','field_60bf7cfb10d31'),(13055,1315,'s6-list','6'),(13056,1315,'_s6-list','field_60bf7d0410d32'),(13057,1315,'s6-list_0_icon','92'),(13058,1315,'_s6-list_0_icon','field_60bf7d1810d33'),(13059,1315,'s6-list_0_text','При підвищеній температурі'),(13060,1315,'_s6-list_0_text','field_60bf7d2710d34'),(13061,1315,'s6-list_1_icon','93'),(13062,1315,'_s6-list_1_icon','field_60bf7d1810d33'),(13063,1315,'s6-list_1_text','При харчових отруєннях'),(13064,1315,'_s6-list_1_text','field_60bf7d2710d34'),(13065,1315,'s6-list_2_icon','94'),(13066,1315,'_s6-list_2_icon','field_60bf7d1810d33'),(13067,1315,'s6-list_2_text','При кишкових інфекціях'),(13068,1315,'_s6-list_2_text','field_60bf7d2710d34'),(13069,1315,'s6-list_3_icon','95'),(13070,1315,'_s6-list_3_icon','field_60bf7d1810d33'),(13071,1315,'s6-list_3_text','Під час вагітності'),(13072,1315,'_s6-list_3_text','field_60bf7d2710d34'),(13073,1315,'s6-list_4_icon','96'),(13074,1315,'_s6-list_4_icon','field_60bf7d1810d33'),(13075,1315,'s6-list_4_text','Під час заняття спортом'),(13076,1315,'_s6-list_4_text','field_60bf7d2710d34'),(13077,1315,'s6-list_5_icon','97'),(13078,1315,'_s6-list_5_icon','field_60bf7d1810d33'),(13079,1315,'s6-list_5_text','При похмільному синдромі'),(13080,1315,'_s6-list_5_text','field_60bf7d2710d34'),(13081,1315,'s4-list_0_ttl','Натрій'),(13082,1315,'_s4-list_0_ttl','field_60bf7fa95a92c'),(13083,1315,'s4-list_0_formula','Na<sup>+</sup>'),(13084,1315,'_s4-list_0_formula','field_60bf7fc65a92d'),(13085,1315,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(13086,1315,'_s4-list_0_text','field_60bf7fd35a92e'),(13087,1315,'s4-list_1_ttl','Вода'),(13088,1315,'_s4-list_1_ttl','field_60bf7fa95a92c'),(13089,1315,'s4-list_1_formula','H<sub>2</sub>O'),(13090,1315,'_s4-list_1_formula','field_60bf7fc65a92d'),(13091,1315,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(13092,1315,'_s4-list_1_text','field_60bf7fd35a92e'),(13093,1315,'s4-list','9'),(13094,1315,'_s4-list','field_60bf7f985a92b'),(13095,1315,'s4-list_2_ttl','Калій'),(13096,1315,'_s4-list_2_ttl','field_60bf7fa95a92c'),(13097,1315,'s4-list_2_formula','K<sup>+</sup>'),(13098,1315,'_s4-list_2_formula','field_60bf7fc65a92d'),(13099,1315,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(13100,1315,'_s4-list_2_text','field_60bf7fd35a92e'),(13101,1315,'s4-list_3_ttl','Гідрокарбонати'),(13102,1315,'_s4-list_3_ttl','field_60bf7fa95a92c'),(13103,1315,'s4-list_3_formula','HCO<sup>3+</sup>'),(13104,1315,'_s4-list_3_formula','field_60bf7fc65a92d'),(13105,1315,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(13106,1315,'_s4-list_3_text','field_60bf7fd35a92e'),(13107,1315,'s4-list_4_ttl','Магній'),(13108,1315,'_s4-list_4_ttl','field_60bf7fa95a92c'),(13109,1315,'s4-list_4_formula','Mg<sup>2+</sup>'),(13110,1315,'_s4-list_4_formula','field_60bf7fc65a92d'),(13111,1315,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(13112,1315,'_s4-list_4_text','field_60bf7fd35a92e'),(13113,1315,'s4-list_5_ttl','Вуглекислий газ'),(13114,1315,'_s4-list_5_ttl','field_60bf7fa95a92c'),(13115,1315,'s4-list_5_formula','CO<sup>2</sup>+'),(13116,1315,'_s4-list_5_formula','field_60bf7fc65a92d'),(13117,1315,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(13118,1315,'_s4-list_5_text','field_60bf7fd35a92e'),(13119,1315,'s4-list_6_ttl','Кальцій'),(13120,1315,'_s4-list_6_ttl','field_60bf7fa95a92c'),(13121,1315,'s4-list_6_formula','Ca<sup>2+</sup>'),(13122,1315,'_s4-list_6_formula','field_60bf7fc65a92d'),(13123,1315,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(13124,1315,'_s4-list_6_text','field_60bf7fd35a92e'),(13125,1315,'s4-list_7_ttl','Сорбіт'),(13126,1315,'_s4-list_7_ttl','field_60bf7fa95a92c'),(13127,1315,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(13128,1315,'_s4-list_7_formula','field_60bf7fc65a92d'),(13129,1315,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(13130,1315,'_s4-list_7_text','field_60bf7fd35a92e'),(13131,1315,'s4-list_8_ttl','Хлор'),(13132,1315,'_s4-list_8_ttl','field_60bf7fa95a92c'),(13133,1315,'s4-list_8_formula','Cl'),(13134,1315,'_s4-list_8_formula','field_60bf7fc65a92d'),(13135,1315,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(13136,1315,'_s4-list_8_text','field_60bf7fd35a92e'),(13137,1315,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(13138,1315,'_s4-feature1','field_60bf80ca480ea'),(13139,1315,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(13140,1315,'_s4-feature2','field_60bf80de480eb'),(13141,1315,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(13142,1315,'_s4-feature3','field_60bf80e2480ec'),(13143,1315,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(13144,1315,'_s4-feature4','field_60bf80e5480ed'),(13145,1315,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(13146,1315,'_s2-list_0_link','field_60ee90d381a4e'),(13147,1315,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(13148,1315,'_s2-list_1_link','field_60ee90d381a4e'),(13149,1315,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(13150,1315,'_s2-list_2_link','field_60ee90d381a4e'),(13151,1315,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(13152,1315,'_s2-list_3_link','field_60ee90d381a4e'),(13153,1315,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(13154,1315,'_s2-list_4_link','field_60ee90d381a4e'),(13155,1315,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(13156,1315,'_s2-list_5_link','field_60ee90d381a4e'),(13157,1315,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(13158,1315,'_s6-list_0_link','field_60ee916b04ace'),(13159,1315,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(13160,1315,'_s6-list_1_link','field_60ee916b04ace'),(13161,1315,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(13162,1315,'_s6-list_2_link','field_60ee916b04ace'),(13163,1315,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(13164,1315,'_s6-list_3_link','field_60ee916b04ace'),(13165,1315,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(13166,1315,'_s6-list_4_link','field_60ee916b04ace'),(13167,1315,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(13168,1315,'_s6-list_5_link','field_60ee916b04ace'),(13169,1315,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(13170,1315,'_slider_0_webplink','field_60fa70c989e88'),(13171,1315,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(13172,1315,'_slider_1_webplink','field_60fa70c989e88'),(13173,1315,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(13174,1315,'_slider_2_webplink','field_60fa70c989e88'),(13175,1315,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(13176,1315,'_slider_3_webplink','field_60fa70c989e88'),(13177,1315,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(13178,1315,'_slider_4_webplink','field_60fa70c989e88'),(13179,1315,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(13180,1315,'_slider_5_webplink','field_60fa70c989e88'),(13181,1315,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(13182,1315,'_slider_6_webplink','field_60fa70c989e88'),(13183,1315,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(13184,1315,'_slider_7_webplink','field_60fa70c989e88'),(13185,1315,'slider_0_slide','50'),(13186,1315,'_slider_0_slide','field_60bf7688f46eb'),(13187,1315,'slider_1_slide','51'),(13188,1315,'_slider_1_slide','field_60bf7688f46eb'),(13189,1315,'slider_2_slide','52'),(13190,1315,'_slider_2_slide','field_60bf7688f46eb'),(13191,1315,'slider_3_slide','53'),(13192,1315,'_slider_3_slide','field_60bf7688f46eb'),(13193,1315,'slider_4_slide','54'),(13194,1315,'_slider_4_slide','field_60bf7688f46eb'),(13195,1315,'slider_5_slide','55'),(13196,1315,'_slider_5_slide','field_60bf7688f46eb'),(13197,1315,'slider_6_slide','56'),(13198,1315,'_slider_6_slide','field_60bf7688f46eb'),(13199,1315,'slider_7_slide','57'),(13200,1315,'_slider_7_slide','field_60bf7688f46eb'),(13201,1316,'s2-list','6'),(13202,1316,'_s2-list','field_60bf76e0f46ee'),(13203,1316,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(13204,1316,'_s2-ttl','field_60bf76d1f46ed'),(13205,1316,'slider','8'),(13206,1316,'_slider','field_60bf767ef46ea'),(13207,1316,'slider_0_slide','332'),(13208,1316,'_slider_0_slide','field_60bf7688f46eb'),(13209,1316,'slider_1_slide','334'),(13210,1316,'_slider_1_slide','field_60bf7688f46eb'),(13211,1316,'slider_2_slide','336'),(13212,1316,'_slider_2_slide','field_60bf7688f46eb'),(13213,1316,'slider_3_slide','338'),(13214,1316,'_slider_3_slide','field_60bf7688f46eb'),(13215,1316,'slider_4_slide','340'),(13216,1316,'_slider_4_slide','field_60bf7688f46eb'),(13217,1316,'slider_5_slide','342'),(13218,1316,'_slider_5_slide','field_60bf7688f46eb'),(13219,1316,'slider_6_slide','344'),(13220,1316,'_slider_6_slide','field_60bf7688f46eb'),(13221,1316,'slider_7_slide','346'),(13222,1316,'_slider_7_slide','field_60bf7688f46eb'),(13223,1316,'s2-list_0_icon','61'),(13224,1316,'_s2-list_0_icon','field_60bf76ecf46ef'),(13225,1316,'s2-list_0_icon-hover','62'),(13226,1316,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(13227,1316,'s2-list_0_text','Лихорадка'),(13228,1316,'_s2-list_0_text','field_60bf7712f46f1'),(13229,1316,'s2-list_1_icon','63'),(13230,1316,'_s2-list_1_icon','field_60bf76ecf46ef'),(13231,1316,'s2-list_1_icon-hover','64'),(13232,1316,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(13233,1316,'s2-list_1_text','Похмельный синдром'),(13234,1316,'_s2-list_1_text','field_60bf7712f46f1'),(13235,1316,'s2-list_2_icon','65'),(13236,1316,'_s2-list_2_icon','field_60bf76ecf46ef'),(13237,1316,'s2-list_2_icon-hover','66'),(13238,1316,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(13239,1316,'s2-list_2_text','Диарея'),(13240,1316,'_s2-list_2_text','field_60bf7712f46f1'),(13241,1316,'s2-list_3_icon','67'),(13242,1316,'_s2-list_3_icon','field_60bf76ecf46ef'),(13243,1316,'s2-list_3_icon-hover','68'),(13244,1316,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(13245,1316,'s2-list_3_text','Рвота'),(13246,1316,'_s2-list_3_text','field_60bf7712f46f1'),(13247,1316,'s2-list_4_icon','69'),(13248,1316,'_s2-list_4_icon','field_60bf76ecf46ef'),(13249,1316,'s2-list_4_icon-hover','70'),(13250,1316,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(13251,1316,'s2-list_4_text','Интенсивные физические нагрузки'),(13252,1316,'_s2-list_4_text','field_60bf7712f46f1'),(13253,1316,'s2-list_5_icon','71'),(13254,1316,'_s2-list_5_icon','field_60bf76ecf46ef'),(13255,1316,'s2-list_5_icon-hover','72'),(13256,1316,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(13257,1316,'s2-list_5_text','Перегрев в жаркую погоду'),(13258,1316,'_s2-list_5_text','field_60bf7712f46f1'),(13259,1316,'s1-slogan','Когда обычной воды недостаточно!'),(13260,1316,'_s1-slogan','field_60bf7ab4d9ba9'),(13261,1316,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(13262,1316,'_s3-text','field_60bf7bb5a7e2b'),(13263,1316,'s4-ttl','РеО – вода для медицинских целей!'),(13264,1316,'_s4-ttl','field_60bf7c831f58c'),(13265,1316,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(13266,1316,'_s4-notes','field_60bf7ca31f58d'),(13267,1316,'s5-video','<iframe width=\"760\" height=\"428\" src=\"https://www.youtube.com/embed/ohrVkaOn9Z0\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(13268,1316,'_s5-video','field_60bf7ccfa01a5'),(13269,1316,'s6-ttl','Когда обычной воды недостаточно!'),(13270,1316,'_s6-ttl','field_60bf7cfb10d31'),(13271,1316,'s6-list','6'),(13272,1316,'_s6-list','field_60bf7d0410d32'),(13273,1316,'s6-list_0_icon','92'),(13274,1316,'_s6-list_0_icon','field_60bf7d1810d33'),(13275,1316,'s6-list_0_text','При повышенной температуре'),(13276,1316,'_s6-list_0_text','field_60bf7d2710d34'),(13277,1316,'s6-list_1_icon','93'),(13278,1316,'_s6-list_1_icon','field_60bf7d1810d33'),(13279,1316,'s6-list_1_text','При пищевых отравлениях'),(13280,1316,'_s6-list_1_text','field_60bf7d2710d34'),(13281,1316,'s6-list_2_icon','94'),(13282,1316,'_s6-list_2_icon','field_60bf7d1810d33'),(13283,1316,'s6-list_2_text','При кишечных инфекциях'),(13284,1316,'_s6-list_2_text','field_60bf7d2710d34'),(13285,1316,'s6-list_3_icon','95'),(13286,1316,'_s6-list_3_icon','field_60bf7d1810d33'),(13287,1316,'s6-list_3_text','Во время беременности'),(13288,1316,'_s6-list_3_text','field_60bf7d2710d34'),(13289,1316,'s6-list_4_icon','96'),(13290,1316,'_s6-list_4_icon','field_60bf7d1810d33'),(13291,1316,'s6-list_4_text','Во время занятий спортом'),(13292,1316,'_s6-list_4_text','field_60bf7d2710d34'),(13293,1316,'s6-list_5_icon','97'),(13294,1316,'_s6-list_5_icon','field_60bf7d1810d33'),(13295,1316,'s6-list_5_text','При похмельном синдроме'),(13296,1316,'_s6-list_5_text','field_60bf7d2710d34'),(13297,1316,'s4-list_0_ttl','Натрий'),(13298,1316,'_s4-list_0_ttl','field_60bf7fa95a92c'),(13299,1316,'s4-list_0_formula','Na<sup>+</sup>'),(13300,1316,'_s4-list_0_formula','field_60bf7fc65a92d'),(13301,1316,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(13302,1316,'_s4-list_0_text','field_60bf7fd35a92e'),(13303,1316,'s4-list_1_ttl','Вода'),(13304,1316,'_s4-list_1_ttl','field_60bf7fa95a92c'),(13305,1316,'s4-list_1_formula','H<sub>2</sub>O'),(13306,1316,'_s4-list_1_formula','field_60bf7fc65a92d'),(13307,1316,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(13308,1316,'_s4-list_1_text','field_60bf7fd35a92e'),(13309,1316,'s4-list','9'),(13310,1316,'_s4-list','field_60bf7f985a92b'),(13311,1316,'s4-list_2_ttl','Калий'),(13312,1316,'_s4-list_2_ttl','field_60bf7fa95a92c'),(13313,1316,'s4-list_2_formula','K<sup>+</sup>'),(13314,1316,'_s4-list_2_formula','field_60bf7fc65a92d'),(13315,1316,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(13316,1316,'_s4-list_2_text','field_60bf7fd35a92e'),(13317,1316,'s4-list_3_ttl','Гидрокарбонаты'),(13318,1316,'_s4-list_3_ttl','field_60bf7fa95a92c'),(13319,1316,'s4-list_3_formula','HCO<sup>3+</sup>'),(13320,1316,'_s4-list_3_formula','field_60bf7fc65a92d'),(13321,1316,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(13322,1316,'_s4-list_3_text','field_60bf7fd35a92e'),(13323,1316,'s4-list_4_ttl','Магний'),(13324,1316,'_s4-list_4_ttl','field_60bf7fa95a92c'),(13325,1316,'s4-list_4_formula','Mg<sup>2+</sup>'),(13326,1316,'_s4-list_4_formula','field_60bf7fc65a92d'),(13327,1316,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(13328,1316,'_s4-list_4_text','field_60bf7fd35a92e'),(13329,1316,'s4-list_5_ttl','Углекислый газ'),(13330,1316,'_s4-list_5_ttl','field_60bf7fa95a92c'),(13331,1316,'s4-list_5_formula','CO<sup>2</sup>+'),(13332,1316,'_s4-list_5_formula','field_60bf7fc65a92d'),(13333,1316,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(13334,1316,'_s4-list_5_text','field_60bf7fd35a92e'),(13335,1316,'s4-list_6_ttl','Кальций'),(13336,1316,'_s4-list_6_ttl','field_60bf7fa95a92c'),(13337,1316,'s4-list_6_formula','Ca<sup>2+</sup>'),(13338,1316,'_s4-list_6_formula','field_60bf7fc65a92d'),(13339,1316,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(13340,1316,'_s4-list_6_text','field_60bf7fd35a92e'),(13341,1316,'s4-list_7_ttl','Сорбит'),(13342,1316,'_s4-list_7_ttl','field_60bf7fa95a92c'),(13343,1316,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(13344,1316,'_s4-list_7_formula','field_60bf7fc65a92d'),(13345,1316,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(13346,1316,'_s4-list_7_text','field_60bf7fd35a92e'),(13347,1316,'s4-list_8_ttl','Хлор'),(13348,1316,'_s4-list_8_ttl','field_60bf7fa95a92c'),(13349,1316,'s4-list_8_formula','Cl'),(13350,1316,'_s4-list_8_formula','field_60bf7fc65a92d'),(13351,1316,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(13352,1316,'_s4-list_8_text','field_60bf7fd35a92e'),(13353,1316,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(13354,1316,'_s4-feature1','field_60bf80ca480ea'),(13355,1316,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(13356,1316,'_s4-feature2','field_60bf80de480eb'),(13357,1316,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(13358,1316,'_s4-feature3','field_60bf80e2480ec'),(13359,1316,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(13360,1316,'_s4-feature4','field_60bf80e5480ed'),(13361,1316,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(13362,1316,'_s2-list_0_link','field_60ee90d381a4e'),(13363,1316,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(13364,1316,'_s2-list_1_link','field_60ee90d381a4e'),(13365,1316,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(13366,1316,'_s2-list_2_link','field_60ee90d381a4e'),(13367,1316,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(13368,1316,'_s2-list_3_link','field_60ee90d381a4e'),(13369,1316,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(13370,1316,'_s2-list_4_link','field_60ee90d381a4e'),(13371,1316,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(13372,1316,'_s2-list_5_link','field_60ee90d381a4e'),(13373,1316,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(13374,1316,'_s6-list_0_link','field_60ee916b04ace'),(13375,1316,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(13376,1316,'_s6-list_1_link','field_60ee916b04ace'),(13377,1316,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(13378,1316,'_s6-list_2_link','field_60ee916b04ace'),(13379,1316,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(13380,1316,'_s6-list_3_link','field_60ee916b04ace'),(13381,1316,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(13382,1316,'_s6-list_4_link','field_60ee916b04ace'),(13383,1316,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(13384,1316,'_s6-list_5_link','field_60ee916b04ace'),(13385,1316,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(13386,1316,'_slider_0_webplink','field_60fa70c989e88'),(13387,1316,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(13388,1316,'_slider_1_webplink','field_60fa70c989e88'),(13389,1316,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(13390,1316,'_slider_2_webplink','field_60fa70c989e88'),(13391,1316,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(13392,1316,'_slider_3_webplink','field_60fa70c989e88'),(13393,1316,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(13394,1316,'_slider_4_webplink','field_60fa70c989e88'),(13395,1316,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(13396,1316,'_slider_5_webplink','field_60fa70c989e88'),(13397,1316,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(13398,1316,'_slider_6_webplink','field_60fa70c989e88'),(13399,1316,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(13400,1316,'_slider_7_webplink','field_60fa70c989e88'),(13401,1317,'_encloseme','1'),(13405,1317,'_wpml_media_duplicate','1'),(13404,1317,'_wpml_media_featured','1'),(13406,1317,'_yoast_wpseo_content_score','60'),(13407,1317,'_yoast_wpseo_estimated-reading-time-minutes','9'),(13408,1317,'dwn-pdf','1265'),(13409,1317,'_dwn-pdf','field_60d5912c4d881'),(13410,1317,'_yoast_wpseo_primary_category','27'),(13413,1317,'_oembed_56f77eca430976f87b255bf48d1a46e4','{{unknown}}'),(13412,1317,'_edit_lock','1630329246:1'),(13414,1317,'_edit_last','1'),(13415,1317,'_wp_old_slug','reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi'),(13416,1319,'dwn-pdf','1265'),(13417,1319,'_dwn-pdf','field_60d5912c4d881'),(13420,1320,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(13421,1320,'_s2-ttl','field_60bf76d1f46ed'),(13422,1320,'slider','8'),(13423,1320,'_slider','field_60bf767ef46ea'),(13424,1320,'slider_0_slide','332'),(13425,1320,'_slider_0_slide','field_60bf7688f46eb'),(13426,1320,'slider_1_slide','334'),(13427,1320,'_slider_1_slide','field_60bf7688f46eb'),(13428,1320,'slider_2_slide','336'),(13429,1320,'_slider_2_slide','field_60bf7688f46eb'),(13430,1320,'slider_3_slide','338'),(13431,1320,'_slider_3_slide','field_60bf7688f46eb'),(13432,1320,'slider_4_slide','340'),(13433,1320,'_slider_4_slide','field_60bf7688f46eb'),(13434,1320,'slider_5_slide','342'),(13435,1320,'_slider_5_slide','field_60bf7688f46eb'),(13436,1320,'slider_6_slide','344'),(13437,1320,'_slider_6_slide','field_60bf7688f46eb'),(13438,1320,'slider_7_slide','346'),(13439,1320,'_slider_7_slide','field_60bf7688f46eb'),(13440,1320,'s2-list_0_icon','61'),(13441,1320,'_s2-list_0_icon','field_60bf76ecf46ef'),(13442,1320,'s2-list_0_icon-hover','62'),(13443,1320,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(13444,1320,'s2-list_0_text','Лихорадка'),(13445,1320,'_s2-list_0_text','field_60bf7712f46f1'),(13446,1320,'s2-list_1_icon','63'),(13447,1320,'_s2-list_1_icon','field_60bf76ecf46ef'),(13448,1320,'s2-list_1_icon-hover','64'),(13449,1320,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(13450,1320,'s2-list_1_text','Похмельный синдром'),(13451,1320,'_s2-list_1_text','field_60bf7712f46f1'),(13452,1320,'s2-list_2_icon','65'),(13453,1320,'_s2-list_2_icon','field_60bf76ecf46ef'),(13454,1320,'s2-list_2_icon-hover','66'),(13455,1320,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(13456,1320,'s2-list_2_text','Диарея'),(13457,1320,'_s2-list_2_text','field_60bf7712f46f1'),(13458,1320,'s2-list_3_icon','67'),(13459,1320,'_s2-list_3_icon','field_60bf76ecf46ef'),(13460,1320,'s2-list_3_icon-hover','68'),(13461,1320,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(13462,1320,'s2-list_3_text','Рвота'),(13463,1320,'_s2-list_3_text','field_60bf7712f46f1'),(13464,1320,'s2-list_4_icon','69'),(13465,1320,'_s2-list_4_icon','field_60bf76ecf46ef'),(13466,1320,'s2-list_4_icon-hover','70'),(13467,1320,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(13468,1320,'s2-list_4_text','Интенсивные физические нагрузки'),(13469,1320,'_s2-list_4_text','field_60bf7712f46f1'),(13470,1320,'s2-list_5_icon','71'),(13471,1320,'_s2-list_5_icon','field_60bf76ecf46ef'),(13472,1320,'s2-list_5_icon-hover','72'),(13473,1320,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(13474,1320,'s2-list_5_text','Перегрев в жаркую погоду'),(13475,1320,'_s2-list_5_text','field_60bf7712f46f1'),(13476,1320,'s1-slogan','Когда обычной воды недостаточно!'),(13477,1320,'_s1-slogan','field_60bf7ab4d9ba9'),(13478,1320,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(13479,1320,'_s3-text','field_60bf7bb5a7e2b'),(13480,1320,'s4-ttl','РеО – вода для медицинских целей!'),(13481,1320,'_s4-ttl','field_60bf7c831f58c'),(13482,1320,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(13483,1320,'_s4-notes','field_60bf7ca31f58d'),(13484,1320,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(13485,1320,'_s5-video','field_60bf7ccfa01a5'),(13486,1320,'s6-ttl','Когда обычной воды недостаточно!'),(13487,1320,'_s6-ttl','field_60bf7cfb10d31'),(13488,1320,'s6-list','6'),(13489,1320,'_s6-list','field_60bf7d0410d32'),(13490,1320,'s6-list_0_icon','92'),(13491,1320,'_s6-list_0_icon','field_60bf7d1810d33'),(13492,1320,'s6-list_0_text','При повышенной температуре'),(13493,1320,'_s6-list_0_text','field_60bf7d2710d34'),(13494,1320,'s6-list_1_icon','93'),(13495,1320,'_s6-list_1_icon','field_60bf7d1810d33'),(13496,1320,'s6-list_1_text','При пищевых отравлениях'),(13497,1320,'_s6-list_1_text','field_60bf7d2710d34'),(13498,1320,'s6-list_2_icon','94'),(13499,1320,'_s6-list_2_icon','field_60bf7d1810d33'),(13500,1320,'s6-list_2_text','При кишечных инфекциях'),(13501,1320,'_s6-list_2_text','field_60bf7d2710d34'),(13502,1320,'s6-list_3_icon','95'),(13503,1320,'_s6-list_3_icon','field_60bf7d1810d33'),(13504,1320,'s6-list_3_text','Во время беременности'),(13505,1320,'_s6-list_3_text','field_60bf7d2710d34'),(13506,1320,'s6-list_4_icon','96'),(13507,1320,'_s6-list_4_icon','field_60bf7d1810d33'),(13508,1320,'s6-list_4_text','Во время занятий спортом'),(13509,1320,'_s6-list_4_text','field_60bf7d2710d34'),(13510,1320,'s6-list_5_icon','97'),(13511,1320,'_s6-list_5_icon','field_60bf7d1810d33'),(13512,1320,'s6-list_5_text','При похмельном синдроме'),(13513,1320,'_s6-list_5_text','field_60bf7d2710d34'),(13514,1320,'s4-list_0_ttl','Натрий'),(13515,1320,'_s4-list_0_ttl','field_60bf7fa95a92c'),(13516,1320,'s4-list_0_formula','Na<sup>+</sup>'),(13517,1320,'_s4-list_0_formula','field_60bf7fc65a92d'),(13518,1320,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(13519,1320,'_s4-list_0_text','field_60bf7fd35a92e'),(13520,1320,'s4-list_1_ttl','Вода'),(13521,1320,'_s4-list_1_ttl','field_60bf7fa95a92c'),(13522,1320,'s4-list_1_formula','H<sub>2</sub>O'),(13523,1320,'_s4-list_1_formula','field_60bf7fc65a92d'),(13524,1320,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(13525,1320,'_s4-list_1_text','field_60bf7fd35a92e'),(13526,1320,'s4-list','9'),(13527,1320,'_s4-list','field_60bf7f985a92b'),(13528,1320,'s4-list_2_ttl','Калий'),(13529,1320,'_s4-list_2_ttl','field_60bf7fa95a92c'),(13530,1320,'s4-list_2_formula','K<sup>+</sup>'),(13531,1320,'_s4-list_2_formula','field_60bf7fc65a92d'),(13532,1320,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(13533,1320,'_s4-list_2_text','field_60bf7fd35a92e'),(13534,1320,'s4-list_3_ttl','Гидрокарбонаты'),(13535,1320,'_s4-list_3_ttl','field_60bf7fa95a92c'),(13536,1320,'s4-list_3_formula','HCO<sup>3+</sup>'),(13537,1320,'_s4-list_3_formula','field_60bf7fc65a92d'),(13538,1320,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(13539,1320,'_s4-list_3_text','field_60bf7fd35a92e'),(13540,1320,'s4-list_4_ttl','Магний'),(13541,1320,'_s4-list_4_ttl','field_60bf7fa95a92c'),(13542,1320,'s4-list_4_formula','Mg<sup>2+</sup>'),(13543,1320,'_s4-list_4_formula','field_60bf7fc65a92d'),(13544,1320,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(13545,1320,'_s4-list_4_text','field_60bf7fd35a92e'),(13546,1320,'s4-list_5_ttl','Углекислый газ'),(13547,1320,'_s4-list_5_ttl','field_60bf7fa95a92c'),(13548,1320,'s4-list_5_formula','CO<sup>2</sup>+'),(13549,1320,'_s4-list_5_formula','field_60bf7fc65a92d'),(13550,1320,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(13551,1320,'_s4-list_5_text','field_60bf7fd35a92e'),(13552,1320,'s4-list_6_ttl','Кальций'),(13553,1320,'_s4-list_6_ttl','field_60bf7fa95a92c'),(13554,1320,'s4-list_6_formula','Ca<sup>2+</sup>'),(13555,1320,'_s4-list_6_formula','field_60bf7fc65a92d'),(13556,1320,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(13557,1320,'_s4-list_6_text','field_60bf7fd35a92e'),(13558,1320,'s4-list_7_ttl','Сорбит'),(13559,1320,'_s4-list_7_ttl','field_60bf7fa95a92c'),(13560,1320,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(13561,1320,'_s4-list_7_formula','field_60bf7fc65a92d'),(13562,1320,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(13563,1320,'_s4-list_7_text','field_60bf7fd35a92e'),(13564,1320,'s4-list_8_ttl','Хлор'),(13565,1320,'_s4-list_8_ttl','field_60bf7fa95a92c'),(13566,1320,'s4-list_8_formula','Cl'),(13567,1320,'_s4-list_8_formula','field_60bf7fc65a92d'),(13568,1320,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. 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Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(13799,1331,'_s4-notes','field_60bf7ca31f58d'),(13800,1331,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(13801,1331,'_s5-video','field_60bf7ccfa01a5'),(13802,1331,'s6-ttl','Оддий сув етарли бўлмаганда!'),(13803,1331,'_s6-ttl','field_60bf7cfb10d31'),(13804,1331,'s6-list','6'),(13805,1331,'_s6-list','field_60bf7d0410d32'),(13806,1331,'s6-list_0_icon','92'),(13807,1331,'_s6-list_0_icon','field_60bf7d1810d33'),(13808,1331,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(13809,1331,'_s6-list_0_text','field_60bf7d2710d34'),(13810,1331,'s6-list_1_icon','93'),(13811,1331,'_s6-list_1_icon','field_60bf7d1810d33'),(13812,1331,'s6-list_1_text','Овқатдан заҳарланишларда'),(13813,1331,'_s6-list_1_text','field_60bf7d2710d34'),(13814,1331,'s6-list_2_icon','94'),(13815,1331,'_s6-list_2_icon','field_60bf7d1810d33'),(13816,1331,'s6-list_2_text','Ичак инфекцияларида'),(13817,1331,'_s6-list_2_text','field_60bf7d2710d34'),(13818,1331,'s6-list_3_icon','95'),(13819,1331,'_s6-list_3_icon','field_60bf7d1810d33'),(13820,1331,'s6-list_3_text','Ҳомиладорлик вақтида'),(13821,1331,'_s6-list_3_text','field_60bf7d2710d34'),(13822,1331,'s6-list_4_icon','96'),(13823,1331,'_s6-list_4_icon','field_60bf7d1810d33'),(13824,1331,'s6-list_4_text','Спорт билан шуғулланганда '),(13825,1331,'_s6-list_4_text','field_60bf7d2710d34'),(13826,1331,'s6-list_5_icon','97'),(13827,1331,'_s6-list_5_icon','field_60bf7d1810d33'),(13828,1331,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(13829,1331,'_s6-list_5_text','field_60bf7d2710d34'),(13830,1331,'s4-list_0_ttl','Натрий'),(13831,1331,'_s4-list_0_ttl','field_60bf7fa95a92c'),(13832,1331,'s4-list_0_formula','Na<sup>+</sup>'),(13833,1331,'_s4-list_0_formula','field_60bf7fc65a92d'),(13834,1331,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(13835,1331,'_s4-list_0_text','field_60bf7fd35a92e'),(13836,1331,'s4-list_1_ttl','Сув'),(13837,1331,'_s4-list_1_ttl','field_60bf7fa95a92c'),(13838,1331,'s4-list_1_formula','H<sub>2</sub>O'),(13839,1331,'_s4-list_1_formula','field_60bf7fc65a92d'),(13840,1331,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(13841,1331,'_s4-list_1_text','field_60bf7fd35a92e'),(13842,1331,'s4-list','9'),(13843,1331,'_s4-list','field_60bf7f985a92b'),(13844,1331,'s4-list_2_ttl','Калий'),(13845,1331,'_s4-list_2_ttl','field_60bf7fa95a92c'),(13846,1331,'s4-list_2_formula','K<sup>+</sup>'),(13847,1331,'_s4-list_2_formula','field_60bf7fc65a92d'),(13848,1331,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(13849,1331,'_s4-list_2_text','field_60bf7fd35a92e'),(13850,1331,'s4-list_3_ttl','Гидрокарбонатлар '),(13851,1331,'_s4-list_3_ttl','field_60bf7fa95a92c'),(13852,1331,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(13853,1331,'_s4-list_3_formula','field_60bf7fc65a92d'),(13854,1331,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(13855,1331,'_s4-list_3_text','field_60bf7fd35a92e'),(13856,1331,'s4-list_4_ttl','Магний'),(13857,1331,'_s4-list_4_ttl','field_60bf7fa95a92c'),(13858,1331,'s4-list_4_formula','Mg<sup>2+</sup>'),(13859,1331,'_s4-list_4_formula','field_60bf7fc65a92d'),(13860,1331,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(13861,1331,'_s4-list_4_text','field_60bf7fd35a92e'),(13862,1331,'s4-list_5_ttl','Углекислый газ'),(13863,1331,'_s4-list_5_ttl','field_60bf7fa95a92c'),(13864,1331,'s4-list_5_formula','CO<sup>2+</sup>'),(13865,1331,'_s4-list_5_formula','field_60bf7fc65a92d'),(13866,1331,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(13867,1331,'_s4-list_5_text','field_60bf7fd35a92e'),(13868,1331,'s4-list_6_ttl','Кальций'),(13869,1331,'_s4-list_6_ttl','field_60bf7fa95a92c'),(13870,1331,'s4-list_6_formula','Ca<sup>2+</sup>'),(13871,1331,'_s4-list_6_formula','field_60bf7fc65a92d'),(13872,1331,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(13873,1331,'_s4-list_6_text','field_60bf7fd35a92e'),(13874,1331,'s4-list_7_ttl','Сорбитол'),(13875,1331,'_s4-list_7_ttl','field_60bf7fa95a92c'),(13876,1331,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(13877,1331,'_s4-list_7_formula','field_60bf7fc65a92d'),(13878,1331,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(13879,1331,'_s4-list_7_text','field_60bf7fd35a92e'),(13880,1331,'s4-list_8_ttl','Хлор'),(13881,1331,'_s4-list_8_ttl','field_60bf7fa95a92c'),(13882,1331,'s4-list_8_formula','Cl<sup>-</sup>'),(13883,1331,'_s4-list_8_formula','field_60bf7fc65a92d'),(13884,1331,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(16351,1556,'s2-list','6'),(16352,1556,'_s2-list','field_60bf76e0f46ee'),(13885,1331,'_s4-list_8_text','field_60bf7fd35a92e'),(13886,1331,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(13887,1331,'_s4-feature1','field_60bf80ca480ea'),(13888,1331,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(13889,1331,'_s4-feature2','field_60bf80de480eb'),(13890,1331,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(13891,1331,'_s4-feature3','field_60bf80e2480ec'),(13892,1331,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон 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юкламалар'),(13993,1335,'_s2-list_4_text','field_60bf7712f46f1'),(13994,1335,'s2-list_5_icon','71'),(13995,1335,'_s2-list_5_icon','field_60bf76ecf46ef'),(13996,1335,'s2-list_5_icon-hover','72'),(13997,1335,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(13998,1335,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(13999,1335,'_s2-list_5_text','field_60bf7712f46f1'),(14000,1335,'s1-slogan','Оддий сув етарли бўлмаганда!'),(14001,1335,'_s1-slogan','field_60bf7ab4d9ba9'),(14002,1335,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди. Регидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(14003,1335,'_s3-text','field_60bf7bb5a7e2b'),(14004,1335,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(14005,1335,'_s4-ttl','field_60bf7c831f58c'),(14006,1335,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(14007,1335,'_s4-notes','field_60bf7ca31f58d'),(14008,1335,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(14009,1335,'_s5-video','field_60bf7ccfa01a5'),(14010,1335,'s6-ttl','Оддий сув етарли бўлмаганда!'),(14011,1335,'_s6-ttl','field_60bf7cfb10d31'),(14012,1335,'s6-list','6'),(14013,1335,'_s6-list','field_60bf7d0410d32'),(14014,1335,'s6-list_0_icon','92'),(14015,1335,'_s6-list_0_icon','field_60bf7d1810d33'),(14016,1335,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(14017,1335,'_s6-list_0_text','field_60bf7d2710d34'),(14018,1335,'s6-list_1_icon','93'),(14019,1335,'_s6-list_1_icon','field_60bf7d1810d33'),(14020,1335,'s6-list_1_text','При пищевых отравлениях'),(14021,1335,'_s6-list_1_text','field_60bf7d2710d34'),(14022,1335,'s6-list_2_icon','94'),(14023,1335,'_s6-list_2_icon','field_60bf7d1810d33'),(14024,1335,'s6-list_2_text','При кишечных инфекциях'),(14025,1335,'_s6-list_2_text','field_60bf7d2710d34'),(14026,1335,'s6-list_3_icon','95'),(14027,1335,'_s6-list_3_icon','field_60bf7d1810d33'),(14028,1335,'s6-list_3_text','Во время беременности'),(14029,1335,'_s6-list_3_text','field_60bf7d2710d34'),(14030,1335,'s6-list_4_icon','96'),(14031,1335,'_s6-list_4_icon','field_60bf7d1810d33'),(14032,1335,'s6-list_4_text','Во время занятий спортом'),(14033,1335,'_s6-list_4_text','field_60bf7d2710d34'),(14034,1335,'s6-list_5_icon','97'),(14035,1335,'_s6-list_5_icon','field_60bf7d1810d33'),(14036,1335,'s6-list_5_text','При похмельном синдроме'),(14037,1335,'_s6-list_5_text','field_60bf7d2710d34'),(14038,1335,'s4-list_0_ttl','Натрий'),(14039,1335,'_s4-list_0_ttl','field_60bf7fa95a92c'),(14040,1335,'s4-list_0_formula','Na<sup>+</sup>'),(14041,1335,'_s4-list_0_formula','field_60bf7fc65a92d'),(14042,1335,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(14043,1335,'_s4-list_0_text','field_60bf7fd35a92e'),(14044,1335,'s4-list_1_ttl','Вода'),(14045,1335,'_s4-list_1_ttl','field_60bf7fa95a92c'),(14046,1335,'s4-list_1_formula','H<sub>2</sub>O'),(14047,1335,'_s4-list_1_formula','field_60bf7fc65a92d'),(14048,1335,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(14049,1335,'_s4-list_1_text','field_60bf7fd35a92e'),(14050,1335,'s4-list','9'),(14051,1335,'_s4-list','field_60bf7f985a92b'),(14052,1335,'s4-list_2_ttl','Калий'),(14053,1335,'_s4-list_2_ttl','field_60bf7fa95a92c'),(14054,1335,'s4-list_2_formula','K<sup>+</sup>'),(14055,1335,'_s4-list_2_formula','field_60bf7fc65a92d'),(14056,1335,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. 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Регидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(14326,1377,'_s3-text','field_60bf7bb5a7e2b'),(14327,1377,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(14328,1377,'_s4-ttl','field_60bf7c831f58c'),(14329,1377,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(14330,1377,'_s4-notes','field_60bf7ca31f58d'),(14331,1377,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(14332,1377,'_s5-video','field_60bf7ccfa01a5'),(14333,1377,'s6-ttl','Оддий сув етарли бўлмаганда!'),(14334,1377,'_s6-ttl','field_60bf7cfb10d31'),(14335,1377,'s6-list','6'),(14336,1377,'_s6-list','field_60bf7d0410d32'),(14337,1377,'s6-list_0_icon','92'),(14338,1377,'_s6-list_0_icon','field_60bf7d1810d33'),(14339,1377,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(14340,1377,'_s6-list_0_text','field_60bf7d2710d34'),(14341,1377,'s6-list_1_icon','93'),(14342,1377,'_s6-list_1_icon','field_60bf7d1810d33'),(14343,1377,'s6-list_1_text','Овқатдан заҳарланишларда'),(14344,1377,'_s6-list_1_text','field_60bf7d2710d34'),(14345,1377,'s6-list_2_icon','94'),(14346,1377,'_s6-list_2_icon','field_60bf7d1810d33'),(14347,1377,'s6-list_2_text','Ичак инфекцияларида'),(14348,1377,'_s6-list_2_text','field_60bf7d2710d34'),(14349,1377,'s6-list_3_icon','95'),(14350,1377,'_s6-list_3_icon','field_60bf7d1810d33'),(14351,1377,'s6-list_3_text','Ҳомиладорлик вақтида'),(14352,1377,'_s6-list_3_text','field_60bf7d2710d34'),(14353,1377,'s6-list_4_icon','96'),(14354,1377,'_s6-list_4_icon','field_60bf7d1810d33'),(14355,1377,'s6-list_4_text','Спорт билан шуғулланганда '),(14356,1377,'_s6-list_4_text','field_60bf7d2710d34'),(14357,1377,'s6-list_5_icon','97'),(14358,1377,'_s6-list_5_icon','field_60bf7d1810d33'),(14359,1377,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(14360,1377,'_s6-list_5_text','field_60bf7d2710d34'),(14361,1377,'s4-list_0_ttl','Натрий'),(14362,1377,'_s4-list_0_ttl','field_60bf7fa95a92c'),(14363,1377,'s4-list_0_formula','Na<sup>+</sup>'),(14364,1377,'_s4-list_0_formula','field_60bf7fc65a92d'),(14365,1377,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(14366,1377,'_s4-list_0_text','field_60bf7fd35a92e'),(14367,1377,'s4-list_1_ttl','Вода'),(14368,1377,'_s4-list_1_ttl','field_60bf7fa95a92c'),(14369,1377,'s4-list_1_formula','H<sub>2</sub>O'),(14370,1377,'_s4-list_1_formula','field_60bf7fc65a92d'),(14371,1377,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(14372,1377,'_s4-list_1_text','field_60bf7fd35a92e'),(14373,1377,'s4-list','9'),(14374,1377,'_s4-list','field_60bf7f985a92b'),(14375,1377,'s4-list_2_ttl','Калий'),(14376,1377,'_s4-list_2_ttl','field_60bf7fa95a92c'),(14377,1377,'s4-list_2_formula','K<sup>+</sup>'),(14378,1377,'_s4-list_2_formula','field_60bf7fc65a92d'),(14379,1377,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(14380,1377,'_s4-list_2_text','field_60bf7fd35a92e'),(14381,1377,'s4-list_3_ttl','Гидрокарбонаты'),(14382,1377,'_s4-list_3_ttl','field_60bf7fa95a92c'),(14383,1377,'s4-list_3_formula','HCO<sup>3+</sup>'),(14384,1377,'_s4-list_3_formula','field_60bf7fc65a92d'),(14385,1377,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(14386,1377,'_s4-list_3_text','field_60bf7fd35a92e'),(14387,1377,'s4-list_4_ttl','Магний'),(14388,1377,'_s4-list_4_ttl','field_60bf7fa95a92c'),(14389,1377,'s4-list_4_formula','Mg<sup>2+</sup>'),(14390,1377,'_s4-list_4_formula','field_60bf7fc65a92d'),(14391,1377,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(14392,1377,'_s4-list_4_text','field_60bf7fd35a92e'),(14393,1377,'s4-list_5_ttl','Углекислый газ'),(14394,1377,'_s4-list_5_ttl','field_60bf7fa95a92c'),(14395,1377,'s4-list_5_formula','CO<sup>2</sup>+'),(14396,1377,'_s4-list_5_formula','field_60bf7fc65a92d'),(14397,1377,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(14398,1377,'_s4-list_5_text','field_60bf7fd35a92e'),(14399,1377,'s4-list_6_ttl','Кальций'),(14400,1377,'_s4-list_6_ttl','field_60bf7fa95a92c'),(14401,1377,'s4-list_6_formula','Ca<sup>2+</sup>'),(14402,1377,'_s4-list_6_formula','field_60bf7fc65a92d'),(14403,1377,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(14404,1377,'_s4-list_6_text','field_60bf7fd35a92e'),(14405,1377,'s4-list_7_ttl','Сорбит'),(14406,1377,'_s4-list_7_ttl','field_60bf7fa95a92c'),(14407,1377,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(14408,1377,'_s4-list_7_formula','field_60bf7fc65a92d'),(14409,1377,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(14410,1377,'_s4-list_7_text','field_60bf7fd35a92e'),(14411,1377,'s4-list_8_ttl','Хлор'),(14412,1377,'_s4-list_8_ttl','field_60bf7fa95a92c'),(14413,1377,'s4-list_8_formula','Cl'),(14414,1377,'_s4-list_8_formula','field_60bf7fc65a92d'),(14415,1377,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(14416,1377,'_s4-list_8_text','field_60bf7fd35a92e'),(14417,1377,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(14418,1377,'_s4-feature1','field_60bf80ca480ea'),(14419,1377,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(14420,1377,'_s4-feature2','field_60bf80de480eb'),(14421,1377,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(14422,1377,'_s4-feature3','field_60bf80e2480ec'),(14423,1377,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(14424,1377,'_s4-feature4','field_60bf80e5480ed'),(14425,1377,'s2-list_0_link',''),(14426,1377,'_s2-list_0_link','field_60ee90d381a4e'),(14427,1377,'s2-list_1_link',''),(14428,1377,'_s2-list_1_link','field_60ee90d381a4e'),(14429,1377,'s2-list_2_link',''),(14430,1377,'_s2-list_2_link','field_60ee90d381a4e'),(14431,1377,'s2-list_3_link',''),(14432,1377,'_s2-list_3_link','field_60ee90d381a4e'),(14433,1377,'s2-list_4_link',''),(14434,1377,'_s2-list_4_link','field_60ee90d381a4e'),(14435,1377,'s2-list_5_link',''),(14436,1377,'_s2-list_5_link','field_60ee90d381a4e'),(14437,1377,'s6-list_0_link',''),(14438,1377,'_s6-list_0_link','field_60ee916b04ace'),(14439,1377,'s6-list_1_link',''),(14440,1377,'_s6-list_1_link','field_60ee916b04ace'),(14441,1377,'s6-list_2_link',''),(14442,1377,'_s6-list_2_link','field_60ee916b04ace'),(14443,1377,'s6-list_3_link',''),(14444,1377,'_s6-list_3_link','field_60ee916b04ace'),(14445,1377,'s6-list_4_link',''),(14446,1377,'_s6-list_4_link','field_60ee916b04ace'),(14447,1377,'s6-list_5_link',''),(14448,1377,'_s6-list_5_link','field_60ee916b04ace'),(14449,1377,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(14450,1377,'_slider_0_webplink','field_60fa70c989e88'),(14451,1377,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(14452,1377,'_slider_1_webplink','field_60fa70c989e88'),(14453,1377,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(14454,1377,'_slider_2_webplink','field_60fa70c989e88'),(14455,1377,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(14456,1377,'_slider_3_webplink','field_60fa70c989e88'),(14457,1377,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(14458,1377,'_slider_4_webplink','field_60fa70c989e88'),(14459,1377,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(14460,1377,'_slider_5_webplink','field_60fa70c989e88'),(14461,1377,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(14462,1377,'_slider_6_webplink','field_60fa70c989e88'),(14463,1377,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(14464,1377,'_slider_7_webplink','field_60fa70c989e88'),(14465,1378,'s2-list','6'),(14466,1378,'_s2-list','field_60bf76e0f46ee'),(14467,1378,'s2-ttl','Тананинг 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юкламалар'),(14516,1378,'_s2-list_4_text','field_60bf7712f46f1'),(14517,1378,'s2-list_5_icon','71'),(14518,1378,'_s2-list_5_icon','field_60bf76ecf46ef'),(14519,1378,'s2-list_5_icon-hover','72'),(14520,1378,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(14521,1378,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(14522,1378,'_s2-list_5_text','field_60bf7712f46f1'),(14523,1378,'s1-slogan','Оддий сув етарли бўлмаганда!'),(14524,1378,'_s1-slogan','field_60bf7ab4d9ba9'),(14525,1378,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди. Регидратация учун мўлжалланган махсус\r\nэритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(14526,1378,'_s3-text','field_60bf7bb5a7e2b'),(14527,1378,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(14528,1378,'_s4-ttl','field_60bf7c831f58c'),(14529,1378,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(14530,1378,'_s4-notes','field_60bf7ca31f58d'),(14531,1378,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(14532,1378,'_s5-video','field_60bf7ccfa01a5'),(14533,1378,'s6-ttl','Оддий сув етарли бўлмаганда!'),(14534,1378,'_s6-ttl','field_60bf7cfb10d31'),(14535,1378,'s6-list','6'),(14536,1378,'_s6-list','field_60bf7d0410d32'),(14537,1378,'s6-list_0_icon','92'),(14538,1378,'_s6-list_0_icon','field_60bf7d1810d33'),(14539,1378,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(14540,1378,'_s6-list_0_text','field_60bf7d2710d34'),(14541,1378,'s6-list_1_icon','93'),(14542,1378,'_s6-list_1_icon','field_60bf7d1810d33'),(14543,1378,'s6-list_1_text','Овқатдан заҳарланишларда'),(14544,1378,'_s6-list_1_text','field_60bf7d2710d34'),(14545,1378,'s6-list_2_icon','94'),(14546,1378,'_s6-list_2_icon','field_60bf7d1810d33'),(14547,1378,'s6-list_2_text','Ичак инфекцияларида'),(14548,1378,'_s6-list_2_text','field_60bf7d2710d34'),(14549,1378,'s6-list_3_icon','95'),(14550,1378,'_s6-list_3_icon','field_60bf7d1810d33'),(14551,1378,'s6-list_3_text','Ҳомиладорлик вақтида'),(14552,1378,'_s6-list_3_text','field_60bf7d2710d34'),(14553,1378,'s6-list_4_icon','96'),(14554,1378,'_s6-list_4_icon','field_60bf7d1810d33'),(14555,1378,'s6-list_4_text','Спорт билан шуғулланганда '),(14556,1378,'_s6-list_4_text','field_60bf7d2710d34'),(14557,1378,'s6-list_5_icon','97'),(14558,1378,'_s6-list_5_icon','field_60bf7d1810d33'),(14559,1378,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(14560,1378,'_s6-list_5_text','field_60bf7d2710d34'),(14561,1378,'s4-list_0_ttl','Натрий'),(14562,1378,'_s4-list_0_ttl','field_60bf7fa95a92c'),(14563,1378,'s4-list_0_formula','Na<sup>+</sup>'),(14564,1378,'_s4-list_0_formula','field_60bf7fc65a92d'),(14565,1378,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(14566,1378,'_s4-list_0_text','field_60bf7fd35a92e'),(14567,1378,'s4-list_1_ttl','Вода'),(14568,1378,'_s4-list_1_ttl','field_60bf7fa95a92c'),(14569,1378,'s4-list_1_formula','H<sub>2</sub>O'),(14570,1378,'_s4-list_1_formula','field_60bf7fc65a92d'),(14571,1378,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(14572,1378,'_s4-list_1_text','field_60bf7fd35a92e'),(14573,1378,'s4-list','9'),(14574,1378,'_s4-list','field_60bf7f985a92b'),(14575,1378,'s4-list_2_ttl','Калий'),(14576,1378,'_s4-list_2_ttl','field_60bf7fa95a92c'),(14577,1378,'s4-list_2_formula','K<sup>+</sup>'),(14578,1378,'_s4-list_2_formula','field_60bf7fc65a92d'),(14579,1378,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(14580,1378,'_s4-list_2_text','field_60bf7fd35a92e'),(14581,1378,'s4-list_3_ttl','Гидрокарбонаты'),(14582,1378,'_s4-list_3_ttl','field_60bf7fa95a92c'),(14583,1378,'s4-list_3_formula','HCO<sup>3+</sup>'),(14584,1378,'_s4-list_3_formula','field_60bf7fc65a92d'),(14585,1378,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(14586,1378,'_s4-list_3_text','field_60bf7fd35a92e'),(14587,1378,'s4-list_4_ttl','Магний'),(14588,1378,'_s4-list_4_ttl','field_60bf7fa95a92c'),(14589,1378,'s4-list_4_formula','Mg<sup>2+</sup>'),(14590,1378,'_s4-list_4_formula','field_60bf7fc65a92d'),(14591,1378,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(14592,1378,'_s4-list_4_text','field_60bf7fd35a92e'),(14593,1378,'s4-list_5_ttl','Углекислый газ'),(14594,1378,'_s4-list_5_ttl','field_60bf7fa95a92c'),(14595,1378,'s4-list_5_formula','CO<sup>2</sup>+'),(14596,1378,'_s4-list_5_formula','field_60bf7fc65a92d'),(14597,1378,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(14598,1378,'_s4-list_5_text','field_60bf7fd35a92e'),(14599,1378,'s4-list_6_ttl','Кальций'),(14600,1378,'_s4-list_6_ttl','field_60bf7fa95a92c'),(14601,1378,'s4-list_6_formula','Ca<sup>2+</sup>'),(14602,1378,'_s4-list_6_formula','field_60bf7fc65a92d'),(14603,1378,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(14604,1378,'_s4-list_6_text','field_60bf7fd35a92e'),(14605,1378,'s4-list_7_ttl','Сорбит'),(14606,1378,'_s4-list_7_ttl','field_60bf7fa95a92c'),(14607,1378,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(14608,1378,'_s4-list_7_formula','field_60bf7fc65a92d'),(14609,1378,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(14610,1378,'_s4-list_7_text','field_60bf7fd35a92e'),(14611,1378,'s4-list_8_ttl','Хлор'),(14612,1378,'_s4-list_8_ttl','field_60bf7fa95a92c'),(14613,1378,'s4-list_8_formula','Cl'),(14614,1378,'_s4-list_8_formula','field_60bf7fc65a92d'),(14615,1378,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(14616,1378,'_s4-list_8_text','field_60bf7fd35a92e'),(14617,1378,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(14618,1378,'_s4-feature1','field_60bf80ca480ea'),(14619,1378,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(14620,1378,'_s4-feature2','field_60bf80de480eb'),(14621,1378,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(14622,1378,'_s4-feature3','field_60bf80e2480ec'),(14623,1378,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(14624,1378,'_s4-feature4','field_60bf80e5480ed'),(14625,1378,'s2-list_0_link',''),(14626,1378,'_s2-list_0_link','field_60ee90d381a4e'),(14627,1378,'s2-list_1_link',''),(14628,1378,'_s2-list_1_link','field_60ee90d381a4e'),(14629,1378,'s2-list_2_link',''),(14630,1378,'_s2-list_2_link','field_60ee90d381a4e'),(14631,1378,'s2-list_3_link',''),(14632,1378,'_s2-list_3_link','field_60ee90d381a4e'),(14633,1378,'s2-list_4_link',''),(14634,1378,'_s2-list_4_link','field_60ee90d381a4e'),(14635,1378,'s2-list_5_link',''),(14636,1378,'_s2-list_5_link','field_60ee90d381a4e'),(14637,1378,'s6-list_0_link',''),(14638,1378,'_s6-list_0_link','field_60ee916b04ace'),(14639,1378,'s6-list_1_link',''),(14640,1378,'_s6-list_1_link','field_60ee916b04ace'),(14641,1378,'s6-list_2_link',''),(14642,1378,'_s6-list_2_link','field_60ee916b04ace'),(14643,1378,'s6-list_3_link',''),(14644,1378,'_s6-list_3_link','field_60ee916b04ace'),(14645,1378,'s6-list_4_link',''),(14646,1378,'_s6-list_4_link','field_60ee916b04ace'),(14647,1378,'s6-list_5_link',''),(14648,1378,'_s6-list_5_link','field_60ee916b04ace'),(14649,1378,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(14650,1378,'_slider_0_webplink','field_60fa70c989e88'),(14651,1378,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(14652,1378,'_slider_1_webplink','field_60fa70c989e88'),(14653,1378,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(14654,1378,'_slider_2_webplink','field_60fa70c989e88'),(14655,1378,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(14656,1378,'_slider_3_webplink','field_60fa70c989e88'),(14657,1378,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(14658,1378,'_slider_4_webplink','field_60fa70c989e88'),(14659,1378,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(14660,1378,'_slider_5_webplink','field_60fa70c989e88'),(14661,1378,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(14662,1378,'_slider_6_webplink','field_60fa70c989e88'),(14663,1378,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(14664,1378,'_slider_7_webplink','field_60fa70c989e88'),(14665,1379,'s2-list','6'),(14666,1379,'_s2-list','field_60bf76e0f46ee'),(14667,1379,'s2-ttl','Тананинг 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юкламалар'),(14716,1379,'_s2-list_4_text','field_60bf7712f46f1'),(14717,1379,'s2-list_5_icon','71'),(14718,1379,'_s2-list_5_icon','field_60bf76ecf46ef'),(14719,1379,'s2-list_5_icon-hover','72'),(14720,1379,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(14721,1379,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(14722,1379,'_s2-list_5_text','field_60bf7712f46f1'),(14723,1379,'s1-slogan','Оддий сув етарли бўлмаганда!'),(14724,1379,'_s1-slogan','field_60bf7ab4d9ba9'),(14725,1379,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(14726,1379,'_s3-text','field_60bf7bb5a7e2b'),(14727,1379,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(14728,1379,'_s4-ttl','field_60bf7c831f58c'),(14729,1379,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(14730,1379,'_s4-notes','field_60bf7ca31f58d'),(14731,1379,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(14732,1379,'_s5-video','field_60bf7ccfa01a5'),(14733,1379,'s6-ttl','Оддий сув етарли бўлмаганда!'),(14734,1379,'_s6-ttl','field_60bf7cfb10d31'),(14735,1379,'s6-list','6'),(14736,1379,'_s6-list','field_60bf7d0410d32'),(14737,1379,'s6-list_0_icon','92'),(14738,1379,'_s6-list_0_icon','field_60bf7d1810d33'),(14739,1379,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(14740,1379,'_s6-list_0_text','field_60bf7d2710d34'),(14741,1379,'s6-list_1_icon','93'),(14742,1379,'_s6-list_1_icon','field_60bf7d1810d33'),(14743,1379,'s6-list_1_text','Овқатдан заҳарланишларда'),(14744,1379,'_s6-list_1_text','field_60bf7d2710d34'),(14745,1379,'s6-list_2_icon','94'),(14746,1379,'_s6-list_2_icon','field_60bf7d1810d33'),(14747,1379,'s6-list_2_text','Ичак инфекцияларида'),(14748,1379,'_s6-list_2_text','field_60bf7d2710d34'),(14749,1379,'s6-list_3_icon','95'),(14750,1379,'_s6-list_3_icon','field_60bf7d1810d33'),(14751,1379,'s6-list_3_text','Ҳомиладорлик вақтида'),(14752,1379,'_s6-list_3_text','field_60bf7d2710d34'),(14753,1379,'s6-list_4_icon','96'),(14754,1379,'_s6-list_4_icon','field_60bf7d1810d33'),(14755,1379,'s6-list_4_text','Спорт билан шуғулланганда '),(14756,1379,'_s6-list_4_text','field_60bf7d2710d34'),(14757,1379,'s6-list_5_icon','97'),(14758,1379,'_s6-list_5_icon','field_60bf7d1810d33'),(14759,1379,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(14760,1379,'_s6-list_5_text','field_60bf7d2710d34'),(14761,1379,'s4-list_0_ttl','Натрий'),(14762,1379,'_s4-list_0_ttl','field_60bf7fa95a92c'),(14763,1379,'s4-list_0_formula','Na<sup>+</sup>'),(14764,1379,'_s4-list_0_formula','field_60bf7fc65a92d'),(14765,1379,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(14766,1379,'_s4-list_0_text','field_60bf7fd35a92e'),(14767,1379,'s4-list_1_ttl','Вода'),(14768,1379,'_s4-list_1_ttl','field_60bf7fa95a92c'),(14769,1379,'s4-list_1_formula','H<sub>2</sub>O'),(14770,1379,'_s4-list_1_formula','field_60bf7fc65a92d'),(14771,1379,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(14772,1379,'_s4-list_1_text','field_60bf7fd35a92e'),(14773,1379,'s4-list','9'),(14774,1379,'_s4-list','field_60bf7f985a92b'),(14775,1379,'s4-list_2_ttl','Калий'),(14776,1379,'_s4-list_2_ttl','field_60bf7fa95a92c'),(14777,1379,'s4-list_2_formula','K<sup>+</sup>'),(14778,1379,'_s4-list_2_formula','field_60bf7fc65a92d'),(14779,1379,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(14780,1379,'_s4-list_2_text','field_60bf7fd35a92e'),(14781,1379,'s4-list_3_ttl','Гидрокарбонаты'),(14782,1379,'_s4-list_3_ttl','field_60bf7fa95a92c'),(14783,1379,'s4-list_3_formula','HCO<sup>3+</sup>'),(14784,1379,'_s4-list_3_formula','field_60bf7fc65a92d'),(14785,1379,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(14786,1379,'_s4-list_3_text','field_60bf7fd35a92e'),(14787,1379,'s4-list_4_ttl','Магний'),(14788,1379,'_s4-list_4_ttl','field_60bf7fa95a92c'),(14789,1379,'s4-list_4_formula','Mg<sup>2+</sup>'),(14790,1379,'_s4-list_4_formula','field_60bf7fc65a92d'),(14791,1379,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(14792,1379,'_s4-list_4_text','field_60bf7fd35a92e'),(14793,1379,'s4-list_5_ttl','Углекислый газ'),(14794,1379,'_s4-list_5_ttl','field_60bf7fa95a92c'),(14795,1379,'s4-list_5_formula','CO<sup>2</sup>+'),(14796,1379,'_s4-list_5_formula','field_60bf7fc65a92d'),(14797,1379,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(14798,1379,'_s4-list_5_text','field_60bf7fd35a92e'),(14799,1379,'s4-list_6_ttl','Кальций'),(14800,1379,'_s4-list_6_ttl','field_60bf7fa95a92c'),(14801,1379,'s4-list_6_formula','Ca<sup>2+</sup>'),(14802,1379,'_s4-list_6_formula','field_60bf7fc65a92d'),(14803,1379,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(14804,1379,'_s4-list_6_text','field_60bf7fd35a92e'),(14805,1379,'s4-list_7_ttl','Сорбит'),(14806,1379,'_s4-list_7_ttl','field_60bf7fa95a92c'),(14807,1379,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(14808,1379,'_s4-list_7_formula','field_60bf7fc65a92d'),(14809,1379,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(14810,1379,'_s4-list_7_text','field_60bf7fd35a92e'),(14811,1379,'s4-list_8_ttl','Хлор'),(14812,1379,'_s4-list_8_ttl','field_60bf7fa95a92c'),(14813,1379,'s4-list_8_formula','Cl'),(14814,1379,'_s4-list_8_formula','field_60bf7fc65a92d'),(14815,1379,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(14816,1379,'_s4-list_8_text','field_60bf7fd35a92e'),(14817,1379,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(14818,1379,'_s4-feature1','field_60bf80ca480ea'),(14819,1379,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(14820,1379,'_s4-feature2','field_60bf80de480eb'),(14821,1379,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(14822,1379,'_s4-feature3','field_60bf80e2480ec'),(14823,1379,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(14824,1379,'_s4-feature4','field_60bf80e5480ed'),(14825,1379,'s2-list_0_link',''),(14826,1379,'_s2-list_0_link','field_60ee90d381a4e'),(14827,1379,'s2-list_1_link',''),(14828,1379,'_s2-list_1_link','field_60ee90d381a4e'),(14829,1379,'s2-list_2_link',''),(14830,1379,'_s2-list_2_link','field_60ee90d381a4e'),(14831,1379,'s2-list_3_link',''),(14832,1379,'_s2-list_3_link','field_60ee90d381a4e'),(14833,1379,'s2-list_4_link',''),(14834,1379,'_s2-list_4_link','field_60ee90d381a4e'),(14835,1379,'s2-list_5_link',''),(14836,1379,'_s2-list_5_link','field_60ee90d381a4e'),(14837,1379,'s6-list_0_link',''),(14838,1379,'_s6-list_0_link','field_60ee916b04ace'),(14839,1379,'s6-list_1_link',''),(14840,1379,'_s6-list_1_link','field_60ee916b04ace'),(14841,1379,'s6-list_2_link',''),(14842,1379,'_s6-list_2_link','field_60ee916b04ace'),(14843,1379,'s6-list_3_link',''),(14844,1379,'_s6-list_3_link','field_60ee916b04ace'),(14845,1379,'s6-list_4_link',''),(14846,1379,'_s6-list_4_link','field_60ee916b04ace'),(14847,1379,'s6-list_5_link',''),(14848,1379,'_s6-list_5_link','field_60ee916b04ace'),(14849,1379,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(14850,1379,'_slider_0_webplink','field_60fa70c989e88'),(14851,1379,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(14852,1379,'_slider_1_webplink','field_60fa70c989e88'),(14853,1379,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(14854,1379,'_slider_2_webplink','field_60fa70c989e88'),(14855,1379,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(14856,1379,'_slider_3_webplink','field_60fa70c989e88'),(14857,1379,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(14858,1379,'_slider_4_webplink','field_60fa70c989e88'),(14859,1379,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(14860,1379,'_slider_5_webplink','field_60fa70c989e88'),(14861,1379,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(14862,1379,'_slider_6_webplink','field_60fa70c989e88'),(14863,1379,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(14864,1379,'_slider_7_webplink','field_60fa70c989e88'),(14865,1380,'s2-list','6'),(14866,1380,'_s2-list','field_60bf76e0f46ee'),(14867,1380,'s2-ttl','Тананинг 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юкламалар'),(14916,1380,'_s2-list_4_text','field_60bf7712f46f1'),(14917,1380,'s2-list_5_icon','71'),(14918,1380,'_s2-list_5_icon','field_60bf76ecf46ef'),(14919,1380,'s2-list_5_icon-hover','72'),(14920,1380,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(14921,1380,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(14922,1380,'_s2-list_5_text','field_60bf7712f46f1'),(14923,1380,'s1-slogan','Оддий сув етарли бўлмаганда!'),(14924,1380,'_s1-slogan','field_60bf7ab4d9ba9'),(14925,1380,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(14926,1380,'_s3-text','field_60bf7bb5a7e2b'),(14927,1380,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(14928,1380,'_s4-ttl','field_60bf7c831f58c'),(14929,1380,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(14930,1380,'_s4-notes','field_60bf7ca31f58d'),(14931,1380,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(14932,1380,'_s5-video','field_60bf7ccfa01a5'),(14933,1380,'s6-ttl','Оддий сув етарли бўлмаганда!'),(14934,1380,'_s6-ttl','field_60bf7cfb10d31'),(14935,1380,'s6-list','6'),(14936,1380,'_s6-list','field_60bf7d0410d32'),(14937,1380,'s6-list_0_icon','92'),(14938,1380,'_s6-list_0_icon','field_60bf7d1810d33'),(14939,1380,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(14940,1380,'_s6-list_0_text','field_60bf7d2710d34'),(14941,1380,'s6-list_1_icon','93'),(14942,1380,'_s6-list_1_icon','field_60bf7d1810d33'),(14943,1380,'s6-list_1_text','Овқатдан заҳарланишларда'),(14944,1380,'_s6-list_1_text','field_60bf7d2710d34'),(14945,1380,'s6-list_2_icon','94'),(14946,1380,'_s6-list_2_icon','field_60bf7d1810d33'),(14947,1380,'s6-list_2_text','Ичак инфекцияларида'),(14948,1380,'_s6-list_2_text','field_60bf7d2710d34'),(14949,1380,'s6-list_3_icon','95'),(14950,1380,'_s6-list_3_icon','field_60bf7d1810d33'),(14951,1380,'s6-list_3_text','Ҳомиладорлик вақтида'),(14952,1380,'_s6-list_3_text','field_60bf7d2710d34'),(14953,1380,'s6-list_4_icon','96'),(14954,1380,'_s6-list_4_icon','field_60bf7d1810d33'),(14955,1380,'s6-list_4_text','Спорт билан шуғулланганда '),(14956,1380,'_s6-list_4_text','field_60bf7d2710d34'),(14957,1380,'s6-list_5_icon','97'),(14958,1380,'_s6-list_5_icon','field_60bf7d1810d33'),(14959,1380,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(14960,1380,'_s6-list_5_text','field_60bf7d2710d34'),(14961,1380,'s4-list_0_ttl','Натрий'),(14962,1380,'_s4-list_0_ttl','field_60bf7fa95a92c'),(14963,1380,'s4-list_0_formula','Na<sup>+</sup>'),(14964,1380,'_s4-list_0_formula','field_60bf7fc65a92d'),(14965,1380,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(14966,1380,'_s4-list_0_text','field_60bf7fd35a92e'),(14967,1380,'s4-list_1_ttl','Вода'),(14968,1380,'_s4-list_1_ttl','field_60bf7fa95a92c'),(14969,1380,'s4-list_1_formula','H<sub>2</sub>O'),(14970,1380,'_s4-list_1_formula','field_60bf7fc65a92d'),(14971,1380,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(14972,1380,'_s4-list_1_text','field_60bf7fd35a92e'),(14973,1380,'s4-list','9'),(14974,1380,'_s4-list','field_60bf7f985a92b'),(14975,1380,'s4-list_2_ttl','Калий'),(14976,1380,'_s4-list_2_ttl','field_60bf7fa95a92c'),(14977,1380,'s4-list_2_formula','K<sup>+</sup>'),(14978,1380,'_s4-list_2_formula','field_60bf7fc65a92d'),(14979,1380,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(14980,1380,'_s4-list_2_text','field_60bf7fd35a92e'),(14981,1380,'s4-list_3_ttl','Гидрокарбонаты'),(14982,1380,'_s4-list_3_ttl','field_60bf7fa95a92c'),(14983,1380,'s4-list_3_formula','HCO<sup>3+</sup>'),(14984,1380,'_s4-list_3_formula','field_60bf7fc65a92d'),(14985,1380,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(14986,1380,'_s4-list_3_text','field_60bf7fd35a92e'),(14987,1380,'s4-list_4_ttl','Магний'),(14988,1380,'_s4-list_4_ttl','field_60bf7fa95a92c'),(14989,1380,'s4-list_4_formula','Mg<sup>2+</sup>'),(14990,1380,'_s4-list_4_formula','field_60bf7fc65a92d'),(14991,1380,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(14992,1380,'_s4-list_4_text','field_60bf7fd35a92e'),(14993,1380,'s4-list_5_ttl','Углекислый газ'),(14994,1380,'_s4-list_5_ttl','field_60bf7fa95a92c'),(14995,1380,'s4-list_5_formula','CO<sup>2</sup>+'),(14996,1380,'_s4-list_5_formula','field_60bf7fc65a92d'),(14997,1380,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(14998,1380,'_s4-list_5_text','field_60bf7fd35a92e'),(14999,1380,'s4-list_6_ttl','Кальций'),(15000,1380,'_s4-list_6_ttl','field_60bf7fa95a92c'),(15001,1380,'s4-list_6_formula','Ca<sup>2+</sup>'),(15002,1380,'_s4-list_6_formula','field_60bf7fc65a92d'),(15003,1380,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(15004,1380,'_s4-list_6_text','field_60bf7fd35a92e'),(15005,1380,'s4-list_7_ttl','Сорбит'),(15006,1380,'_s4-list_7_ttl','field_60bf7fa95a92c'),(15007,1380,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(15008,1380,'_s4-list_7_formula','field_60bf7fc65a92d'),(15009,1380,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(15010,1380,'_s4-list_7_text','field_60bf7fd35a92e'),(15011,1380,'s4-list_8_ttl','Хлор'),(15012,1380,'_s4-list_8_ttl','field_60bf7fa95a92c'),(15013,1380,'s4-list_8_formula','Cl'),(15014,1380,'_s4-list_8_formula','field_60bf7fc65a92d'),(15015,1380,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(15016,1380,'_s4-list_8_text','field_60bf7fd35a92e'),(15017,1380,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(15018,1380,'_s4-feature1','field_60bf80ca480ea'),(15019,1380,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(15020,1380,'_s4-feature2','field_60bf80de480eb'),(15021,1380,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(15022,1380,'_s4-feature3','field_60bf80e2480ec'),(15023,1380,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон 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value=\"90\">\n</div>\n</div>\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"total-price\"></p></div>\n<div class=\"col-md-12\"><p class=\"align-center\">Битта ўрамда 12 та бутилка</p>\n</div>\n</div>\n<div class=\"row\">\n<div class=\"col-md-6\" style=\"z-index: 999;\">\n<div class=\"form-group\">[tel* tel class:form-control class:phone-select placeholder \"Телефон рақамингиз*\"]</div>\n</div>\n<div class=\"col-md-6\">\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Исмингиз*\"]</div>\n</div>\n</div>\n<div class=\"form-group\">[text* adress class:form-control placeholder \"Етказиб бериш манзили*\"]</div>\n<div class=\"form-group agree\">[checkbox* agree \"\"] Мен <a href=\"/uz/terms-of-use/\" target=\"_blank\">Махфийлик сиёсати</a> билан розиман.</div>\n<div class=\"form-group align-right\">[submit class:butn class:order-butn \"Буюртмани расмийлаштириш\"]</div>\n<div class=\"form-group requaired\"><p>* Юлдузча билан 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(ReO)\";s:6:\"sender\";s:11:\"send@reo.ua\";s:9:\"recipient\";s:47:\"Sanzhar.Tursunov@uf.ua, tetiana.filipchuk@uf.ua\";s:4:\"body\";s:204:\"<p><strong>Количество:</strong> [products]</p>\n<p><strong>Имя:</strong> [nname]</p>\n<p><strong>Телефон:</strong> [tel]</p>\n<p><strong>Адрес доставки:</strong> [adress]</p>\";s:18:\"additional_headers\";s:0:\"\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:1;s:13:\"exclude_blank\";b:1;}'),(18510,1736,'fb','https://www.facebook.com/reo.uz'),(15076,1382,'_mail_2','a:9:{s:6:\"active\";b:0;s:7:\"subject\";s:30:\"[_site_title] \"[your-subject]\"\";s:6:\"sender\";s:43:\"[_site_title] <wordpress@reo.tonic-adv.com>\";s:9:\"recipient\";s:12:\"[your-email]\";s:4:\"body\";s:128:\"Сообщение:\n[your-message]\n\n-- \nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\";s:18:\"additional_headers\";s:29:\"Reply-To: 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Амосова, 10'),(15231,1402,'_adress','field_60cb20d1cbf7c'),(15232,1402,'tel','+38 (044) 246-83-83, 275-01-08'),(15233,1402,'_tel','field_60cb2128cbf7d'),(15234,1402,'email','uf@uf.ua'),(15235,1402,'_email','field_60cb2131cbf7e'),(15236,1402,'site','www.uf.ua'),(15237,1402,'_site','field_60cb213acbf7f'),(15241,1403,'_yoast_wpseo_estimated-reading-time-minutes',''),(15240,1403,'_wp_page_template','page-manufacturer.php'),(15242,1403,'_wpml_media_featured','1'),(15243,1403,'_wpml_media_duplicate','1'),(15244,1403,'sc1-afterlogo','Халқаро ихтисослашган \r\nфармацевтика корпорацияси'),(15245,1403,'_sc1-afterlogo','field_60c85338b3453'),(15246,1403,'sc1-left','инфузион препаратлар ишлаб \r\nчиқариш бўйича тан олинган етакчи'),(15247,1403,'_sc1-left','field_60c85356b3454'),(15248,1403,'sc1-right','Украинада госпитал \r\nсотувлар бўйича етакчи'),(15249,1403,'_sc1-right','field_60c85408b3455'),(15250,1403,'sc2-ttl','«Юрия-Фарм» корпорацияси:'),(15251,1403,'_sc2-ttl','field_60c8556cfdbcb'),(15252,1403,'sc2-round1','<h3>TOП-3</h3>\r\nУкраинадаги энг йирик\r\nфармацевтика маҳсулотлари\r\nишлаб чиқарувчилар\r\nқаторига киради'),(15253,1403,'_sc2-round1','field_60c855a5fdbcc'),(15254,1403,'sc2-round2','<h3>ТОП-10</h3>\r\nУкраина фармацевтика бозорининг\r\nетакчиларига киради'),(15255,1403,'_sc2-round2','field_60c855b6fdbcd'),(15256,1403,'sc2-mission','<strong>Бизнинг вазифамиз</strong> –\r\nодамларни соғломлаштириш ва\r\nдаволаш учун ноёб ечимларни яратиш'),(15257,1403,'_sc2-mission','field_60c855bffdbce'),(15258,1403,'sc2-filosophy','<strong>Бизнинг фалсафамиз</strong>\r\nҲаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(15259,1403,'_sc2-filosophy','field_60c855cafdbcf'),(15260,1403,'sc3-ttl','Бизнинг ишлаб чиқаришимиз тўғрисида қисқа фактлар:'),(15261,1403,'_sc3-ttl','field_60c85818d1bf2'),(15262,1403,'sc3-list_0_icon','232'),(15263,1403,'_sc3-list_0_icon','field_60c85834d1bf4'),(15264,1403,'sc3-list_0_text','<h3><strong>Черкассы</strong>\r\nшаҳрида жойлашган</h3>'),(15265,1403,'_sc3-list_0_text','field_60c85852d1bf5'),(15266,1403,'sc3-list_1_icon','234'),(15267,1403,'_sc3-list_1_icon','field_60c85834d1bf4'),(15268,1403,'sc3-list_1_text','<h3>ишлаб чиқариш линиялари сони:\r\n<strong class=\"counter-value\">41</strong>та</h3>'),(15269,1403,'_sc3-list_1_text','field_60c85852d1bf5'),(15270,1403,'sc3-list_2_icon','236'),(15271,1403,'_sc3-list_2_icon','field_60c85834d1bf4'),(15272,1403,'sc3-list_2_text','<h3>дори воситалари:\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(15273,1403,'_sc3-list_2_text','field_60c85852d1bf5'),(15274,1403,'sc3-list_3_icon','238'),(15275,1403,'_sc3-list_3_icon','field_60c85834d1bf4'),(15276,1403,'sc3-list_3_text','<h3>ишлаб чиқариш майдони:\r\n<strong><i class=\"counter-value\">25</i> минг кв. м.</strong></h3>'),(15277,1403,'_sc3-list_3_text','field_60c85852d1bf5'),(15278,1403,'sc3-list_4_icon','240'),(15279,1403,'_sc3-list_4_icon','field_60c85834d1bf4'),(15280,1403,'sc3-list_4_text','<h3>ишлаб чиқариш қуввати:\r\n<strong>йилига <i class=\"counter-value\">290</i> млн</strong>\r\nбирликдан ортиқ маҳсулот</h3>'),(15281,1403,'_sc3-list_4_text','field_60c85852d1bf5'),(15282,1403,'sc3-list_5_icon','242'),(15283,1403,'_sc3-list_5_icon','field_60c85834d1bf4'),(15284,1403,'sc3-list_5_text','<h3>тиббий буюмлар –\r\n<strong><i class=\"counter-value\">86</i> млн дан ортиқ</strong></h3>'),(15285,1403,'_sc3-list_5_text','field_60c85852d1bf5'),(15286,1403,'sc3-list','6'),(15287,1403,'_sc3-list','field_60c85827d1bf3'),(15288,1403,'sc4-list_0_num','2500'),(15289,1403,'_sc4-list_0_num','field_60c85bf773ac3'),(15290,1403,'sc4-list_0_text','ходим'),(15291,1403,'_sc4-list_0_text','field_60c85c0173ac4'),(15292,1403,'sc4-list_1_num','160'),(15293,1403,'_sc4-list_1_num','field_60c85bf773ac3'),(15294,1403,'sc4-list_1_text','позиция'),(15295,1403,'_sc4-list_1_text','field_60c85c0173ac4'),(15296,1403,'sc4-list_2_num','20'),(15297,1403,'_sc4-list_2_num','field_60c85bf773ac3'),(15298,1403,'sc4-list_2_text','дан ортиқ мамлакатлар'),(15299,1403,'_sc4-list_2_text','field_60c85c0173ac4'),(15300,1403,'sc4-list','3'),(15301,1403,'_sc4-list','field_60c85be773ac2'),(15302,1403,'sc4-text','<strong>2500 ходимнинг</strong> кундалик меҳнати  <strong>160 позициядан</strong> ортиқ ассортиментдаги маҳсулотни ишлаб чиқариш ва <strong>дунёнинг 20 дан ортиқ мамлакатидаги</strong> даволаш-профилактика муассасаларига етказиб бериш имконини беради. Булар – Украинада ишлаб чиқилган оригинал инфузион препаратлар, антибиотиклар, фунгицид препаратлар, ичиш учун эритмалар, антисептиклар, парентерал овқатланиш учун препаратлар, туберкулез (сил касаллиги)га қарши препаратлар, шприцлар, инфузиялар учун системалар ва кўплаб бошқа препаратлардир.'),(15303,1403,'_sc4-text','field_60c85c0d73ac5'),(15304,1403,'sc5-ttl','Маҳсулотимиз сифатини кафолатлайдиган \r\nхалқаро сертификатлар'),(15305,1403,'_sc5-ttl','field_60c85c2b73ac7'),(15306,1403,'sc5-list','2'),(15307,1403,'_sc5-list','field_60c85c6373ac8'),(15308,1403,'sc6-text','<h2><strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nбирликдан ортиқ маҳсулот</h2>\r\nҳар йили ўн минглаб врачларни одамларни даволаш ва соғломлаштириш учун самарали воситалар билан таъминлайди. Уларга яқинроқ бўлиш учун биз ўз дистрибьюция хизматимизни яратдик. Ҳар куни бутун Ўзбекистон бўйлаб омборлардан минглаб тонна инфузион препаратлар ва тиббий мақсадларга мўлжалланган буюмлар жўнатилади, бу врачларга юз минглаб ҳаётни қутқариш имконини беради.'),(15309,1403,'_sc6-text','field_60c85cad73acc'),(15310,1403,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(15311,1403,'_sc7-video','field_60c85cca73ace'),(15312,1403,'sc7-text','Инфузион эритмаларни ишлаб чиқариш бўйича жаҳон тажрибасидан фойдаланган ҳолда, беморларнинг ҳаёт сифатини яхшилаш ва даволаш мақсадида биз ўз ғояларимизни ишлаб чиқиш, ишлаб чиқаришга жорий этиш ва амалга ошириш устида ишламоқдамиз.'),(15313,1403,'_sc7-text','field_60c85ce173acf'),(15314,1403,'sc7-textborder','Ҳаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(15315,1403,'_sc7-textborder','field_60c85cea73ad0'),(15316,1403,'sc5-list_0_logo','262'),(15317,1403,'_sc5-list_0_logo','field_60c85c6f73ac9'),(15318,1403,'sc5-list_0_text','Украина GMP, EU GMP, Кения GMP –\r\nТегишли ишлаб чиқариш амалиёти'),(15319,1403,'_sc5-list_0_text','field_60c85c7e73aca'),(15320,1403,'sc5-list_1_logo','264'),(15321,1403,'_sc5-list_1_logo','field_60c85c6f73ac9'),(15322,1403,'sc5-list_1_text','ISO 9001:2009 – фармацевтика маҳсулотини \r\nишлаб чиқариш ва улгуржи сотиш'),(15323,1403,'_sc5-list_1_text','field_60c85c7e73aca'),(15324,1403,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(15325,1403,'_sc6-ttl','field_60c85f2f52aa8'),(15326,1403,'sc7-ttl','Биз ҳақимизда кўпроқ билиш учун қисқа видео:'),(15327,1403,'_sc7-ttl','field_60c860b4429a2'),(15333,1403,'_edit_last','1'),(15329,1404,'_wp_attachment_metadata',''),(15330,1404,'_wp_attached_file','2021/06/facts-icon-1.svg'),(15331,1404,'wpml_media_processed','1'),(15332,1403,'_edit_lock','1630153930:1'),(15334,1405,'sc1-afterlogo','Международная специализированная \r\nфармацевтическая корпорация:'),(15335,1405,'_sc1-afterlogo','field_60c85338b3453'),(15336,1405,'sc1-left','признанный лидер рынка\r\nвнутривенных препаратов'),(15337,1405,'_sc1-left','field_60c85356b3454'),(15338,1405,'sc1-right','лидер госпитальных\r\nпродаж в Украине'),(15339,1405,'_sc1-right','field_60c85408b3455'),(15340,1405,'sc2-ttl','Корпорация «Юрия-Фарм» входит в:'),(15341,1405,'_sc2-ttl','field_60c8556cfdbcb'),(15342,1405,'sc2-round1','<h3>TOП-3</h3>\r\nкрупнейших отечественных\r\nфармацевтических\r\nпроизводителей;'),(15343,1405,'_sc2-round1','field_60c855a5fdbcc'),(15344,1405,'sc2-round2','<h3>ТОП-10</h3>\r\nлидеров фармацевтического\r\nрынка Украины.'),(15345,1405,'_sc2-round2','field_60c855b6fdbcd'),(15346,1405,'sc2-mission','<strong>Наша миссия</strong> –\r\nсоздавать уникальные решения\r\nдля оздоровления и лечения людей.'),(15347,1405,'_sc2-mission','field_60c855bffdbce'),(15348,1405,'sc2-filosophy','<strong>Наша философия</strong>\r\nЖизнь – главная земная ценность.\r\nМы призваны сохранять и улучшать ее!'),(15349,1405,'_sc2-filosophy','field_60c855cafdbcf'),(15350,1405,'sc3-ttl','Краткие факты о нашем производстве:'),(15351,1405,'_sc3-ttl','field_60c85818d1bf2'),(15352,1405,'sc3-list_0_icon','232'),(15353,1405,'_sc3-list_0_icon','field_60c85834d1bf4'),(15354,1405,'sc3-list_0_text','<h3>сосредоточено в\r\n<strong>г. Черкассы</strong></h3>'),(15355,1405,'_sc3-list_0_text','field_60c85852d1bf5'),(15356,1405,'sc3-list_1_icon','234'),(15357,1405,'_sc3-list_1_icon','field_60c85834d1bf4'),(15358,1405,'sc3-list_1_text','<h3>производственных линий:\r\n<strong class=\"counter-value\">41</strong></h3>'),(15359,1405,'_sc3-list_1_text','field_60c85852d1bf5'),(15360,1405,'sc3-list_2_icon','236'),(15361,1405,'_sc3-list_2_icon','field_60c85834d1bf4'),(15362,1405,'sc3-list_2_text','<h3>лекарственных средств –\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(15363,1405,'_sc3-list_2_text','field_60c85852d1bf5'),(15364,1405,'sc3-list_3_icon','238'),(15365,1405,'_sc3-list_3_icon','field_60c85834d1bf4'),(15366,1405,'sc3-list_3_text','<h3>производственные площади:\r\n<strong><i class=\"counter-value\">25</i> тыс. кв. м.</strong></h3>'),(15367,1405,'_sc3-list_3_text','field_60c85852d1bf5'),(15368,1405,'sc3-list_4_icon','240'),(15369,1405,'_sc3-list_4_icon','field_60c85834d1bf4'),(15370,1405,'sc3-list_4_text','<h3>производственные мощности:\r\n<strong>более <i class=\"counter-value\">290</i> млн</strong>\r\nединиц продукции в год,</h3>'),(15371,1405,'_sc3-list_4_text','field_60c85852d1bf5'),(15372,1405,'sc3-list_5_icon','242'),(15373,1405,'_sc3-list_5_icon','field_60c85834d1bf4'),(15374,1405,'sc3-list_5_text','<h3>изделий медицинского назначения –\r\n<strong>более <i class=\"counter-value\">86</i> млн</strong></h3>'),(15375,1405,'_sc3-list_5_text','field_60c85852d1bf5'),(15376,1405,'sc3-list','6'),(15377,1405,'_sc3-list','field_60c85827d1bf3'),(15378,1405,'sc4-list_0_num','2500'),(15379,1405,'_sc4-list_0_num','field_60c85bf773ac3'),(15380,1405,'sc4-list_0_text','сотрудников'),(15381,1405,'_sc4-list_0_text','field_60c85c0173ac4'),(15382,1405,'sc4-list_1_num','160'),(15383,1405,'_sc4-list_1_num','field_60c85bf773ac3'),(15384,1405,'sc4-list_1_text','позиций'),(15385,1405,'_sc4-list_1_text','field_60c85c0173ac4'),(15386,1405,'sc4-list_2_num','20'),(15387,1405,'_sc4-list_2_num','field_60c85bf773ac3'),(15388,1405,'sc4-list_2_text','стран мира'),(15389,1405,'_sc4-list_2_text','field_60c85c0173ac4'),(15390,1405,'sc4-list','3'),(15391,1405,'_sc4-list','field_60c85be773ac2'),(15392,1405,'sc4-text','Ежедневный труд <strong>2500 сотрудников</strong> позволяет производить и поставлять продукцию, ассортиментом более <strong>160 позиций</strong>, лечебно-профилактическим учреждениям более чем <strong>20 стран мира</strong>. Это оригинальные инфузионные препараты собственной разработки, антибиотики, фунгицидные препараты, растворы для питья, антисептики, препараты для парентерального питания, противотуберкулезные препараты, шприцы, системы для инфузий и многие другие.'),(15393,1405,'_sc4-text','field_60c85c0d73ac5'),(15394,1405,'sc5-ttl','Международные сертификаты, \r\nкоторые гарантируют качество \r\nнашей продукции:'),(15395,1405,'_sc5-ttl','field_60c85c2b73ac7'),(15396,1405,'sc5-list','2'),(15397,1405,'_sc5-list','field_60c85c6373ac8'),(15398,1405,'sc6-text','<h2>Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции</h2>\r\nежегодно обеспечивают десятки тысяч врачей эффективными средствами для лечения и оздоровления людей. Чтобы быть ближе к ним мы создали собственную службу дистрибуции. Ежедневно со складов по всей Украине отправляются тысячи тонн инфузионных препаратов и изделий медицинского назначения, позволяет врачам спасать сотни тысяч жизней.'),(15399,1405,'_sc6-text','field_60c85cad73acc'),(15400,1405,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(15401,1405,'_sc7-video','field_60c85cca73ace'),(15402,1405,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(15403,1405,'_sc7-text','field_60c85ce173acf'),(15404,1405,'sc7-textborder','Жизнь – главная земная ценность. \r\nМы призваны сохранять и улучшать ее!'),(15405,1405,'_sc7-textborder','field_60c85cea73ad0'),(15406,1405,'sc5-list_0_logo','262'),(15407,1405,'_sc5-list_0_logo','field_60c85c6f73ac9'),(15408,1405,'sc5-list_0_text','GMP Украины, GMP EU, GMP Кения – \r\nНадлежащая производственная \r\nпрактика'),(15409,1405,'_sc5-list_0_text','field_60c85c7e73aca'),(15410,1405,'sc5-list_1_logo','264'),(15411,1405,'_sc5-list_1_logo','field_60c85c6f73ac9'),(15412,1405,'sc5-list_1_text','ISO 9001:2009 – \r\nпроизводство и оптовая \r\nпродажа фармацевтической \r\nпродукции'),(15413,1405,'_sc5-list_1_text','field_60c85c7e73aca'),(15414,1405,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(15415,1405,'_sc6-ttl','field_60c85f2f52aa8'),(15416,1405,'sc7-ttl','Больше о нас в коротком видео:'),(15417,1405,'_sc7-ttl','field_60c860b4429a2'),(15418,1406,'_wp_attachment_metadata',''),(15419,1406,'_wp_attached_file','2021/06/facts-icon-2.svg'),(15420,1406,'wpml_media_processed','1'),(15421,1407,'_wp_attachment_metadata',''),(15422,1407,'_wp_attached_file','2021/06/facts-icon-3.svg'),(15423,1407,'wpml_media_processed','1'),(15424,1408,'_wp_attachment_metadata',''),(15425,1408,'_wp_attached_file','2021/06/facts-icon-4.svg'),(15426,1408,'wpml_media_processed','1'),(15427,1409,'_wp_attachment_metadata',''),(15428,1409,'_wp_attached_file','2021/06/facts-icon-5.svg'),(15429,1409,'wpml_media_processed','1'),(15430,1410,'_wp_attachment_metadata',''),(15431,1410,'_wp_attached_file','2021/06/facts-icon-6.svg'),(15432,1410,'wpml_media_processed','1'),(15433,1411,'_wp_attachment_metadata',''),(15434,1411,'_wp_attached_file','2021/06/sertificat-gmp.svg'),(15435,1411,'wpml_media_processed','1'),(15436,1412,'_wp_attachment_metadata',''),(15437,1412,'_wp_attached_file','2021/06/sertificat-iso.svg'),(15438,1412,'wpml_media_processed','1'),(15442,1413,'_yoast_wpseo_estimated-reading-time-minutes',''),(15441,1413,'_wp_page_template','page-about.php'),(15443,1413,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(15444,1413,'_s1-text','field_60c069d69838b'),(15445,1413,'s3-list','5'),(15446,1413,'_s3-list','field_60c06d9298394'),(15447,1413,'s3-list2','3'),(15448,1413,'_s3-list2','field_60c06dd498396'),(15449,1413,'s4-ttl','ReO суви дегидратация ва интоксикация белгиларини камайтиради'),(15450,1413,'_s4-ttl','field_60c06ba39838e'),(15451,1413,'s4-list','7'),(15452,1413,'_s4-list','field_60c06bb39838f'),(15453,1413,'s4-slogan','ReO сув-туз мувозанатини тиклайди ва умумий аҳволни яхшилайди'),(15454,1413,'_s4-slogan','field_60c06d6d98392'),(15455,1413,'s4-list_0_icon','127'),(15456,1413,'_s4-list_0_icon','field_60c06bc298390'),(15457,1413,'s4-list_0_text','<strong>Тана ҳарорати</strong> кўтарилиши ва/ёки'),(15458,1413,'_s4-list_0_text','field_60c06bce98391'),(15459,1413,'s4-list_1_icon','128'),(15460,1413,'_s4-list_1_icon','field_60c06bc298390'),(15461,1413,'s4-list_1_text','<strong>бош айланиши</strong>'),(15462,1413,'_s4-list_1_text','field_60c06bce98391'),(15463,1413,'s4-list_2_icon','68'),(15464,1413,'_s4-list_2_icon','field_60c06bc298390'),(15465,1413,'s4-list_2_text','<strong>кўнгил айниши,</strong>\r\nқайт қилиш\r\nва/ёки'),(15466,1413,'_s4-list_2_text','field_60c06bce98391'),(15467,1413,'s4-list_3_icon','64'),(15468,1413,'_s4-list_3_icon','field_60c06bc298390'),(15469,1413,'s4-list_3_text','умумий\r\n<strong>ҳолсизлик</strong>'),(15470,1413,'_s4-list_3_text','field_60c06bce98391'),(15471,1413,'s4-list_4_icon','129'),(15472,1413,'_s4-list_4_icon','field_60c06bc298390'),(15473,1413,'s4-list_4_text','<strong>ич кетиши</strong>'),(15474,1413,'_s4-list_4_text','field_60c06bce98391'),(15475,1413,'s4-list_5_icon','130'),(15476,1413,'_s4-list_5_icon','field_60c06bc298390'),(15477,1413,'s4-list_5_text','қуриши\r\n<strong>оғиз</strong>'),(15478,1413,'_s4-list_5_text','field_60c06bce98391'),(15479,1413,'s4-list_6_icon','131'),(15480,1413,'_s4-list_6_icon','field_60c06bc298390'),(15481,1413,'s4-list_6_text','<strong>бош</strong>\r\nоғриғи'),(15482,1413,'_s4-list_6_text','field_60c06bce98391'),(15483,1413,'s3-list_0_li','мувозанатлаштирилган таркибга эга'),(15484,1413,'_s3-list_0_li','field_60c06db098395'),(15485,1413,'s3-list_1_li','таркибида қўшимча энергия манбаи – сорбитол бор'),(15486,1413,'_s3-list_1_li','field_60c06db098395'),(15487,1413,'s3-list_2_li','сув ва электролитларни тез сўрилишини таъминлайди'),(15488,1413,'_s3-list_2_li','field_60c06db098395'),(15489,1413,'s3-list_3_li','ёқимли таъмга эга бўлиб, ҳатто кўнгил айниганда ҳам осон ичилади '),(15490,1413,'_s3-list_3_li','field_60c06db098395'),(15491,1413,'s3-list_4_li','консервант, бўёқлар ва углеводларсиз'),(15492,1413,'_s3-list_4_li','field_60c06db098395'),(15493,1413,'s3-list2_0_li','Сувсизланиш белгиларини бартараф этади'),(15494,1413,'_s3-list2_0_li','field_60c06dd498397'),(15495,1413,'s3-list2_1_li','Диурезни нормаллаштиради, интоксикацияни камайтиради'),(15496,1413,'_s3-list2_1_li','field_60c06dd498397'),(15497,1413,'s3-list2_2_li','Стационарда даволаниш вақтида ва уйга чиққандан сўнг сув-электролит мувозанатини тиклашга ёрдам беради'),(15498,1413,'_s3-list2_2_li','field_60c06dd498397'),(15499,1413,'_s2-list_3_text','field_60c0749d53147'),(15500,1413,'s2-list_3_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(15501,1413,'_s2-list_3_size','field_60c0749553146'),(15502,1413,'_s2-list_3_formula','field_60c0747253145'),(15503,1413,'s2-list_3_size','- 1300 мг/л'),(15504,1413,'s2-list_3_formula','Na<sup>+</sup>'),(15505,1413,'s2-list_3_ttl','Натрий'),(15506,1413,'_s2-list_3_ttl','field_60c0745253144'),(15507,1413,'_s2-list_2_text','field_60c0749d53147'),(15508,1413,'s2-list_2_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(15509,1413,'_s2-list_2_size','field_60c0749553146'),(15510,1413,'s2-list_2_size','до 90 мг/л'),(15511,1413,'_s2-list_2_formula','field_60c0747253145'),(15512,1413,'s2-list_2_formula','Сорбитол'),(15513,1413,'_s2-list_2_ttl','field_60c0745253144'),(15514,1413,'s2-list_2_ttl','Сорбитол'),(15515,1413,'_s2-list_1_text','field_60c0749d53147'),(15516,1413,'s2-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(15517,1413,'_s2-list_1_size','field_60c0749553146'),(15518,1413,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(15519,1413,'_s2-list_1_formula','field_60c0747253145'),(15520,1413,'s2-list_1_formula','Минерализация'),(15521,1413,'s2-list_1_ttl','Минерализация'),(15522,1413,'_s2-list_1_ttl','field_60c0745253144'),(15523,1413,'s2-list_0_ttl','Углекислота'),(15524,1413,'_s2-list_0_ttl','field_60c0745253144'),(15525,1413,'s2-list_0_formula','Углекислота'),(15526,1413,'_s2-list_0_formula','field_60c0747253145'),(15527,1413,'s2-list_0_size','- 0,05-0,3%'),(15528,1413,'_s2-list_0_size','field_60c0749553146'),(15529,1413,'s2-list_0_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(15530,1413,'_s2-list_0_text','field_60c0749d53147'),(15531,1413,'s2-list','9'),(15532,1413,'_s2-list','field_60c0743a53143'),(15533,1413,'s2-list_4_ttl','Магний'),(15534,1413,'_s2-list_4_ttl','field_60c0745253144'),(15535,1413,'s2-list_4_formula','Mg<sup>2+</sup>'),(15536,1413,'_s2-list_4_formula','field_60c0747253145'),(15537,1413,'s2-list_4_size','- 80 мг/л'),(15538,1413,'_s2-list_4_size','field_60c0749553146'),(15539,1413,'s2-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(15540,1413,'_s2-list_4_text','field_60c0749d53147'),(15541,1413,'s2-list_5_ttl','Хлор'),(15542,1413,'_s2-list_5_ttl','field_60c0745253144'),(15543,1413,'s2-list_5_formula','Cl<sup>-</sup>'),(15544,1413,'_s2-list_5_formula','field_60c0747253145'),(15545,1413,'s2-list_5_size','- 2000 мг/л'),(15546,1413,'_s2-list_5_size','field_60c0749553146'),(15547,1413,'s2-list_5_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(15548,1413,'_s2-list_5_text','field_60c0749d53147'),(15549,1413,'s2-list_6_ttl','Калий'),(15550,1413,'_s2-list_6_ttl','field_60c0745253144'),(15551,1413,'s2-list_6_formula','K<sup>+</sup>'),(15552,1413,'_s2-list_6_formula','field_60c0747253145'),(15553,1413,'s2-list_6_size','- 220 мг/л'),(15554,1413,'_s2-list_6_size','field_60c0749553146'),(15555,1413,'s2-list_6_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(15556,1413,'_s2-list_6_text','field_60c0749d53147'),(15557,1413,'s2-list_7_ttl','Кальций'),(15558,1413,'_s2-list_7_ttl','field_60c0745253144'),(15559,1413,'s2-list_7_formula','Ca<sup>2+</sup>'),(15560,1413,'_s2-list_7_formula','field_60c0747253145'),(15561,1413,'s2-list_7_size','- 80 мг/л'),(15562,1413,'_s2-list_7_size','field_60c0749553146'),(15563,1413,'s2-list_7_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(15564,1413,'_s2-list_7_text','field_60c0749d53147'),(15565,1413,'s2-list_8_ttl','Гидрокарбонатлар '),(15566,1413,'_s2-list_8_ttl','field_60c0745253144'),(15567,1413,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(15568,1413,'_s2-list_8_formula','field_60c0747253145'),(15569,1413,'s2-list_8_size','- 200-400 мг/л'),(15570,1413,'_s2-list_8_size','field_60c0749553146'),(15571,1413,'s2-list_8_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(15572,1413,'_s2-list_8_text','field_60c0749d53147'),(15573,1413,'_wpml_media_featured','1'),(15574,1413,'_wpml_media_duplicate','1'),(15580,1413,'_edit_last','1'),(15576,1414,'_wp_attachment_metadata',''),(15577,1414,'_wp_attached_file','2021/06/symptoms-icon-1.svg'),(15578,1414,'wpml_media_processed','1'),(15579,1413,'_edit_lock','1640082463:1'),(15581,1415,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(15582,1415,'_s1-text','field_60c069d69838b'),(15583,1415,'s3-list','5'),(15584,1415,'_s3-list','field_60c06d9298394'),(15585,1415,'s3-list2','3'),(15586,1415,'_s3-list2','field_60c06dd498396'),(15587,1415,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(15588,1415,'_s4-ttl','field_60c06ba39838e'),(15589,1415,'s4-list','7'),(15590,1415,'_s4-list','field_60c06bb39838f'),(15591,1415,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(15592,1415,'_s4-slogan','field_60c06d6d98392'),(15593,1415,'s4-list_0_icon','127'),(15594,1415,'_s4-list_0_icon','field_60c06bc298390'),(15595,1415,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(15596,1415,'_s4-list_0_text','field_60c06bce98391'),(15597,1415,'s4-list_1_icon','128'),(15598,1415,'_s4-list_1_icon','field_60c06bc298390'),(15599,1415,'s4-list_1_text','<strong>головокружение</strong>'),(15600,1415,'_s4-list_1_text','field_60c06bce98391'),(15601,1415,'s4-list_2_icon','68'),(15602,1415,'_s4-list_2_icon','field_60c06bc298390'),(15603,1415,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(15604,1415,'_s4-list_2_text','field_60c06bce98391'),(15605,1415,'s4-list_3_icon','64'),(15606,1415,'_s4-list_3_icon','field_60c06bc298390'),(15607,1415,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(15608,1415,'_s4-list_3_text','field_60c06bce98391'),(15609,1415,'s4-list_4_icon','129'),(15610,1415,'_s4-list_4_icon','field_60c06bc298390'),(15611,1415,'s4-list_4_text','<strong>диарея</strong>'),(15612,1415,'_s4-list_4_text','field_60c06bce98391'),(15613,1415,'s4-list_5_icon','130'),(15614,1415,'_s4-list_5_icon','field_60c06bc298390'),(15615,1415,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(15616,1415,'_s4-list_5_text','field_60c06bce98391'),(15617,1415,'s4-list_6_icon','131'),(15618,1415,'_s4-list_6_icon','field_60c06bc298390'),(15619,1415,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(15620,1415,'_s4-list_6_text','field_60c06bce98391'),(15621,1415,'s3-list_0_li','имеет сбалансированный<br /> состав'),(15622,1415,'_s3-list_0_li','field_60c06db098395'),(15623,1415,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(15624,1415,'_s3-list_1_li','field_60c06db098395'),(15625,1415,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(15626,1415,'_s3-list_2_li','field_60c06db098395'),(15627,1415,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(15628,1415,'_s3-list_3_li','field_60c06db098395'),(15629,1415,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(15630,1415,'_s3-list_4_li','field_60c06db098395'),(15631,1415,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(15632,1415,'_s3-list2_0_li','field_60c06dd498397'),(15633,1415,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(15634,1415,'_s3-list2_1_li','field_60c06dd498397'),(15635,1415,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(15636,1415,'_s3-list2_2_li','field_60c06dd498397'),(15637,1415,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(15638,1415,'_s2-list_3_text','field_60c0749d53147'),(15639,1415,'s2-list_3_size','- 900 мл/г'),(15640,1415,'_s2-list_3_size','field_60c0749553146'),(15641,1415,'s2-list_3_formula','Na<sup>+</sup>'),(15642,1415,'_s2-list_3_formula','field_60c0747253145'),(15643,1415,'s2-list_3_ttl','Натрий'),(15644,1415,'_s2-list_3_ttl','field_60c0745253144'),(15645,1415,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(15646,1415,'_s2-list_2_text','field_60c0749d53147'),(15647,1415,'s2-list_2_size','до 900 мл/г'),(15648,1415,'_s2-list_2_size','field_60c0749553146'),(15649,1415,'s2-list_2_formula','Сорбитол'),(15650,1415,'_s2-list_2_formula','field_60c0747253145'),(15651,1415,'s2-list_2_ttl','Сорбитол'),(15652,1415,'_s2-list_2_ttl','field_60c0745253144'),(15653,1415,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(15654,1415,'_s2-list_1_text','field_60c0749d53147'),(15655,1415,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(15656,1415,'_s2-list_1_size','field_60c0749553146'),(15657,1415,'s2-list_1_formula','Минерализация'),(15658,1415,'_s2-list_1_formula','field_60c0747253145'),(15659,1415,'s2-list_1_ttl','Минерализация'),(15660,1415,'_s2-list_1_ttl','field_60c0745253144'),(15661,1415,'s2-list_0_ttl','Углекислота'),(15662,1415,'_s2-list_0_ttl','field_60c0745253144'),(15663,1415,'s2-list_0_formula','Углекислота'),(15664,1415,'_s2-list_0_formula','field_60c0747253145'),(15665,1415,'s2-list_0_size','- 0,05-0,3%'),(15666,1415,'_s2-list_0_size','field_60c0749553146'),(15667,1415,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(15668,1415,'_s2-list_0_text','field_60c0749d53147'),(15669,1415,'s2-list','9'),(15670,1415,'_s2-list','field_60c0743a53143'),(15671,1415,'s2-list_4_ttl','Магний'),(15672,1415,'_s2-list_4_ttl','field_60c0745253144'),(15673,1415,'s2-list_4_formula','Mg<sup>2+</sup>'),(15674,1415,'_s2-list_4_formula','field_60c0747253145'),(15675,1415,'s2-list_4_size','- 50 мл/г'),(15676,1415,'_s2-list_4_size','field_60c0749553146'),(15677,1415,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(15678,1415,'_s2-list_4_text','field_60c0749d53147'),(15679,1415,'s2-list_5_ttl','Хлор'),(15680,1415,'_s2-list_5_ttl','field_60c0745253144'),(15681,1415,'s2-list_5_formula','Cl<sup>-</sup>'),(15682,1415,'_s2-list_5_formula','field_60c0747253145'),(15683,1415,'s2-list_5_size','- 600 мл/г'),(15684,1415,'_s2-list_5_size','field_60c0749553146'),(15685,1415,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(15686,1415,'_s2-list_5_text','field_60c0749d53147'),(15687,1415,'s2-list_6_ttl','Калий'),(15688,1415,'_s2-list_6_ttl','field_60c0745253144'),(15689,1415,'s2-list_6_formula','K<sup>+</sup>'),(15690,1415,'_s2-list_6_formula','field_60c0747253145'),(15691,1415,'s2-list_6_size','- 160 мл/г'),(15692,1415,'_s2-list_6_size','field_60c0749553146'),(15693,1415,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(15694,1415,'_s2-list_6_text','field_60c0749d53147'),(15695,1415,'s2-list_7_ttl','Кальций'),(15696,1415,'_s2-list_7_ttl','field_60c0745253144'),(15697,1415,'s2-list_7_formula','Ca<sup>2+</sup>'),(15698,1415,'_s2-list_7_formula','field_60c0747253145'),(15699,1415,'s2-list_7_size','- 50 мл/г'),(15700,1415,'_s2-list_7_size','field_60c0749553146'),(15701,1415,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(15702,1415,'_s2-list_7_text','field_60c0749d53147'),(15703,1415,'s2-list_8_ttl','Гидрокарбонаты'),(15704,1415,'_s2-list_8_ttl','field_60c0745253144'),(15705,1415,'s2-list_8_formula','HCO<sup>3+</sup>'),(15706,1415,'_s2-list_8_formula','field_60c0747253145'),(15707,1415,'s2-list_8_size','- 300 мл/г'),(15708,1415,'_s2-list_8_size','field_60c0749553146'),(15709,1415,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. 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Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(16416,1556,'_s4-notes','field_60bf7ca31f58d'),(16417,1556,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(16418,1556,'_s5-video','field_60bf7ccfa01a5'),(16419,1556,'s6-ttl','Оддий сув етарли бўлмаганда!'),(16420,1556,'_s6-ttl','field_60bf7cfb10d31'),(16421,1556,'s6-list','6'),(16422,1556,'_s6-list','field_60bf7d0410d32'),(16423,1556,'s6-list_0_icon','92'),(16424,1556,'_s6-list_0_icon','field_60bf7d1810d33'),(16425,1556,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(16426,1556,'_s6-list_0_text','field_60bf7d2710d34'),(16427,1556,'s6-list_1_icon','93'),(16428,1556,'_s6-list_1_icon','field_60bf7d1810d33'),(16429,1556,'s6-list_1_text','Овқатдан заҳарланишларда'),(16430,1556,'_s6-list_1_text','field_60bf7d2710d34'),(16431,1556,'s6-list_2_icon','94'),(16432,1556,'_s6-list_2_icon','field_60bf7d1810d33'),(16433,1556,'s6-list_2_text','Ичак инфекцияларида'),(16434,1556,'_s6-list_2_text','field_60bf7d2710d34'),(16435,1556,'s6-list_3_icon','95'),(16436,1556,'_s6-list_3_icon','field_60bf7d1810d33'),(16437,1556,'s6-list_3_text','Ҳомиладорлик вақтида'),(16438,1556,'_s6-list_3_text','field_60bf7d2710d34'),(16439,1556,'s6-list_4_icon','96'),(16440,1556,'_s6-list_4_icon','field_60bf7d1810d33'),(16441,1556,'s6-list_4_text','Спорт билан шуғулланганда '),(16442,1556,'_s6-list_4_text','field_60bf7d2710d34'),(16443,1556,'s6-list_5_icon','97'),(16444,1556,'_s6-list_5_icon','field_60bf7d1810d33'),(16445,1556,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(16446,1556,'_s6-list_5_text','field_60bf7d2710d34'),(16447,1556,'s4-list_0_ttl','Натрий'),(16448,1556,'_s4-list_0_ttl','field_60bf7fa95a92c'),(16449,1556,'s4-list_0_formula','Na<sup>+</sup>'),(16450,1556,'_s4-list_0_formula','field_60bf7fc65a92d'),(16451,1556,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(16452,1556,'_s4-list_0_text','field_60bf7fd35a92e'),(16453,1556,'s4-list_1_ttl','Сув'),(16454,1556,'_s4-list_1_ttl','field_60bf7fa95a92c'),(16455,1556,'s4-list_1_formula','H<sub>2</sub>O'),(16456,1556,'_s4-list_1_formula','field_60bf7fc65a92d'),(16457,1556,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(16458,1556,'_s4-list_1_text','field_60bf7fd35a92e'),(16459,1556,'s4-list','9'),(16460,1556,'_s4-list','field_60bf7f985a92b'),(16461,1556,'s4-list_2_ttl','Калий'),(16462,1556,'_s4-list_2_ttl','field_60bf7fa95a92c'),(16463,1556,'s4-list_2_formula','K<sup>+</sup>'),(16464,1556,'_s4-list_2_formula','field_60bf7fc65a92d'),(16465,1556,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(16466,1556,'_s4-list_2_text','field_60bf7fd35a92e'),(16467,1556,'s4-list_3_ttl','Гидрокарбонатлар '),(16468,1556,'_s4-list_3_ttl','field_60bf7fa95a92c'),(16469,1556,'s4-list_3_formula','HCO<sup>3+</sup>'),(16470,1556,'_s4-list_3_formula','field_60bf7fc65a92d'),(16471,1556,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(16472,1556,'_s4-list_3_text','field_60bf7fd35a92e'),(16473,1556,'s4-list_4_ttl','Магний'),(16474,1556,'_s4-list_4_ttl','field_60bf7fa95a92c'),(16475,1556,'s4-list_4_formula','Mg<sup>2+</sup>'),(16476,1556,'_s4-list_4_formula','field_60bf7fc65a92d'),(16477,1556,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(16478,1556,'_s4-list_4_text','field_60bf7fd35a92e'),(16479,1556,'s4-list_5_ttl','Углекислый газ'),(16480,1556,'_s4-list_5_ttl','field_60bf7fa95a92c'),(16481,1556,'s4-list_5_formula','CO<sup>2</sup>+'),(16482,1556,'_s4-list_5_formula','field_60bf7fc65a92d'),(16483,1556,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(16484,1556,'_s4-list_5_text','field_60bf7fd35a92e'),(16485,1556,'s4-list_6_ttl','Кальций'),(16486,1556,'_s4-list_6_ttl','field_60bf7fa95a92c'),(16487,1556,'s4-list_6_formula','Ca<sup>2+</sup>'),(16488,1556,'_s4-list_6_formula','field_60bf7fc65a92d'),(16489,1556,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(16490,1556,'_s4-list_6_text','field_60bf7fd35a92e'),(16491,1556,'s4-list_7_ttl','Сорбитол'),(16492,1556,'_s4-list_7_ttl','field_60bf7fa95a92c'),(16493,1556,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(16494,1556,'_s4-list_7_formula','field_60bf7fc65a92d'),(16495,1556,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(16496,1556,'_s4-list_7_text','field_60bf7fd35a92e'),(16497,1556,'s4-list_8_ttl','Хлор'),(16498,1556,'_s4-list_8_ttl','field_60bf7fa95a92c'),(16499,1556,'s4-list_8_formula','Cl'),(16500,1556,'_s4-list_8_formula','field_60bf7fc65a92d'),(16501,1556,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(16502,1556,'_s4-list_8_text','field_60bf7fd35a92e'),(16503,1556,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(16504,1556,'_s4-feature1','field_60bf80ca480ea'),(16505,1556,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(16506,1556,'_s4-feature2','field_60bf80de480eb'),(16507,1556,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(16508,1556,'_s4-feature3','field_60bf80e2480ec'),(16509,1556,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(16510,1556,'_s4-feature4','field_60bf80e5480ed'),(16511,1556,'s2-list_0_link',''),(16512,1556,'_s2-list_0_link','field_60ee90d381a4e'),(16513,1556,'s2-list_1_link',''),(16514,1556,'_s2-list_1_link','field_60ee90d381a4e'),(16515,1556,'s2-list_2_link',''),(16516,1556,'_s2-list_2_link','field_60ee90d381a4e'),(16517,1556,'s2-list_3_link',''),(16518,1556,'_s2-list_3_link','field_60ee90d381a4e'),(16519,1556,'s2-list_4_link',''),(16520,1556,'_s2-list_4_link','field_60ee90d381a4e'),(16521,1556,'s2-list_5_link',''),(16522,1556,'_s2-list_5_link','field_60ee90d381a4e'),(16523,1556,'s6-list_0_link',''),(16524,1556,'_s6-list_0_link','field_60ee916b04ace'),(16525,1556,'s6-list_1_link',''),(16526,1556,'_s6-list_1_link','field_60ee916b04ace'),(16527,1556,'s6-list_2_link',''),(16528,1556,'_s6-list_2_link','field_60ee916b04ace'),(16529,1556,'s6-list_3_link',''),(16530,1556,'_s6-list_3_link','field_60ee916b04ace'),(16531,1556,'s6-list_4_link',''),(16532,1556,'_s6-list_4_link','field_60ee916b04ace'),(16533,1556,'s6-list_5_link',''),(16534,1556,'_s6-list_5_link','field_60ee916b04ace'),(16535,1556,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(16536,1556,'_slider_0_webplink','field_60fa70c989e88'),(16537,1556,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(16538,1556,'_slider_1_webplink','field_60fa70c989e88'),(16539,1556,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(16540,1556,'_slider_2_webplink','field_60fa70c989e88'),(16541,1556,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(16542,1556,'_slider_3_webplink','field_60fa70c989e88'),(16543,1556,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(16544,1556,'_slider_4_webplink','field_60fa70c989e88'),(16545,1556,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(16546,1556,'_slider_5_webplink','field_60fa70c989e88'),(16547,1556,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(16548,1556,'_slider_6_webplink','field_60fa70c989e88'),(16549,1556,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(16550,1556,'_slider_7_webplink','field_60fa70c989e88'),(16551,1557,'fb','https://www.facebook.com/reo.ua/'),(16552,1557,'_fb','field_60c9db2f4e024'),(16553,1557,'inst','https://www.instagram.com/explore/tags/reowater/'),(16554,1557,'_inst','field_60c9db364e025'),(16555,1557,'adress','Тошкент шаҳри, Миробод тумани, Нукус кўчаси, 71-уй'),(16556,1557,'_adress','field_60cb20d1cbf7c'),(16557,1557,'tel','+998 78 150-71-00'),(16558,1557,'_tel','field_60cb2128cbf7d'),(16559,1557,'email','uf@uf.ua'),(16560,1557,'_email','field_60cb2131cbf7e'),(16561,1557,'site','www.uf.ua'),(16562,1557,'_site','field_60cb213acbf7f'),(16563,1558,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(16564,1558,'_s1-text','field_60c069d69838b'),(16565,1558,'s3-list','5'),(16566,1558,'_s3-list','field_60c06d9298394'),(16567,1558,'s3-list2','3'),(16568,1558,'_s3-list2','field_60c06dd498396'),(16569,1558,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(16570,1558,'_s4-ttl','field_60c06ba39838e'),(16571,1558,'s4-list','7'),(16572,1558,'_s4-list','field_60c06bb39838f'),(16573,1558,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(16574,1558,'_s4-slogan','field_60c06d6d98392'),(16575,1558,'s4-list_0_icon','127'),(16576,1558,'_s4-list_0_icon','field_60c06bc298390'),(16577,1558,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(16578,1558,'_s4-list_0_text','field_60c06bce98391'),(16579,1558,'s4-list_1_icon','128'),(16580,1558,'_s4-list_1_icon','field_60c06bc298390'),(16581,1558,'s4-list_1_text','<strong>головокружение</strong>'),(16582,1558,'_s4-list_1_text','field_60c06bce98391'),(16583,1558,'s4-list_2_icon','68'),(16584,1558,'_s4-list_2_icon','field_60c06bc298390'),(16585,1558,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(16586,1558,'_s4-list_2_text','field_60c06bce98391'),(16587,1558,'s4-list_3_icon','64'),(16588,1558,'_s4-list_3_icon','field_60c06bc298390'),(16589,1558,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(16590,1558,'_s4-list_3_text','field_60c06bce98391'),(16591,1558,'s4-list_4_icon','129'),(16592,1558,'_s4-list_4_icon','field_60c06bc298390'),(16593,1558,'s4-list_4_text','<strong>диарея</strong>'),(16594,1558,'_s4-list_4_text','field_60c06bce98391'),(16595,1558,'s4-list_5_icon','130'),(16596,1558,'_s4-list_5_icon','field_60c06bc298390'),(16597,1558,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(16598,1558,'_s4-list_5_text','field_60c06bce98391'),(16599,1558,'s4-list_6_icon','131'),(16600,1558,'_s4-list_6_icon','field_60c06bc298390'),(16601,1558,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(16602,1558,'_s4-list_6_text','field_60c06bce98391'),(16603,1558,'s3-list_0_li','имеет сбалансированный<br /> состав'),(16604,1558,'_s3-list_0_li','field_60c06db098395'),(16605,1558,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(16606,1558,'_s3-list_1_li','field_60c06db098395'),(16607,1558,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(16608,1558,'_s3-list_2_li','field_60c06db098395'),(16609,1558,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(16610,1558,'_s3-list_3_li','field_60c06db098395'),(16611,1558,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(16612,1558,'_s3-list_4_li','field_60c06db098395'),(16613,1558,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(16614,1558,'_s3-list2_0_li','field_60c06dd498397'),(16615,1558,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(16616,1558,'_s3-list2_1_li','field_60c06dd498397'),(16617,1558,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(16618,1558,'_s3-list2_2_li','field_60c06dd498397'),(16619,1558,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(16620,1558,'_s2-list_3_text','field_60c0749d53147'),(16621,1558,'s2-list_3_size','- 900 мл/г'),(16622,1558,'_s2-list_3_size','field_60c0749553146'),(16623,1558,'s2-list_3_formula','Na<sup>+</sup>'),(16624,1558,'_s2-list_3_formula','field_60c0747253145'),(16625,1558,'s2-list_3_ttl','Натрий'),(16626,1558,'_s2-list_3_ttl','field_60c0745253144'),(16627,1558,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(16628,1558,'_s2-list_2_text','field_60c0749d53147'),(16629,1558,'s2-list_2_size','до 900 мл/г'),(16630,1558,'_s2-list_2_size','field_60c0749553146'),(16631,1558,'s2-list_2_formula','Сорбитол'),(16632,1558,'_s2-list_2_formula','field_60c0747253145'),(16633,1558,'s2-list_2_ttl','Сорбитол'),(16634,1558,'_s2-list_2_ttl','field_60c0745253144'),(16635,1558,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(16636,1558,'_s2-list_1_text','field_60c0749d53147'),(16637,1558,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(16638,1558,'_s2-list_1_size','field_60c0749553146'),(16639,1558,'s2-list_1_formula','Минерализация'),(16640,1558,'_s2-list_1_formula','field_60c0747253145'),(16641,1558,'s2-list_1_ttl','Минерализация'),(16642,1558,'_s2-list_1_ttl','field_60c0745253144'),(16643,1558,'s2-list_0_ttl','Углекислота'),(16644,1558,'_s2-list_0_ttl','field_60c0745253144'),(16645,1558,'s2-list_0_formula','Углекислота'),(16646,1558,'_s2-list_0_formula','field_60c0747253145'),(16647,1558,'s2-list_0_size','- 0,05-0,3%'),(16648,1558,'_s2-list_0_size','field_60c0749553146'),(16649,1558,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(16650,1558,'_s2-list_0_text','field_60c0749d53147'),(16651,1558,'s2-list','9'),(16652,1558,'_s2-list','field_60c0743a53143'),(16653,1558,'s2-list_4_ttl','Магний'),(16654,1558,'_s2-list_4_ttl','field_60c0745253144'),(16655,1558,'s2-list_4_formula','Mg<sup>2+</sup>'),(16656,1558,'_s2-list_4_formula','field_60c0747253145'),(16657,1558,'s2-list_4_size','- 50 мл/г'),(16658,1558,'_s2-list_4_size','field_60c0749553146'),(16659,1558,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(16660,1558,'_s2-list_4_text','field_60c0749d53147'),(16661,1558,'s2-list_5_ttl','Хлор'),(16662,1558,'_s2-list_5_ttl','field_60c0745253144'),(16663,1558,'s2-list_5_formula','Cl<sup>-</sup>'),(16664,1558,'_s2-list_5_formula','field_60c0747253145'),(16665,1558,'s2-list_5_size','- 600 мл/г'),(16666,1558,'_s2-list_5_size','field_60c0749553146'),(16667,1558,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(16668,1558,'_s2-list_5_text','field_60c0749d53147'),(16669,1558,'s2-list_6_ttl','Калий'),(16670,1558,'_s2-list_6_ttl','field_60c0745253144'),(16671,1558,'s2-list_6_formula','K<sup>+</sup>'),(16672,1558,'_s2-list_6_formula','field_60c0747253145'),(16673,1558,'s2-list_6_size','- 160 мл/г'),(16674,1558,'_s2-list_6_size','field_60c0749553146'),(16675,1558,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(16676,1558,'_s2-list_6_text','field_60c0749d53147'),(16677,1558,'s2-list_7_ttl','Кальций'),(16678,1558,'_s2-list_7_ttl','field_60c0745253144'),(16679,1558,'s2-list_7_formula','Ca<sup>2+</sup>'),(16680,1558,'_s2-list_7_formula','field_60c0747253145'),(16681,1558,'s2-list_7_size','- 50 мл/г'),(16682,1558,'_s2-list_7_size','field_60c0749553146'),(16683,1558,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(16684,1558,'_s2-list_7_text','field_60c0749d53147'),(16685,1558,'s2-list_8_ttl','Гидрокарбонаты'),(16686,1558,'_s2-list_8_ttl','field_60c0745253144'),(16687,1558,'s2-list_8_formula','HCO<sup>3+</sup>'),(16688,1558,'_s2-list_8_formula','field_60c0747253145'),(16689,1558,'s2-list_8_size','- 300 мл/г'),(16690,1558,'_s2-list_8_size','field_60c0749553146'),(16691,1558,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(16692,1558,'_s2-list_8_text','field_60c0749d53147'),(17350,1588,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(16693,1559,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(16694,1559,'_s1-text','field_60c069d69838b'),(16695,1559,'s3-list','5'),(16696,1559,'_s3-list','field_60c06d9298394'),(16697,1559,'s3-list2','3'),(16698,1559,'_s3-list2','field_60c06dd498396'),(16699,1559,'s4-ttl','Вода ReO суви дегидратация ва интоксикация белгиларини камайтиради'),(16700,1559,'_s4-ttl','field_60c06ba39838e'),(16701,1559,'s4-list','7'),(16702,1559,'_s4-list','field_60c06bb39838f'),(16703,1559,'s4-slogan','ReO сув-туз мувозанатини тиклайди ва умумий аҳволни яхшилайди'),(16704,1559,'_s4-slogan','field_60c06d6d98392'),(16705,1559,'s4-list_0_icon','127'),(16706,1559,'_s4-list_0_icon','field_60c06bc298390'),(16707,1559,'s4-list_0_text','<strong>Тана ҳарорати</strong> кўтарилиши ва/ёки'),(16708,1559,'_s4-list_0_text','field_60c06bce98391'),(16709,1559,'s4-list_1_icon','128'),(16710,1559,'_s4-list_1_icon','field_60c06bc298390'),(16711,1559,'s4-list_1_text','<strong>бош айланиши</strong>'),(16712,1559,'_s4-list_1_text','field_60c06bce98391'),(16713,1559,'s4-list_2_icon','68'),(16714,1559,'_s4-list_2_icon','field_60c06bc298390'),(16715,1559,'s4-list_2_text','<strong>кўнгил айниши,</strong>\r\nқайт қилиш\r\nва/ёки'),(16716,1559,'_s4-list_2_text','field_60c06bce98391'),(16717,1559,'s4-list_3_icon','64'),(16718,1559,'_s4-list_3_icon','field_60c06bc298390'),(16719,1559,'s4-list_3_text','умумий\r\n<strong>ҳолсизлик</strong>'),(16720,1559,'_s4-list_3_text','field_60c06bce98391'),(16721,1559,'s4-list_4_icon','129'),(16722,1559,'_s4-list_4_icon','field_60c06bc298390'),(16723,1559,'s4-list_4_text','<strong>ич кетиши</strong>'),(16724,1559,'_s4-list_4_text','field_60c06bce98391'),(16725,1559,'s4-list_5_icon','130'),(16726,1559,'_s4-list_5_icon','field_60c06bc298390'),(16727,1559,'s4-list_5_text','қуриши\r\n<strong>оғиз</strong>'),(16728,1559,'_s4-list_5_text','field_60c06bce98391'),(16729,1559,'s4-list_6_icon','131'),(16730,1559,'_s4-list_6_icon','field_60c06bc298390'),(16731,1559,'s4-list_6_text','<strong>бош</strong>\r\nоғриғи'),(16732,1559,'_s4-list_6_text','field_60c06bce98391'),(16733,1559,'s3-list_0_li','мувозанатлаштирилган таркибга эга'),(16734,1559,'_s3-list_0_li','field_60c06db098395'),(16735,1559,'s3-list_1_li','таркибида қўшимча энергия манбаи – сорбитол бор'),(16736,1559,'_s3-list_1_li','field_60c06db098395'),(16737,1559,'s3-list_2_li','сув ва электролитларни тез сўрилишини таъминлайди'),(16738,1559,'_s3-list_2_li','field_60c06db098395'),(16739,1559,'s3-list_3_li','ёқимли таъмга эга бўлиб, ҳатто кўнгил айниганда ҳам осон ичилади '),(16740,1559,'_s3-list_3_li','field_60c06db098395'),(16741,1559,'s3-list_4_li','консервант, бўёқлар ва углеводларсиз'),(16742,1559,'_s3-list_4_li','field_60c06db098395'),(16743,1559,'s3-list2_0_li','Сувсизланиш белгиларини бартараф этади'),(16744,1559,'_s3-list2_0_li','field_60c06dd498397'),(16745,1559,'s3-list2_1_li','Диурезни нормаллаштиради, интоксикацияни камайтиради'),(16746,1559,'_s3-list2_1_li','field_60c06dd498397'),(16747,1559,'s3-list2_2_li','Стационарда даволаниш вақтида ва уйга чиққандан сўнг сув-электролит мувозанатини тиклашга ёрдам беради'),(16748,1559,'_s3-list2_2_li','field_60c06dd498397'),(16749,1559,'s2-list_3_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(16750,1559,'_s2-list_3_text','field_60c0749d53147'),(16751,1559,'s2-list_3_size','- 900 мл/г'),(16752,1559,'_s2-list_3_size','field_60c0749553146'),(16753,1559,'s2-list_3_formula','Na<sup>+</sup>'),(16754,1559,'_s2-list_3_formula','field_60c0747253145'),(16755,1559,'s2-list_3_ttl','Натрий'),(16756,1559,'_s2-list_3_ttl','field_60c0745253144'),(16757,1559,'s2-list_2_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(16758,1559,'_s2-list_2_text','field_60c0749d53147'),(16759,1559,'s2-list_2_size','до 900 мл/г'),(16760,1559,'_s2-list_2_size','field_60c0749553146'),(16761,1559,'s2-list_2_formula','Сорбитол'),(16762,1559,'_s2-list_2_formula','field_60c0747253145'),(16763,1559,'s2-list_2_ttl','Сорбитол'),(16764,1559,'_s2-list_2_ttl','field_60c0745253144'),(16765,1559,'s2-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(16766,1559,'_s2-list_1_text','field_60c0749d53147'),(16767,1559,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(16768,1559,'_s2-list_1_size','field_60c0749553146'),(16769,1559,'s2-list_1_formula','Минерализация'),(16770,1559,'_s2-list_1_formula','field_60c0747253145'),(16771,1559,'s2-list_1_ttl','Минерализация'),(16772,1559,'_s2-list_1_ttl','field_60c0745253144'),(16773,1559,'s2-list_0_ttl','Углекислота'),(16774,1559,'_s2-list_0_ttl','field_60c0745253144'),(16775,1559,'s2-list_0_formula','Углекислота'),(16776,1559,'_s2-list_0_formula','field_60c0747253145'),(16777,1559,'s2-list_0_size','- 0,05-0,3%'),(16778,1559,'_s2-list_0_size','field_60c0749553146'),(16779,1559,'s2-list_0_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(16780,1559,'_s2-list_0_text','field_60c0749d53147'),(16781,1559,'s2-list','9'),(16782,1559,'_s2-list','field_60c0743a53143'),(16783,1559,'s2-list_4_ttl','Магний'),(16784,1559,'_s2-list_4_ttl','field_60c0745253144'),(16785,1559,'s2-list_4_formula','Mg<sup>2+</sup>'),(16786,1559,'_s2-list_4_formula','field_60c0747253145'),(16787,1559,'s2-list_4_size','- 50 мл/г'),(16788,1559,'_s2-list_4_size','field_60c0749553146'),(16789,1559,'s2-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(16790,1559,'_s2-list_4_text','field_60c0749d53147'),(16791,1559,'s2-list_5_ttl','Хлор'),(16792,1559,'_s2-list_5_ttl','field_60c0745253144'),(16793,1559,'s2-list_5_formula','Cl<sup>-</sup>'),(16794,1559,'_s2-list_5_formula','field_60c0747253145'),(16795,1559,'s2-list_5_size','- 600 мл/г'),(16796,1559,'_s2-list_5_size','field_60c0749553146'),(16797,1559,'s2-list_5_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(16798,1559,'_s2-list_5_text','field_60c0749d53147'),(16799,1559,'s2-list_6_ttl','Калий'),(16800,1559,'_s2-list_6_ttl','field_60c0745253144'),(16801,1559,'s2-list_6_formula','K<sup>+</sup>'),(16802,1559,'_s2-list_6_formula','field_60c0747253145'),(16803,1559,'s2-list_6_size','- 160 мл/г'),(16804,1559,'_s2-list_6_size','field_60c0749553146'),(16805,1559,'s2-list_6_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(16806,1559,'_s2-list_6_text','field_60c0749d53147'),(16807,1559,'s2-list_7_ttl','Кальций'),(16808,1559,'_s2-list_7_ttl','field_60c0745253144'),(16809,1559,'s2-list_7_formula','Ca<sup>2+</sup>'),(16810,1559,'_s2-list_7_formula','field_60c0747253145'),(16811,1559,'s2-list_7_size','- 50 мл/г'),(16812,1559,'_s2-list_7_size','field_60c0749553146'),(16813,1559,'s2-list_7_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(16814,1559,'_s2-list_7_text','field_60c0749d53147'),(16815,1559,'s2-list_8_ttl','Гидрокарбонатлар '),(16816,1559,'_s2-list_8_ttl','field_60c0745253144'),(16817,1559,'s2-list_8_formula','HCO<sup>3+</sup>'),(16818,1559,'_s2-list_8_formula','field_60c0747253145'),(16819,1559,'s2-list_8_size','- 300 мл/г'),(16820,1559,'_s2-list_8_size','field_60c0749553146'),(16821,1559,'s2-list_8_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(16822,1559,'_s2-list_8_text','field_60c0749d53147'),(16823,1561,'logos_0_logo','1450'),(16824,1561,'_logos_0_logo','field_60defacd5a9bb'),(16825,1561,'logos_0_link',''),(16826,1561,'_logos_0_link','field_60defad65a9bc'),(16827,1561,'logos_1_logo','1453'),(16828,1561,'_logos_1_logo','field_60defacd5a9bb'),(16829,1561,'logos_1_link',''),(16830,1561,'_logos_1_link','field_60defad65a9bc'),(16831,1561,'logos_2_logo','1456'),(16832,1561,'_logos_2_logo','field_60defacd5a9bb'),(16833,1561,'logos_2_link',''),(16834,1561,'_logos_2_link','field_60defad65a9bc'),(16835,1561,'logos_3_logo','1459'),(16836,1561,'_logos_3_logo','field_60defacd5a9bb'),(16837,1561,'logos_3_link',''),(16838,1561,'_logos_3_link','field_60defad65a9bc'),(16839,1561,'logos_4_logo','1462'),(16840,1561,'_logos_4_logo','field_60defacd5a9bb'),(16841,1561,'logos_4_link',''),(16842,1561,'_logos_4_link','field_60defad65a9bc'),(16843,1561,'logos','5'),(16844,1561,'_logos','field_60defabb5a9ba'),(16845,1562,'sc1-afterlogo','Халқаро ихтисослашган \r\nфармацевтика корпорацияси'),(16846,1562,'_sc1-afterlogo','field_60c85338b3453'),(16847,1562,'sc1-left','инфузион препаратлар ишлаб \r\nчиқариш бўйича тан олинган етакчи'),(16848,1562,'_sc1-left','field_60c85356b3454'),(16849,1562,'sc1-right','Украинада госпитал \r\nсотувлар бўйича етакчи'),(16850,1562,'_sc1-right','field_60c85408b3455'),(16851,1562,'sc2-ttl','«Юрия-Фарм» корпорацияси:'),(16852,1562,'_sc2-ttl','field_60c8556cfdbcb'),(16853,1562,'sc2-round1','<h3>TOП-3</h3>\r\nУкраинадаги энг йирик\r\nфармацевтика маҳсулотлари\r\nишлаб чиқарувчилар\r\nқаторига киради'),(16854,1562,'_sc2-round1','field_60c855a5fdbcc'),(16855,1562,'sc2-round2','<h3>ТОП-10</h3>\r\nУкраина фармацевтика бозорининг\r\nетакчиларига киради'),(16856,1562,'_sc2-round2','field_60c855b6fdbcd'),(16857,1562,'sc2-mission','<strong>Бизнинг вазифамиз</strong> –\r\nодамларни соғломлаштириш ва\r\nдаволаш учун ноёб ечимларни яратиш'),(16858,1562,'_sc2-mission','field_60c855bffdbce'),(16859,1562,'sc2-filosophy','<strong>Бизнинг фалсафамиз</strong>\r\nҲаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(16860,1562,'_sc2-filosophy','field_60c855cafdbcf'),(16861,1562,'sc3-ttl','Бизнинг ишлаб чиқаришимиз тўғрисида қисқа фактлар:'),(16862,1562,'_sc3-ttl','field_60c85818d1bf2'),(16863,1562,'sc3-list_0_icon','232'),(16864,1562,'_sc3-list_0_icon','field_60c85834d1bf4'),(16865,1562,'sc3-list_0_text','<h3><strong>Черкассы</strong>шаҳрида жойлашган</h3>'),(16866,1562,'_sc3-list_0_text','field_60c85852d1bf5'),(16867,1562,'sc3-list_1_icon','234'),(16868,1562,'_sc3-list_1_icon','field_60c85834d1bf4'),(16869,1562,'sc3-list_1_text','<h3>ишлаб чиқариш линиялари сони:\r\n<strong class=\"counter-value\">41</strong>та</h3>'),(16870,1562,'_sc3-list_1_text','field_60c85852d1bf5'),(16871,1562,'sc3-list_2_icon','236'),(16872,1562,'_sc3-list_2_icon','field_60c85834d1bf4'),(16873,1562,'sc3-list_2_text','<h3>дори воситалари:\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(16874,1562,'_sc3-list_2_text','field_60c85852d1bf5'),(16875,1562,'sc3-list_3_icon','238'),(16876,1562,'_sc3-list_3_icon','field_60c85834d1bf4'),(16877,1562,'sc3-list_3_text','<h3>ишлаб чиқариш майдони:\r\n<strong><i class=\"counter-value\">25</i> минг кв. м.</strong></h3>'),(16878,1562,'_sc3-list_3_text','field_60c85852d1bf5'),(16879,1562,'sc3-list_4_icon','240'),(16880,1562,'_sc3-list_4_icon','field_60c85834d1bf4'),(16881,1562,'sc3-list_4_text','<h3>ишлаб чиқариш қуввати:\r\n<strong>йилига <i class=\"counter-value\">290</i> млн</strong>\r\nбирликдан ортиқ маҳсулот</h3>'),(16882,1562,'_sc3-list_4_text','field_60c85852d1bf5'),(16883,1562,'sc3-list_5_icon','242'),(16884,1562,'_sc3-list_5_icon','field_60c85834d1bf4'),(16885,1562,'sc3-list_5_text','<h3>тиббий буюмлар –\r\n<strong>более <i class=\"counter-value\">86</i> млн дан ортиқ</strong></h3>'),(16886,1562,'_sc3-list_5_text','field_60c85852d1bf5'),(16887,1562,'sc3-list','6'),(16888,1562,'_sc3-list','field_60c85827d1bf3'),(16889,1562,'sc4-list_0_num','2500'),(16890,1562,'_sc4-list_0_num','field_60c85bf773ac3'),(16891,1562,'sc4-list_0_text','ходим'),(16892,1562,'_sc4-list_0_text','field_60c85c0173ac4'),(16893,1562,'sc4-list_1_num','160'),(16894,1562,'_sc4-list_1_num','field_60c85bf773ac3'),(16895,1562,'sc4-list_1_text','позиция'),(16896,1562,'_sc4-list_1_text','field_60c85c0173ac4'),(16897,1562,'sc4-list_2_num','20'),(16898,1562,'_sc4-list_2_num','field_60c85bf773ac3'),(16899,1562,'sc4-list_2_text','дунё бўйлаб 20 дан ортиқ мамлакатлар'),(16900,1562,'_sc4-list_2_text','field_60c85c0173ac4'),(16901,1562,'sc4-list','3'),(16902,1562,'_sc4-list','field_60c85be773ac2'),(16903,1562,'sc4-text','<strong>2500 ходимнинг</strong> кундалик меҳнати  <strong>160 позициядан</strong> ортиқ ассортиментдаги маҳсулотни ишлаб чиқариш ва <strong>дунёнинг 20 дан ортиқ мамлакатидаги</strong> даволаш-профилактика муассасаларига етказиб бериш имконини беради. Булар – Украинада ишлаб чиқилган оригинал инфузион препаратлар, антибиотиклар, фунгицид препаратлар, ичиш учун эритмалар, антисептиклар, парентерал овқатланиш учун препаратлар, туберкулез (сил касаллиги)га қарши препаратлар, шприцлар, инфузиялар учун системалар ва кўплаб бошқа препаратлардир.'),(16904,1562,'_sc4-text','field_60c85c0d73ac5'),(16905,1562,'sc5-ttl','Маҳсулотимиз сифатини кафолатлайдиган \r\nхалқаро сертификатлар'),(16906,1562,'_sc5-ttl','field_60c85c2b73ac7'),(16907,1562,'sc5-list','2'),(16908,1562,'_sc5-list','field_60c85c6373ac8'),(16909,1562,'sc6-text','<h2><strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nбирликдан ортиқ маҳсулот</h2>\r\nҳар йили ўн минглаб врачларни одамларни даволаш ва соғломлаштириш учун самарали воситалар билан таъминлайди. Уларга яқинроқ бўлиш учун биз ўз дистрибьюция хизматимизни яратдик. Ҳар куни бутун Ўзбекистон бўйлаб омборлардан минглаб тонна инфузион препаратлар ва тиббий мақсадларга мўлжалланган буюмлар жўнатилади, бу врачларга юз минглаб ҳаётни қутқариш имконини беради.'),(16910,1562,'_sc6-text','field_60c85cad73acc'),(16911,1562,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(16912,1562,'_sc7-video','field_60c85cca73ace'),(16913,1562,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(16914,1562,'_sc7-text','field_60c85ce173acf'),(16915,1562,'sc7-textborder','Ҳаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(16916,1562,'_sc7-textborder','field_60c85cea73ad0'),(16917,1562,'sc5-list_0_logo','262'),(16918,1562,'_sc5-list_0_logo','field_60c85c6f73ac9'),(16919,1562,'sc5-list_0_text','Украина GMP, EU GMP, Кения GMP –\r\nТегишли ишлаб чиқариш амалиёти'),(16920,1562,'_sc5-list_0_text','field_60c85c7e73aca'),(16921,1562,'sc5-list_1_logo','264'),(16922,1562,'_sc5-list_1_logo','field_60c85c6f73ac9'),(16923,1562,'sc5-list_1_text','ISO 9001:2009 – фармацевтика маҳсулотини \r\nишлаб чиқариш ва улгуржи сотиш'),(16924,1562,'_sc5-list_1_text','field_60c85c7e73aca'),(16925,1562,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(16926,1562,'_sc6-ttl','field_60c85f2f52aa8'),(16927,1562,'sc7-ttl','Биз ҳақимизда кўпроқ билиш учун қисқа видео:'),(16928,1562,'_sc7-ttl','field_60c860b4429a2'),(16929,1563,'sc1-afterlogo','Халқаро ихтисослашган \r\nфармацевтика корпорацияси'),(16930,1563,'_sc1-afterlogo','field_60c85338b3453'),(16931,1563,'sc1-left','инфузион препаратлар ишлаб \r\nчиқариш бўйича тан олинган етакчи'),(16932,1563,'_sc1-left','field_60c85356b3454'),(16933,1563,'sc1-right','Украинада госпитал \r\nсотувлар бўйича етакчи'),(16934,1563,'_sc1-right','field_60c85408b3455'),(16935,1563,'sc2-ttl','«Юрия-Фарм» корпорацияси:'),(16936,1563,'_sc2-ttl','field_60c8556cfdbcb'),(16937,1563,'sc2-round1','<h3>TOП-3</h3>\r\nУкраинадаги энг йирик\r\nфармацевтика маҳсулотлари\r\nишлаб чиқарувчилар\r\nқаторига киради'),(16938,1563,'_sc2-round1','field_60c855a5fdbcc'),(16939,1563,'sc2-round2','<h3>ТОП-10</h3>\r\nУкраина фармацевтика бозорининг\r\nетакчиларига киради'),(16940,1563,'_sc2-round2','field_60c855b6fdbcd'),(16941,1563,'sc2-mission','<strong>Бизнинг вазифамиз</strong> –\r\nодамларни соғломлаштириш ва\r\nдаволаш учун ноёб ечимларни яратиш'),(16942,1563,'_sc2-mission','field_60c855bffdbce'),(16943,1563,'sc2-filosophy','<strong>Бизнинг фалсафамиз</strong>\r\nҲаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(16944,1563,'_sc2-filosophy','field_60c855cafdbcf'),(16945,1563,'sc3-ttl','Бизнинг ишлаб чиқаришимиз тўғрисида қисқа фактлар:'),(16946,1563,'_sc3-ttl','field_60c85818d1bf2'),(16947,1563,'sc3-list_0_icon','232'),(16948,1563,'_sc3-list_0_icon','field_60c85834d1bf4'),(16949,1563,'sc3-list_0_text','<h3><strong>Черкассы</strong>\r\nшаҳрида жойлашган</h3>'),(16950,1563,'_sc3-list_0_text','field_60c85852d1bf5'),(16951,1563,'sc3-list_1_icon','234'),(16952,1563,'_sc3-list_1_icon','field_60c85834d1bf4'),(16953,1563,'sc3-list_1_text','<h3>ишлаб чиқариш линиялари сони:\r\n<strong class=\"counter-value\">41</strong>та</h3>'),(16954,1563,'_sc3-list_1_text','field_60c85852d1bf5'),(16955,1563,'sc3-list_2_icon','236'),(16956,1563,'_sc3-list_2_icon','field_60c85834d1bf4'),(16957,1563,'sc3-list_2_text','<h3>дори воситалари:\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(16958,1563,'_sc3-list_2_text','field_60c85852d1bf5'),(16959,1563,'sc3-list_3_icon','238'),(16960,1563,'_sc3-list_3_icon','field_60c85834d1bf4'),(16961,1563,'sc3-list_3_text','<h3>ишлаб чиқариш майдони:\r\n<strong><i class=\"counter-value\">25</i> минг кв. м.</strong></h3>'),(16962,1563,'_sc3-list_3_text','field_60c85852d1bf5'),(16963,1563,'sc3-list_4_icon','240'),(16964,1563,'_sc3-list_4_icon','field_60c85834d1bf4'),(16965,1563,'sc3-list_4_text','<h3>ишлаб чиқариш қуввати:\r\n<strong>йилига <i class=\"counter-value\">290</i> млн</strong>\r\nбирликдан ортиқ маҳсулот</h3>'),(16966,1563,'_sc3-list_4_text','field_60c85852d1bf5'),(16967,1563,'sc3-list_5_icon','242'),(16968,1563,'_sc3-list_5_icon','field_60c85834d1bf4'),(16969,1563,'sc3-list_5_text','<h3>тиббий буюмлар –\r\n<strong>более <i class=\"counter-value\">86</i> млн дан ортиқ</strong></h3>'),(16970,1563,'_sc3-list_5_text','field_60c85852d1bf5'),(16971,1563,'sc3-list','6'),(16972,1563,'_sc3-list','field_60c85827d1bf3'),(16973,1563,'sc4-list_0_num','2500'),(16974,1563,'_sc4-list_0_num','field_60c85bf773ac3'),(16975,1563,'sc4-list_0_text','ходим'),(16976,1563,'_sc4-list_0_text','field_60c85c0173ac4'),(16977,1563,'sc4-list_1_num','160'),(16978,1563,'_sc4-list_1_num','field_60c85bf773ac3'),(16979,1563,'sc4-list_1_text','позиция'),(16980,1563,'_sc4-list_1_text','field_60c85c0173ac4'),(16981,1563,'sc4-list_2_num','20'),(16982,1563,'_sc4-list_2_num','field_60c85bf773ac3'),(16983,1563,'sc4-list_2_text','дунё бўйлаб 20 дан ортиқ мамлакатлар'),(16984,1563,'_sc4-list_2_text','field_60c85c0173ac4'),(16985,1563,'sc4-list','3'),(16986,1563,'_sc4-list','field_60c85be773ac2'),(16987,1563,'sc4-text','<strong>2500 ходимнинг</strong> кундалик меҳнати  <strong>160 позициядан</strong> ортиқ ассортиментдаги маҳсулотни ишлаб чиқариш ва <strong>дунёнинг 20 дан ортиқ мамлакатидаги</strong> даволаш-профилактика муассасаларига етказиб бериш имконини беради. Булар – Украинада ишлаб чиқилган оригинал инфузион препаратлар, антибиотиклар, фунгицид препаратлар, ичиш учун эритмалар, антисептиклар, парентерал овқатланиш учун препаратлар, туберкулез (сил касаллиги)га қарши препаратлар, шприцлар, инфузиялар учун системалар ва кўплаб бошқа препаратлардир.'),(16988,1563,'_sc4-text','field_60c85c0d73ac5'),(16989,1563,'sc5-ttl','Маҳсулотимиз сифатини кафолатлайдиган \r\nхалқаро сертификатлар'),(16990,1563,'_sc5-ttl','field_60c85c2b73ac7'),(16991,1563,'sc5-list','2'),(16992,1563,'_sc5-list','field_60c85c6373ac8'),(16993,1563,'sc6-text','<h2><strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nбирликдан ортиқ маҳсулот</h2>\r\nҳар йили ўн минглаб врачларни одамларни даволаш ва соғломлаштириш учун самарали воситалар билан таъминлайди. Уларга яқинроқ бўлиш учун биз ўз дистрибьюция хизматимизни яратдик. Ҳар куни бутун Ўзбекистон бўйлаб омборлардан минглаб тонна инфузион препаратлар ва тиббий мақсадларга мўлжалланган буюмлар жўнатилади, бу врачларга юз минглаб ҳаётни қутқариш имконини беради.'),(16994,1563,'_sc6-text','field_60c85cad73acc'),(16995,1563,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(16996,1563,'_sc7-video','field_60c85cca73ace'),(16997,1563,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(16998,1563,'_sc7-text','field_60c85ce173acf'),(16999,1563,'sc7-textborder','Ҳаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(17000,1563,'_sc7-textborder','field_60c85cea73ad0'),(17001,1563,'sc5-list_0_logo','262'),(17002,1563,'_sc5-list_0_logo','field_60c85c6f73ac9'),(17003,1563,'sc5-list_0_text','Украина GMP, EU GMP, Кения GMP –\r\nТегишли ишлаб чиқариш амалиёти'),(17004,1563,'_sc5-list_0_text','field_60c85c7e73aca'),(17005,1563,'sc5-list_1_logo','264'),(17006,1563,'_sc5-list_1_logo','field_60c85c6f73ac9'),(17007,1563,'sc5-list_1_text','ISO 9001:2009 – фармацевтика маҳсулотини \r\nишлаб чиқариш ва улгуржи сотиш'),(17008,1563,'_sc5-list_1_text','field_60c85c7e73aca'),(17009,1563,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(17010,1563,'_sc6-ttl','field_60c85f2f52aa8'),(17011,1563,'sc7-ttl','Биз ҳақимизда кўпроқ билиш учун қисқа видео:'),(17012,1563,'_sc7-ttl','field_60c860b4429a2'),(17013,1564,'sc1-afterlogo','Халқаро ихтисослашган \r\nфармацевтика корпорацияси'),(17014,1564,'_sc1-afterlogo','field_60c85338b3453'),(17015,1564,'sc1-left','инфузион препаратлар ишлаб \r\nчиқариш бўйича тан олинган етакчи'),(17016,1564,'_sc1-left','field_60c85356b3454'),(17017,1564,'sc1-right','Украинада госпитал \r\nсотувлар бўйича етакчи'),(17018,1564,'_sc1-right','field_60c85408b3455'),(17019,1564,'sc2-ttl','«Юрия-Фарм» корпорацияси:'),(17020,1564,'_sc2-ttl','field_60c8556cfdbcb'),(17021,1564,'sc2-round1','<h3>TOП-3</h3>\r\nУкраинадаги энг йирик\r\nфармацевтика маҳсулотлари\r\nишлаб чиқарувчилар\r\nқаторига киради'),(17022,1564,'_sc2-round1','field_60c855a5fdbcc'),(17023,1564,'sc2-round2','<h3>ТОП-10</h3>\r\nУкраина фармацевтика бозорининг\r\nетакчиларига киради'),(17024,1564,'_sc2-round2','field_60c855b6fdbcd'),(17025,1564,'sc2-mission','<strong>Бизнинг вазифамиз</strong> –\r\nодамларни соғломлаштириш ва\r\nдаволаш учун ноёб ечимларни яратиш'),(17026,1564,'_sc2-mission','field_60c855bffdbce'),(17027,1564,'sc2-filosophy','<strong>Бизнинг фалсафамиз</strong>\r\nҲаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(17028,1564,'_sc2-filosophy','field_60c855cafdbcf'),(17029,1564,'sc3-ttl','Бизнинг ишлаб чиқаришимиз тўғрисида қисқа фактлар:'),(17030,1564,'_sc3-ttl','field_60c85818d1bf2'),(17031,1564,'sc3-list_0_icon','232'),(17032,1564,'_sc3-list_0_icon','field_60c85834d1bf4'),(17033,1564,'sc3-list_0_text','<h3><strong>Черкассы</strong>\r\nшаҳрида жойлашган</h3>'),(17034,1564,'_sc3-list_0_text','field_60c85852d1bf5'),(17035,1564,'sc3-list_1_icon','234'),(17036,1564,'_sc3-list_1_icon','field_60c85834d1bf4'),(17037,1564,'sc3-list_1_text','<h3>ишлаб чиқариш линиялари сони:\r\n<strong class=\"counter-value\">41</strong>та</h3>'),(17038,1564,'_sc3-list_1_text','field_60c85852d1bf5'),(17039,1564,'sc3-list_2_icon','236'),(17040,1564,'_sc3-list_2_icon','field_60c85834d1bf4'),(17041,1564,'sc3-list_2_text','<h3>дори воситалари:\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(17042,1564,'_sc3-list_2_text','field_60c85852d1bf5'),(17043,1564,'sc3-list_3_icon','238'),(17044,1564,'_sc3-list_3_icon','field_60c85834d1bf4'),(17045,1564,'sc3-list_3_text','<h3>ишлаб чиқариш майдони:\r\n<strong><i class=\"counter-value\">25</i> минг кв. м.</strong></h3>'),(17046,1564,'_sc3-list_3_text','field_60c85852d1bf5'),(17047,1564,'sc3-list_4_icon','240'),(17048,1564,'_sc3-list_4_icon','field_60c85834d1bf4'),(17049,1564,'sc3-list_4_text','<h3>ишлаб чиқариш қуввати:\r\n<strong>йилига <i class=\"counter-value\">290</i> млн</strong>\r\nбирликдан ортиқ маҳсулот</h3>'),(17050,1564,'_sc3-list_4_text','field_60c85852d1bf5'),(17051,1564,'sc3-list_5_icon','242'),(17052,1564,'_sc3-list_5_icon','field_60c85834d1bf4'),(17053,1564,'sc3-list_5_text','<h3>тиббий буюмлар –\r\n<strong><i class=\"counter-value\">86</i> млн дан ортиқ</strong></h3>'),(17054,1564,'_sc3-list_5_text','field_60c85852d1bf5'),(17055,1564,'sc3-list','6'),(17056,1564,'_sc3-list','field_60c85827d1bf3'),(17057,1564,'sc4-list_0_num','2500'),(17058,1564,'_sc4-list_0_num','field_60c85bf773ac3'),(17059,1564,'sc4-list_0_text','ходим'),(17060,1564,'_sc4-list_0_text','field_60c85c0173ac4'),(17061,1564,'sc4-list_1_num','160'),(17062,1564,'_sc4-list_1_num','field_60c85bf773ac3'),(17063,1564,'sc4-list_1_text','позиция'),(17064,1564,'_sc4-list_1_text','field_60c85c0173ac4'),(17065,1564,'sc4-list_2_num','20'),(17066,1564,'_sc4-list_2_num','field_60c85bf773ac3'),(17067,1564,'sc4-list_2_text','дунё бўйлаб 20 дан ортиқ мамлакатлар'),(17068,1564,'_sc4-list_2_text','field_60c85c0173ac4'),(17069,1564,'sc4-list','3'),(17070,1564,'_sc4-list','field_60c85be773ac2'),(17071,1564,'sc4-text','<strong>2500 ходимнинг</strong> кундалик меҳнати  <strong>160 позициядан</strong> ортиқ ассортиментдаги маҳсулотни ишлаб чиқариш ва <strong>дунёнинг 20 дан ортиқ мамлакатидаги</strong> даволаш-профилактика муассасаларига етказиб бериш имконини беради. Булар – Украинада ишлаб чиқилган оригинал инфузион препаратлар, антибиотиклар, фунгицид препаратлар, ичиш учун эритмалар, антисептиклар, парентерал овқатланиш учун препаратлар, туберкулез (сил касаллиги)га қарши препаратлар, шприцлар, инфузиялар учун системалар ва кўплаб бошқа препаратлардир.'),(17072,1564,'_sc4-text','field_60c85c0d73ac5'),(17073,1564,'sc5-ttl','Маҳсулотимиз сифатини кафолатлайдиган \r\nхалқаро сертификатлар'),(17074,1564,'_sc5-ttl','field_60c85c2b73ac7'),(17075,1564,'sc5-list','2'),(17076,1564,'_sc5-list','field_60c85c6373ac8'),(17077,1564,'sc6-text','<h2><strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nбирликдан ортиқ маҳсулот</h2>\r\nҳар йили ўн минглаб врачларни одамларни даволаш ва соғломлаштириш учун самарали воситалар билан таъминлайди. Уларга яқинроқ бўлиш учун биз ўз дистрибьюция хизматимизни яратдик. Ҳар куни бутун Ўзбекистон бўйлаб омборлардан минглаб тонна инфузион препаратлар ва тиббий мақсадларга мўлжалланган буюмлар жўнатилади, бу врачларга юз минглаб ҳаётни қутқариш имконини беради.'),(17078,1564,'_sc6-text','field_60c85cad73acc'),(17079,1564,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(17080,1564,'_sc7-video','field_60c85cca73ace'),(17081,1564,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(17082,1564,'_sc7-text','field_60c85ce173acf'),(17083,1564,'sc7-textborder','Ҳаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(17084,1564,'_sc7-textborder','field_60c85cea73ad0'),(17085,1564,'sc5-list_0_logo','262'),(17086,1564,'_sc5-list_0_logo','field_60c85c6f73ac9'),(17087,1564,'sc5-list_0_text','Украина GMP, EU GMP, Кения GMP –\r\nТегишли ишлаб чиқариш амалиёти'),(17088,1564,'_sc5-list_0_text','field_60c85c7e73aca'),(17089,1564,'sc5-list_1_logo','264'),(17090,1564,'_sc5-list_1_logo','field_60c85c6f73ac9'),(17091,1564,'sc5-list_1_text','ISO 9001:2009 – фармацевтика маҳсулотини \r\nишлаб чиқариш ва улгуржи сотиш'),(17092,1564,'_sc5-list_1_text','field_60c85c7e73aca'),(17093,1564,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(17094,1564,'_sc6-ttl','field_60c85f2f52aa8'),(17095,1564,'sc7-ttl','Биз ҳақимизда кўпроқ билиш учун қисқа видео:'),(17096,1564,'_sc7-ttl','field_60c860b4429a2'),(17097,1565,'sc1-afterlogo','Халқаро ихтисослашган \r\nфармацевтика корпорацияси'),(17098,1565,'_sc1-afterlogo','field_60c85338b3453'),(17099,1565,'sc1-left','инфузион препаратлар ишлаб \r\nчиқариш бўйича тан олинган етакчи'),(17100,1565,'_sc1-left','field_60c85356b3454'),(17101,1565,'sc1-right','Украинада госпитал \r\nсотувлар бўйича етакчи'),(17102,1565,'_sc1-right','field_60c85408b3455'),(17103,1565,'sc2-ttl','«Юрия-Фарм» корпорацияси:'),(17104,1565,'_sc2-ttl','field_60c8556cfdbcb'),(17105,1565,'sc2-round1','<h3>TOП-3</h3>\r\nУкраинадаги энг йирик\r\nфармацевтика маҳсулотлари\r\nишлаб чиқарувчилар\r\nқаторига киради'),(17106,1565,'_sc2-round1','field_60c855a5fdbcc'),(17107,1565,'sc2-round2','<h3>ТОП-10</h3>\r\nУкраина фармацевтика бозорининг\r\nетакчиларига киради'),(17108,1565,'_sc2-round2','field_60c855b6fdbcd'),(17109,1565,'sc2-mission','<strong>Бизнинг вазифамиз</strong> –\r\nодамларни соғломлаштириш ва\r\nдаволаш учун ноёб ечимларни яратиш'),(17110,1565,'_sc2-mission','field_60c855bffdbce'),(17111,1565,'sc2-filosophy','<strong>Бизнинг фалсафамиз</strong>\r\nҲаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(17112,1565,'_sc2-filosophy','field_60c855cafdbcf'),(17113,1565,'sc3-ttl','Бизнинг ишлаб чиқаришимиз тўғрисида қисқа фактлар:'),(17114,1565,'_sc3-ttl','field_60c85818d1bf2'),(17115,1565,'sc3-list_0_icon','232'),(17116,1565,'_sc3-list_0_icon','field_60c85834d1bf4'),(17117,1565,'sc3-list_0_text','<h3><strong>Черкассы</strong>\r\nшаҳрида жойлашган</h3>'),(17118,1565,'_sc3-list_0_text','field_60c85852d1bf5'),(17119,1565,'sc3-list_1_icon','234'),(17120,1565,'_sc3-list_1_icon','field_60c85834d1bf4'),(17121,1565,'sc3-list_1_text','<h3>ишлаб чиқариш линиялари сони:\r\n<strong class=\"counter-value\">41</strong>та</h3>'),(17122,1565,'_sc3-list_1_text','field_60c85852d1bf5'),(17123,1565,'sc3-list_2_icon','236'),(17124,1565,'_sc3-list_2_icon','field_60c85834d1bf4'),(17125,1565,'sc3-list_2_text','<h3>дори воситалари:\r\n<strong><i class=\"counter-value\">204</i> млн</strong></h3>'),(17126,1565,'_sc3-list_2_text','field_60c85852d1bf5'),(17127,1565,'sc3-list_3_icon','238'),(17128,1565,'_sc3-list_3_icon','field_60c85834d1bf4'),(17129,1565,'sc3-list_3_text','<h3>ишлаб чиқариш майдони:\r\n<strong><i class=\"counter-value\">25</i> минг кв. м.</strong></h3>'),(17130,1565,'_sc3-list_3_text','field_60c85852d1bf5'),(17131,1565,'sc3-list_4_icon','240'),(17132,1565,'_sc3-list_4_icon','field_60c85834d1bf4'),(17133,1565,'sc3-list_4_text','<h3>ишлаб чиқариш қуввати:\r\n<strong>йилига <i class=\"counter-value\">290</i> млн</strong>\r\nбирликдан ортиқ маҳсулот</h3>'),(17134,1565,'_sc3-list_4_text','field_60c85852d1bf5'),(17135,1565,'sc3-list_5_icon','242'),(17136,1565,'_sc3-list_5_icon','field_60c85834d1bf4'),(17137,1565,'sc3-list_5_text','<h3>тиббий буюмлар –\r\n<strong><i class=\"counter-value\">86</i> млн дан ортиқ</strong></h3>'),(17138,1565,'_sc3-list_5_text','field_60c85852d1bf5'),(17139,1565,'sc3-list','6'),(17140,1565,'_sc3-list','field_60c85827d1bf3'),(17141,1565,'sc4-list_0_num','2500'),(17142,1565,'_sc4-list_0_num','field_60c85bf773ac3'),(17143,1565,'sc4-list_0_text','ходим'),(17144,1565,'_sc4-list_0_text','field_60c85c0173ac4'),(17145,1565,'sc4-list_1_num','160'),(17146,1565,'_sc4-list_1_num','field_60c85bf773ac3'),(17147,1565,'sc4-list_1_text','позиция'),(17148,1565,'_sc4-list_1_text','field_60c85c0173ac4'),(17149,1565,'sc4-list_2_num','20'),(17150,1565,'_sc4-list_2_num','field_60c85bf773ac3'),(17151,1565,'sc4-list_2_text','дан ортиқ мамлакатлар'),(17152,1565,'_sc4-list_2_text','field_60c85c0173ac4'),(17153,1565,'sc4-list','3'),(17154,1565,'_sc4-list','field_60c85be773ac2'),(17155,1565,'sc4-text','<strong>2500 ходимнинг</strong> кундалик меҳнати  <strong>160 позициядан</strong> ортиқ ассортиментдаги маҳсулотни ишлаб чиқариш ва <strong>дунёнинг 20 дан ортиқ мамлакатидаги</strong> даволаш-профилактика муассасаларига етказиб бериш имконини беради. Булар – Украинада ишлаб чиқилган оригинал инфузион препаратлар, антибиотиклар, фунгицид препаратлар, ичиш учун эритмалар, антисептиклар, парентерал овқатланиш учун препаратлар, туберкулез (сил касаллиги)га қарши препаратлар, шприцлар, инфузиялар учун системалар ва кўплаб бошқа препаратлардир.'),(17156,1565,'_sc4-text','field_60c85c0d73ac5'),(17157,1565,'sc5-ttl','Маҳсулотимиз сифатини кафолатлайдиган \r\nхалқаро сертификатлар'),(17158,1565,'_sc5-ttl','field_60c85c2b73ac7'),(17159,1565,'sc5-list','2'),(17160,1565,'_sc5-list','field_60c85c6373ac8'),(17161,1565,'sc6-text','<h2><strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nбирликдан ортиқ маҳсулот</h2>\r\nҳар йили ўн минглаб врачларни одамларни даволаш ва соғломлаштириш учун самарали воситалар билан таъминлайди. Уларга яқинроқ бўлиш учун биз ўз дистрибьюция хизматимизни яратдик. Ҳар куни бутун Ўзбекистон бўйлаб омборлардан минглаб тонна инфузион препаратлар ва тиббий мақсадларга мўлжалланган буюмлар жўнатилади, бу врачларга юз минглаб ҳаётни қутқариш имконини беради.'),(17162,1565,'_sc6-text','field_60c85cad73acc'),(17163,1565,'sc7-video','<iframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/ltQmQwjb3EU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen></iframe>'),(17164,1565,'_sc7-video','field_60c85cca73ace'),(17165,1565,'sc7-text','Используя мировой опыт производства инфузионных растворов, мы работаем над разработкой, внедрением в производство и воплощением наших идей для лечения и улучшения качества жизни больных людей.'),(17166,1565,'_sc7-text','field_60c85ce173acf'),(17167,1565,'sc7-textborder','Ҳаёт – бу Ердаги буюк неъмат.\r\nБиз уни сақлаш ва яхшилашга даъват этилганмиз!'),(17168,1565,'_sc7-textborder','field_60c85cea73ad0'),(17169,1565,'sc5-list_0_logo','262'),(17170,1565,'_sc5-list_0_logo','field_60c85c6f73ac9'),(17171,1565,'sc5-list_0_text','Украина GMP, EU GMP, Кения GMP –\r\nТегишли ишлаб чиқариш амалиёти'),(17172,1565,'_sc5-list_0_text','field_60c85c7e73aca'),(17173,1565,'sc5-list_1_logo','264'),(17174,1565,'_sc5-list_1_logo','field_60c85c6f73ac9'),(17175,1565,'sc5-list_1_text','ISO 9001:2009 – фармацевтика маҳсулотини \r\nишлаб чиқариш ва улгуржи сотиш'),(17176,1565,'_sc5-list_1_text','field_60c85c7e73aca'),(17177,1565,'sc6-ttl','Более\r\n<strong><span class=\"counter-value\">290</span> 000 000</strong>\r\nединиц продукции'),(17178,1565,'_sc6-ttl','field_60c85f2f52aa8'),(17179,1565,'sc7-ttl','Биз ҳақимизда кўпроқ билиш учун қисқа 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Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(17827,1672,'_s4-notes','field_60bf7ca31f58d'),(17828,1672,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(17829,1672,'_s5-video','field_60bf7ccfa01a5'),(17830,1672,'s6-ttl','Оддий сув етарли бўлмаганда!'),(17831,1672,'_s6-ttl','field_60bf7cfb10d31'),(17832,1672,'s6-list','6'),(17833,1672,'_s6-list','field_60bf7d0410d32'),(17834,1672,'s6-list_0_icon','92'),(17835,1672,'_s6-list_0_icon','field_60bf7d1810d33'),(17836,1672,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(17837,1672,'_s6-list_0_text','field_60bf7d2710d34'),(17838,1672,'s6-list_1_icon','93'),(17839,1672,'_s6-list_1_icon','field_60bf7d1810d33'),(17840,1672,'s6-list_1_text','Овқатдан заҳарланишларда'),(17841,1672,'_s6-list_1_text','field_60bf7d2710d34'),(17842,1672,'s6-list_2_icon','94'),(17843,1672,'_s6-list_2_icon','field_60bf7d1810d33'),(17844,1672,'s6-list_2_text','Ичак инфекцияларида'),(17845,1672,'_s6-list_2_text','field_60bf7d2710d34'),(17846,1672,'s6-list_3_icon','95'),(17847,1672,'_s6-list_3_icon','field_60bf7d1810d33'),(17848,1672,'s6-list_3_text','Ҳомиладорлик вақтида'),(17849,1672,'_s6-list_3_text','field_60bf7d2710d34'),(17850,1672,'s6-list_4_icon','96'),(17851,1672,'_s6-list_4_icon','field_60bf7d1810d33'),(17852,1672,'s6-list_4_text','Спорт билан шуғулланганда '),(17853,1672,'_s6-list_4_text','field_60bf7d2710d34'),(17854,1672,'s6-list_5_icon','97'),(17855,1672,'_s6-list_5_icon','field_60bf7d1810d33'),(17856,1672,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(17857,1672,'_s6-list_5_text','field_60bf7d2710d34'),(17858,1672,'s4-list_0_ttl','Натрий'),(17859,1672,'_s4-list_0_ttl','field_60bf7fa95a92c'),(17860,1672,'s4-list_0_formula','Na<sup>+</sup>'),(17861,1672,'_s4-list_0_formula','field_60bf7fc65a92d'),(17862,1672,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. 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Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(18185,1734,'_s4-notes','field_60bf7ca31f58d'),(18186,1734,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(18187,1734,'_s5-video','field_60bf7ccfa01a5'),(18188,1734,'s6-ttl','Оддий сув етарли бўлмаганда!'),(18189,1734,'_s6-ttl','field_60bf7cfb10d31'),(18190,1734,'s6-list','6'),(18191,1734,'_s6-list','field_60bf7d0410d32'),(18192,1734,'s6-list_0_icon','92'),(18193,1734,'_s6-list_0_icon','field_60bf7d1810d33'),(18194,1734,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(18195,1734,'_s6-list_0_text','field_60bf7d2710d34'),(18196,1734,'s6-list_1_icon','93'),(18197,1734,'_s6-list_1_icon','field_60bf7d1810d33'),(18198,1734,'s6-list_1_text','Овқатдан заҳарланишларда'),(18199,1734,'_s6-list_1_text','field_60bf7d2710d34'),(18200,1734,'s6-list_2_icon','94'),(18201,1734,'_s6-list_2_icon','field_60bf7d1810d33'),(18202,1734,'s6-list_2_text','Ичак инфекцияларида'),(18203,1734,'_s6-list_2_text','field_60bf7d2710d34'),(18204,1734,'s6-list_3_icon','95'),(18205,1734,'_s6-list_3_icon','field_60bf7d1810d33'),(18206,1734,'s6-list_3_text','Ҳомиладорлик вақтида'),(18207,1734,'_s6-list_3_text','field_60bf7d2710d34'),(18208,1734,'s6-list_4_icon','96'),(18209,1734,'_s6-list_4_icon','field_60bf7d1810d33'),(18210,1734,'s6-list_4_text','Спорт билан шуғулланганда '),(18211,1734,'_s6-list_4_text','field_60bf7d2710d34'),(18212,1734,'s6-list_5_icon','97'),(18213,1734,'_s6-list_5_icon','field_60bf7d1810d33'),(18214,1734,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(18215,1734,'_s6-list_5_text','field_60bf7d2710d34'),(18216,1734,'s4-list_0_ttl','Натрий'),(18217,1734,'_s4-list_0_ttl','field_60bf7fa95a92c'),(18218,1734,'s4-list_0_formula','Na<sup>+</sup>'),(18219,1734,'_s4-list_0_formula','field_60bf7fc65a92d'),(18220,1734,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(18221,1734,'_s4-list_0_text','field_60bf7fd35a92e'),(18222,1734,'s4-list_1_ttl','Сув'),(18223,1734,'_s4-list_1_ttl','field_60bf7fa95a92c'),(18224,1734,'s4-list_1_formula','H<sub>2</sub>O'),(18225,1734,'_s4-list_1_formula','field_60bf7fc65a92d'),(18226,1734,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(18227,1734,'_s4-list_1_text','field_60bf7fd35a92e'),(18228,1734,'s4-list','9'),(18229,1734,'_s4-list','field_60bf7f985a92b'),(18230,1734,'s4-list_2_ttl','Калий'),(18231,1734,'_s4-list_2_ttl','field_60bf7fa95a92c'),(18232,1734,'s4-list_2_formula','K<sup>+</sup>'),(18233,1734,'_s4-list_2_formula','field_60bf7fc65a92d'),(18234,1734,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(18235,1734,'_s4-list_2_text','field_60bf7fd35a92e'),(18236,1734,'s4-list_3_ttl','Гидрокарбонатлар '),(18237,1734,'_s4-list_3_ttl','field_60bf7fa95a92c'),(18238,1734,'s4-list_3_formula','HCO<sup>3+</sup>'),(18239,1734,'_s4-list_3_formula','field_60bf7fc65a92d'),(18240,1734,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(18241,1734,'_s4-list_3_text','field_60bf7fd35a92e'),(18242,1734,'s4-list_4_ttl','Магний'),(18243,1734,'_s4-list_4_ttl','field_60bf7fa95a92c'),(18244,1734,'s4-list_4_formula','Mg<sup>2+</sup>'),(18245,1734,'_s4-list_4_formula','field_60bf7fc65a92d'),(18246,1734,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(18247,1734,'_s4-list_4_text','field_60bf7fd35a92e'),(18248,1734,'s4-list_5_ttl','Углекислый газ'),(18249,1734,'_s4-list_5_ttl','field_60bf7fa95a92c'),(18250,1734,'s4-list_5_formula','CO<sup>2</sup>+'),(18251,1734,'_s4-list_5_formula','field_60bf7fc65a92d'),(18252,1734,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. 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Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(18259,1734,'_s4-list_6_text','field_60bf7fd35a92e'),(18260,1734,'s4-list_7_ttl','Сорбитол'),(18261,1734,'_s4-list_7_ttl','field_60bf7fa95a92c'),(18262,1734,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(18263,1734,'_s4-list_7_formula','field_60bf7fc65a92d'),(18264,1734,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(18265,1734,'_s4-list_7_text','field_60bf7fd35a92e'),(18266,1734,'s4-list_8_ttl','Хлор'),(18267,1734,'_s4-list_8_ttl','field_60bf7fa95a92c'),(18268,1734,'s4-list_8_formula','Cl'),(18269,1734,'_s4-list_8_formula','field_60bf7fc65a92d'),(18270,1734,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(18271,1734,'_s4-list_8_text','field_60bf7fd35a92e'),(18272,1734,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(18273,1734,'_s4-feature1','field_60bf80ca480ea'),(18274,1734,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(18275,1734,'_s4-feature2','field_60bf80de480eb'),(18276,1734,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(18277,1734,'_s4-feature3','field_60bf80e2480ec'),(18278,1734,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон 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сув-туз мувозанати бузилишига олиб келадиган ҳолатлар мавжуд'),(18323,1735,'_s2-ttl','field_60bf76d1f46ed'),(18324,1735,'slider','3'),(18325,1735,'_slider','field_60bf767ef46ea'),(18326,1735,'slider_0_slide','1663'),(18327,1735,'_slider_0_slide','field_60bf7688f46eb'),(18328,1735,'slider_1_slide','1666'),(18329,1735,'_slider_1_slide','field_60bf7688f46eb'),(18330,1735,'slider_2_slide','1669'),(18331,1735,'_slider_2_slide','field_60bf7688f46eb'),(18332,1735,'s2-list_0_icon','61'),(18333,1735,'_s2-list_0_icon','field_60bf76ecf46ef'),(18334,1735,'s2-list_0_icon-hover','62'),(18335,1735,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(18336,1735,'s2-list_0_text','Иситма'),(18337,1735,'_s2-list_0_text','field_60bf7712f46f1'),(18338,1735,'s2-list_1_icon','63'),(18339,1735,'_s2-list_1_icon','field_60bf76ecf46ef'),(18340,1735,'s2-list_1_icon-hover','64'),(18341,1735,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(18342,1735,'s2-list_1_text','Алкоголдан кейинги 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юкламалар'),(18361,1735,'_s2-list_4_text','field_60bf7712f46f1'),(18362,1735,'s2-list_5_icon','71'),(18363,1735,'_s2-list_5_icon','field_60bf76ecf46ef'),(18364,1735,'s2-list_5_icon-hover','72'),(18365,1735,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(18366,1735,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(18367,1735,'_s2-list_5_text','field_60bf7712f46f1'),(18368,1735,'s1-slogan','Оддий сув етарли бўлмаганда!'),(18369,1735,'_s1-slogan','field_60bf7ab4d9ba9'),(18370,1735,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(18371,1735,'_s3-text','field_60bf7bb5a7e2b'),(18372,1735,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(18373,1735,'_s4-ttl','field_60bf7c831f58c'),(18374,1735,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(18375,1735,'_s4-notes','field_60bf7ca31f58d'),(18376,1735,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(18377,1735,'_s5-video','field_60bf7ccfa01a5'),(18378,1735,'s6-ttl','Оддий сув етарли бўлмаганда!'),(18379,1735,'_s6-ttl','field_60bf7cfb10d31'),(18380,1735,'s6-list','6'),(18381,1735,'_s6-list','field_60bf7d0410d32'),(18382,1735,'s6-list_0_icon','92'),(18383,1735,'_s6-list_0_icon','field_60bf7d1810d33'),(18384,1735,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(18385,1735,'_s6-list_0_text','field_60bf7d2710d34'),(18386,1735,'s6-list_1_icon','93'),(18387,1735,'_s6-list_1_icon','field_60bf7d1810d33'),(18388,1735,'s6-list_1_text','Овқатдан заҳарланишларда'),(18389,1735,'_s6-list_1_text','field_60bf7d2710d34'),(18390,1735,'s6-list_2_icon','94'),(18391,1735,'_s6-list_2_icon','field_60bf7d1810d33'),(18392,1735,'s6-list_2_text','Ичак инфекцияларида'),(18393,1735,'_s6-list_2_text','field_60bf7d2710d34'),(18394,1735,'s6-list_3_icon','95'),(18395,1735,'_s6-list_3_icon','field_60bf7d1810d33'),(18396,1735,'s6-list_3_text','Ҳомиладорлик вақтида'),(18397,1735,'_s6-list_3_text','field_60bf7d2710d34'),(18398,1735,'s6-list_4_icon','96'),(18399,1735,'_s6-list_4_icon','field_60bf7d1810d33'),(18400,1735,'s6-list_4_text','Спорт билан шуғулланганда '),(18401,1735,'_s6-list_4_text','field_60bf7d2710d34'),(18402,1735,'s6-list_5_icon','97'),(18403,1735,'_s6-list_5_icon','field_60bf7d1810d33'),(18404,1735,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(18405,1735,'_s6-list_5_text','field_60bf7d2710d34'),(18406,1735,'s4-list_0_ttl','Натрий'),(18407,1735,'_s4-list_0_ttl','field_60bf7fa95a92c'),(18408,1735,'s4-list_0_formula','Na<sup>+</sup>'),(18409,1735,'_s4-list_0_formula','field_60bf7fc65a92d'),(18410,1735,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(18411,1735,'_s4-list_0_text','field_60bf7fd35a92e'),(18412,1735,'s4-list_1_ttl','Сув'),(18413,1735,'_s4-list_1_ttl','field_60bf7fa95a92c'),(18414,1735,'s4-list_1_formula','H<sub>2</sub>O'),(18415,1735,'_s4-list_1_formula','field_60bf7fc65a92d'),(18416,1735,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(18417,1735,'_s4-list_1_text','field_60bf7fd35a92e'),(18418,1735,'s4-list','9'),(18419,1735,'_s4-list','field_60bf7f985a92b'),(18420,1735,'s4-list_2_ttl','Калий'),(18421,1735,'_s4-list_2_ttl','field_60bf7fa95a92c'),(18422,1735,'s4-list_2_formula','K<sup>+</sup>'),(18423,1735,'_s4-list_2_formula','field_60bf7fc65a92d'),(18424,1735,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(18425,1735,'_s4-list_2_text','field_60bf7fd35a92e'),(18426,1735,'s4-list_3_ttl','Гидрокарбонатлар '),(18427,1735,'_s4-list_3_ttl','field_60bf7fa95a92c'),(18428,1735,'s4-list_3_formula','HCO<sup>3+</sup>'),(18429,1735,'_s4-list_3_formula','field_60bf7fc65a92d'),(18430,1735,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(18431,1735,'_s4-list_3_text','field_60bf7fd35a92e'),(18432,1735,'s4-list_4_ttl','Магний'),(18433,1735,'_s4-list_4_ttl','field_60bf7fa95a92c'),(18434,1735,'s4-list_4_formula','Mg<sup>2+</sup>'),(18435,1735,'_s4-list_4_formula','field_60bf7fc65a92d'),(18436,1735,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(18437,1735,'_s4-list_4_text','field_60bf7fd35a92e'),(18438,1735,'s4-list_5_ttl','Углекислый газ'),(18439,1735,'_s4-list_5_ttl','field_60bf7fa95a92c'),(18440,1735,'s4-list_5_formula','CO<sup>2</sup>+'),(18441,1735,'_s4-list_5_formula','field_60bf7fc65a92d'),(18442,1735,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(18443,1735,'_s4-list_5_text','field_60bf7fd35a92e'),(18444,1735,'s4-list_6_ttl','Кальций'),(18445,1735,'_s4-list_6_ttl','field_60bf7fa95a92c'),(18446,1735,'s4-list_6_formula','Ca<sup>2+</sup>'),(18447,1735,'_s4-list_6_formula','field_60bf7fc65a92d'),(18448,1735,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(18449,1735,'_s4-list_6_text','field_60bf7fd35a92e'),(18450,1735,'s4-list_7_ttl','Сорбитол'),(18451,1735,'_s4-list_7_ttl','field_60bf7fa95a92c'),(18452,1735,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(18453,1735,'_s4-list_7_formula','field_60bf7fc65a92d'),(18454,1735,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(18455,1735,'_s4-list_7_text','field_60bf7fd35a92e'),(18456,1735,'s4-list_8_ttl','Хлор'),(18457,1735,'_s4-list_8_ttl','field_60bf7fa95a92c'),(18458,1735,'s4-list_8_formula','Cl'),(18459,1735,'_s4-list_8_formula','field_60bf7fc65a92d'),(18460,1735,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(18461,1735,'_s4-list_8_text','field_60bf7fd35a92e'),(18462,1735,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(18463,1735,'_s4-feature1','field_60bf80ca480ea'),(18464,1735,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(18465,1735,'_s4-feature2','field_60bf80de480eb'),(18466,1735,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(18467,1735,'_s4-feature3','field_60bf80e2480ec'),(18468,1735,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон 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стани організму, що ведуть до порушень водно-сольового балансу:'),(18592,1760,'_s2-ttl','field_60bf76d1f46ed'),(18593,1760,'s2-list','6'),(18594,1760,'_s2-list','field_60bf76e0f46ee'),(18595,1760,'s2-list_0_icon','61'),(18596,1760,'_s2-list_0_icon','field_60bf76ecf46ef'),(18597,1760,'s2-list_0_icon-hover','62'),(18598,1760,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(18599,1760,'s2-list_0_text','Лихоманка'),(18600,1760,'_s2-list_0_text','field_60bf7712f46f1'),(18601,1760,'s2-list_1_icon','63'),(18602,1760,'_s2-list_1_icon','field_60bf76ecf46ef'),(18603,1760,'s2-list_1_icon-hover','64'),(18604,1760,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(18605,1760,'s2-list_1_text','Похмільний 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навантаження'),(18624,1760,'_s2-list_4_text','field_60bf7712f46f1'),(18625,1760,'s2-list_5_icon','71'),(18626,1760,'_s2-list_5_icon','field_60bf76ecf46ef'),(18627,1760,'s2-list_5_icon-hover','72'),(18628,1760,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(18629,1760,'s2-list_5_text','Перегрівання в спекотну погоду'),(18630,1760,'_s2-list_5_text','field_60bf7712f46f1'),(18631,1760,'s1-slogan','Коли звичайної води замало!'),(18632,1760,'_s1-slogan','field_60bf7ab4d9ba9'),(18633,1760,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(18634,1760,'_s3-text','field_60bf7bb5a7e2b'),(18635,1760,'s4-ttl','РеО – вода для медичних цілей'),(18636,1760,'_s4-ttl','field_60bf7c831f58c'),(18637,1760,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(18638,1760,'_s4-notes','field_60bf7ca31f58d'),(18639,1760,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(18640,1760,'_s5-video','field_60bf7ccfa01a5'),(18641,1760,'s6-ttl','Коли звичайної води замало!'),(18642,1760,'_s6-ttl','field_60bf7cfb10d31'),(18643,1760,'s6-list','6'),(18644,1760,'_s6-list','field_60bf7d0410d32'),(18645,1760,'s6-list_0_icon','92'),(18646,1760,'_s6-list_0_icon','field_60bf7d1810d33'),(18647,1760,'s6-list_0_text','При підвищеній температурі'),(18648,1760,'_s6-list_0_text','field_60bf7d2710d34'),(18649,1760,'s6-list_1_icon','93'),(18650,1760,'_s6-list_1_icon','field_60bf7d1810d33'),(18651,1760,'s6-list_1_text','При харчових отруєннях'),(18652,1760,'_s6-list_1_text','field_60bf7d2710d34'),(18653,1760,'s6-list_2_icon','94'),(18654,1760,'_s6-list_2_icon','field_60bf7d1810d33'),(18655,1760,'s6-list_2_text','При кишкових інфекціях'),(18656,1760,'_s6-list_2_text','field_60bf7d2710d34'),(18657,1760,'s6-list_3_icon','95'),(18658,1760,'_s6-list_3_icon','field_60bf7d1810d33'),(18659,1760,'s6-list_3_text','Під час вагітності'),(18660,1760,'_s6-list_3_text','field_60bf7d2710d34'),(18661,1760,'s6-list_4_icon','96'),(18662,1760,'_s6-list_4_icon','field_60bf7d1810d33'),(18663,1760,'s6-list_4_text','Під час заняття спортом'),(18664,1760,'_s6-list_4_text','field_60bf7d2710d34'),(18665,1760,'s6-list_5_icon','97'),(18666,1760,'_s6-list_5_icon','field_60bf7d1810d33'),(18667,1760,'s6-list_5_text','При похмільному синдромі'),(18668,1760,'_s6-list_5_text','field_60bf7d2710d34'),(18669,1760,'s4-list_0_ttl','Натрій'),(18670,1760,'_s4-list_0_ttl','field_60bf7fa95a92c'),(18671,1760,'s4-list_0_formula','Na<sup>+</sup>'),(18672,1760,'_s4-list_0_formula','field_60bf7fc65a92d'),(18673,1760,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(18674,1760,'_s4-list_0_text','field_60bf7fd35a92e'),(18675,1760,'s4-list_1_ttl','Вода'),(18676,1760,'_s4-list_1_ttl','field_60bf7fa95a92c'),(18677,1760,'s4-list_1_formula','H<sub>2</sub>O'),(18678,1760,'_s4-list_1_formula','field_60bf7fc65a92d'),(18679,1760,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(18680,1760,'_s4-list_1_text','field_60bf7fd35a92e'),(18681,1760,'s4-list','9'),(18682,1760,'_s4-list','field_60bf7f985a92b'),(18683,1760,'s4-list_2_ttl','Калій'),(18684,1760,'_s4-list_2_ttl','field_60bf7fa95a92c'),(18685,1760,'s4-list_2_formula','K<sup>+</sup>'),(18686,1760,'_s4-list_2_formula','field_60bf7fc65a92d'),(18687,1760,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(18688,1760,'_s4-list_2_text','field_60bf7fd35a92e'),(18689,1760,'s4-list_3_ttl','Гідрокарбонати'),(18690,1760,'_s4-list_3_ttl','field_60bf7fa95a92c'),(18691,1760,'s4-list_3_formula','HCO<sup>3+</sup>'),(18692,1760,'_s4-list_3_formula','field_60bf7fc65a92d'),(18693,1760,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(18694,1760,'_s4-list_3_text','field_60bf7fd35a92e'),(18695,1760,'s4-list_4_ttl','Магній'),(18696,1760,'_s4-list_4_ttl','field_60bf7fa95a92c'),(18697,1760,'s4-list_4_formula','Mg<sup>2+</sup>'),(18698,1760,'_s4-list_4_formula','field_60bf7fc65a92d'),(18699,1760,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(18700,1760,'_s4-list_4_text','field_60bf7fd35a92e'),(18701,1760,'s4-list_5_ttl','Вуглекислий газ'),(18702,1760,'_s4-list_5_ttl','field_60bf7fa95a92c'),(18703,1760,'s4-list_5_formula','CO<sup>2</sup>+'),(18704,1760,'_s4-list_5_formula','field_60bf7fc65a92d'),(18705,1760,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(18706,1760,'_s4-list_5_text','field_60bf7fd35a92e'),(18707,1760,'s4-list_6_ttl','Кальцій'),(18708,1760,'_s4-list_6_ttl','field_60bf7fa95a92c'),(18709,1760,'s4-list_6_formula','Ca<sup>2+</sup>'),(18710,1760,'_s4-list_6_formula','field_60bf7fc65a92d'),(18711,1760,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(18712,1760,'_s4-list_6_text','field_60bf7fd35a92e'),(18713,1760,'s4-list_7_ttl','Сорбіт'),(18714,1760,'_s4-list_7_ttl','field_60bf7fa95a92c'),(18715,1760,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(18716,1760,'_s4-list_7_formula','field_60bf7fc65a92d'),(18717,1760,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(18718,1760,'_s4-list_7_text','field_60bf7fd35a92e'),(18719,1760,'s4-list_8_ttl','Хлор'),(18720,1760,'_s4-list_8_ttl','field_60bf7fa95a92c'),(18721,1760,'s4-list_8_formula','Cl-'),(18722,1760,'_s4-list_8_formula','field_60bf7fc65a92d'),(18723,1760,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(18724,1760,'_s4-list_8_text','field_60bf7fd35a92e'),(18725,1760,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(18726,1760,'_s4-feature1','field_60bf80ca480ea'),(18727,1760,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(18728,1760,'_s4-feature2','field_60bf80de480eb'),(18729,1760,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(18730,1760,'_s4-feature3','field_60bf80e2480ec'),(18731,1760,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(18732,1760,'_s4-feature4','field_60bf80e5480ed'),(18733,1760,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(18734,1760,'_s2-list_0_link','field_60ee90d381a4e'),(18735,1760,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(18736,1760,'_s2-list_1_link','field_60ee90d381a4e'),(18737,1760,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(18738,1760,'_s2-list_2_link','field_60ee90d381a4e'),(18739,1760,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(18740,1760,'_s2-list_3_link','field_60ee90d381a4e'),(18741,1760,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(18742,1760,'_s2-list_4_link','field_60ee90d381a4e'),(18743,1760,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(18744,1760,'_s2-list_5_link','field_60ee90d381a4e'),(18745,1760,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(18746,1760,'_s6-list_0_link','field_60ee916b04ace'),(18747,1760,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(18748,1760,'_s6-list_1_link','field_60ee916b04ace'),(18749,1760,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(18750,1760,'_s6-list_2_link','field_60ee916b04ace'),(18751,1760,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(18752,1760,'_s6-list_3_link','field_60ee916b04ace'),(18753,1760,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(18754,1760,'_s6-list_4_link','field_60ee916b04ace'),(18755,1760,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(18756,1760,'_s6-list_5_link','field_60ee916b04ace'),(18757,1760,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(18758,1760,'_slider_0_webplink','field_60fa70c989e88'),(18759,1760,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(18760,1760,'_slider_1_webplink','field_60fa70c989e88'),(18761,1760,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(18762,1760,'_slider_2_webplink','field_60fa70c989e88'),(18763,1760,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(18764,1760,'_slider_3_webplink','field_60fa70c989e88'),(18765,1760,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(18766,1760,'_slider_4_webplink','field_60fa70c989e88'),(18767,1760,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(18768,1760,'_slider_5_webplink','field_60fa70c989e88'),(18769,1760,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(18770,1760,'_slider_6_webplink','field_60fa70c989e88'),(18771,1760,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(18772,1760,'_slider_7_webplink','field_60fa70c989e88'),(18773,1760,'slider_0_slide','50'),(18774,1760,'_slider_0_slide','field_60bf7688f46eb'),(18775,1760,'slider_1_slide','51'),(18776,1760,'_slider_1_slide','field_60bf7688f46eb'),(18777,1760,'slider_2_slide','52'),(18778,1760,'_slider_2_slide','field_60bf7688f46eb'),(18779,1760,'slider_3_slide','53'),(18780,1760,'_slider_3_slide','field_60bf7688f46eb'),(18781,1760,'slider_4_slide','54'),(18782,1760,'_slider_4_slide','field_60bf7688f46eb'),(18783,1760,'slider_5_slide','55'),(18784,1760,'_slider_5_slide','field_60bf7688f46eb'),(18785,1760,'slider_6_slide','56'),(18786,1760,'_slider_6_slide','field_60bf7688f46eb'),(18787,1760,'slider_7_slide','57'),(18788,1760,'_slider_7_slide','field_60bf7688f46eb'),(18789,1761,'slider','8'),(18790,1761,'_slider','field_60bf767ef46ea'),(18791,1761,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(18792,1761,'_s2-ttl','field_60bf76d1f46ed'),(18793,1761,'s2-list','6'),(18794,1761,'_s2-list','field_60bf76e0f46ee'),(18795,1761,'s2-list_0_icon','61'),(18796,1761,'_s2-list_0_icon','field_60bf76ecf46ef'),(18797,1761,'s2-list_0_icon-hover','62'),(18798,1761,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(18799,1761,'s2-list_0_text','Лихоманка'),(18800,1761,'_s2-list_0_text','field_60bf7712f46f1'),(18801,1761,'s2-list_1_icon','63'),(18802,1761,'_s2-list_1_icon','field_60bf76ecf46ef'),(18803,1761,'s2-list_1_icon-hover','64'),(18804,1761,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(18805,1761,'s2-list_1_text','Похмільний синдром'),(18806,1761,'_s2-list_1_text','field_60bf7712f46f1'),(18807,1761,'s2-list_2_icon','65'),(18808,1761,'_s2-list_2_icon','field_60bf76ecf46ef'),(18809,1761,'s2-list_2_icon-hover','66'),(18810,1761,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(18811,1761,'s2-list_2_text','Діарея'),(18812,1761,'_s2-list_2_text','field_60bf7712f46f1'),(18813,1761,'s2-list_3_icon','67'),(18814,1761,'_s2-list_3_icon','field_60bf76ecf46ef'),(18815,1761,'s2-list_3_icon-hover','68'),(18816,1761,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(18817,1761,'s2-list_3_text','Блювота'),(18818,1761,'_s2-list_3_text','field_60bf7712f46f1'),(18819,1761,'s2-list_4_icon','69'),(18820,1761,'_s2-list_4_icon','field_60bf76ecf46ef'),(18821,1761,'s2-list_4_icon-hover','70'),(18822,1761,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(18823,1761,'s2-list_4_text','Інтенсивні фізичні навантаження'),(18824,1761,'_s2-list_4_text','field_60bf7712f46f1'),(18825,1761,'s2-list_5_icon','71'),(18826,1761,'_s2-list_5_icon','field_60bf76ecf46ef'),(18827,1761,'s2-list_5_icon-hover','72'),(18828,1761,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(18829,1761,'s2-list_5_text','Перегрівання в спекотну погоду'),(18830,1761,'_s2-list_5_text','field_60bf7712f46f1'),(18831,1761,'s1-slogan','Коли звичайної води замало!'),(18832,1761,'_s1-slogan','field_60bf7ab4d9ba9'),(18833,1761,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(18834,1761,'_s3-text','field_60bf7bb5a7e2b'),(18835,1761,'s4-ttl','РеО – вода для медичних цілей'),(18836,1761,'_s4-ttl','field_60bf7c831f58c'),(18837,1761,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(18838,1761,'_s4-notes','field_60bf7ca31f58d'),(18839,1761,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(18840,1761,'_s5-video','field_60bf7ccfa01a5'),(18841,1761,'s6-ttl','Коли звичайної води замало!'),(18842,1761,'_s6-ttl','field_60bf7cfb10d31'),(18843,1761,'s6-list','6'),(18844,1761,'_s6-list','field_60bf7d0410d32'),(18845,1761,'s6-list_0_icon','92'),(18846,1761,'_s6-list_0_icon','field_60bf7d1810d33'),(18847,1761,'s6-list_0_text','При підвищеній температурі'),(18848,1761,'_s6-list_0_text','field_60bf7d2710d34'),(18849,1761,'s6-list_1_icon','93'),(18850,1761,'_s6-list_1_icon','field_60bf7d1810d33'),(18851,1761,'s6-list_1_text','При харчових отруєннях'),(18852,1761,'_s6-list_1_text','field_60bf7d2710d34'),(18853,1761,'s6-list_2_icon','94'),(18854,1761,'_s6-list_2_icon','field_60bf7d1810d33'),(18855,1761,'s6-list_2_text','При кишкових інфекціях'),(18856,1761,'_s6-list_2_text','field_60bf7d2710d34'),(18857,1761,'s6-list_3_icon','95'),(18858,1761,'_s6-list_3_icon','field_60bf7d1810d33'),(18859,1761,'s6-list_3_text','Під час вагітності'),(18860,1761,'_s6-list_3_text','field_60bf7d2710d34'),(18861,1761,'s6-list_4_icon','96'),(18862,1761,'_s6-list_4_icon','field_60bf7d1810d33'),(18863,1761,'s6-list_4_text','Під час заняття спортом'),(18864,1761,'_s6-list_4_text','field_60bf7d2710d34'),(18865,1761,'s6-list_5_icon','97'),(18866,1761,'_s6-list_5_icon','field_60bf7d1810d33'),(18867,1761,'s6-list_5_text','При похмільному синдромі'),(18868,1761,'_s6-list_5_text','field_60bf7d2710d34'),(18869,1761,'s4-list_0_ttl','Натрій'),(18870,1761,'_s4-list_0_ttl','field_60bf7fa95a92c'),(18871,1761,'s4-list_0_formula','Na<sup>+</sup>'),(18872,1761,'_s4-list_0_formula','field_60bf7fc65a92d'),(18873,1761,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(18874,1761,'_s4-list_0_text','field_60bf7fd35a92e'),(18875,1761,'s4-list_1_ttl','Вода'),(18876,1761,'_s4-list_1_ttl','field_60bf7fa95a92c'),(18877,1761,'s4-list_1_formula','H<sub>2</sub>O'),(18878,1761,'_s4-list_1_formula','field_60bf7fc65a92d'),(18879,1761,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(18880,1761,'_s4-list_1_text','field_60bf7fd35a92e'),(18881,1761,'s4-list','9'),(18882,1761,'_s4-list','field_60bf7f985a92b'),(18883,1761,'s4-list_2_ttl','Калій'),(18884,1761,'_s4-list_2_ttl','field_60bf7fa95a92c'),(18885,1761,'s4-list_2_formula','K<sup>+</sup>'),(18886,1761,'_s4-list_2_formula','field_60bf7fc65a92d'),(18887,1761,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(18888,1761,'_s4-list_2_text','field_60bf7fd35a92e'),(18889,1761,'s4-list_3_ttl','Гідрокарбонати'),(18890,1761,'_s4-list_3_ttl','field_60bf7fa95a92c'),(18891,1761,'s4-list_3_formula','HCO<sup>3+</sup>'),(18892,1761,'_s4-list_3_formula','field_60bf7fc65a92d'),(18893,1761,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(18894,1761,'_s4-list_3_text','field_60bf7fd35a92e'),(18895,1761,'s4-list_4_ttl','Магній'),(18896,1761,'_s4-list_4_ttl','field_60bf7fa95a92c'),(18897,1761,'s4-list_4_formula','Mg<sup>2+</sup>'),(18898,1761,'_s4-list_4_formula','field_60bf7fc65a92d'),(18899,1761,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(18900,1761,'_s4-list_4_text','field_60bf7fd35a92e'),(18901,1761,'s4-list_5_ttl','Вуглекислий газ'),(18902,1761,'_s4-list_5_ttl','field_60bf7fa95a92c'),(18903,1761,'s4-list_5_formula','CO<sup>2</sup>+'),(18904,1761,'_s4-list_5_formula','field_60bf7fc65a92d'),(18905,1761,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(18906,1761,'_s4-list_5_text','field_60bf7fd35a92e'),(18907,1761,'s4-list_6_ttl','Кальцій'),(18908,1761,'_s4-list_6_ttl','field_60bf7fa95a92c'),(18909,1761,'s4-list_6_formula','Ca<sup>2+</sup>'),(18910,1761,'_s4-list_6_formula','field_60bf7fc65a92d'),(18911,1761,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(18912,1761,'_s4-list_6_text','field_60bf7fd35a92e'),(18913,1761,'s4-list_7_ttl','Сорбіт'),(18914,1761,'_s4-list_7_ttl','field_60bf7fa95a92c'),(18915,1761,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(18916,1761,'_s4-list_7_formula','field_60bf7fc65a92d'),(18917,1761,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(18918,1761,'_s4-list_7_text','field_60bf7fd35a92e'),(18919,1761,'s4-list_8_ttl','Хлор'),(18920,1761,'_s4-list_8_ttl','field_60bf7fa95a92c'),(18921,1761,'s4-list_8_formula','Cl<sup>-</sup>'),(18922,1761,'_s4-list_8_formula','field_60bf7fc65a92d'),(18923,1761,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(18924,1761,'_s4-list_8_text','field_60bf7fd35a92e'),(18925,1761,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(18926,1761,'_s4-feature1','field_60bf80ca480ea'),(18927,1761,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(18928,1761,'_s4-feature2','field_60bf80de480eb'),(18929,1761,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(18930,1761,'_s4-feature3','field_60bf80e2480ec'),(18931,1761,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(18932,1761,'_s4-feature4','field_60bf80e5480ed'),(18933,1761,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(18934,1761,'_s2-list_0_link','field_60ee90d381a4e'),(18935,1761,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(18936,1761,'_s2-list_1_link','field_60ee90d381a4e'),(18937,1761,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(18938,1761,'_s2-list_2_link','field_60ee90d381a4e'),(18939,1761,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(18940,1761,'_s2-list_3_link','field_60ee90d381a4e'),(18941,1761,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(18942,1761,'_s2-list_4_link','field_60ee90d381a4e'),(18943,1761,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(18944,1761,'_s2-list_5_link','field_60ee90d381a4e'),(18945,1761,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(18946,1761,'_s6-list_0_link','field_60ee916b04ace'),(18947,1761,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(18948,1761,'_s6-list_1_link','field_60ee916b04ace'),(18949,1761,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(18950,1761,'_s6-list_2_link','field_60ee916b04ace'),(18951,1761,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(18952,1761,'_s6-list_3_link','field_60ee916b04ace'),(18953,1761,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(18954,1761,'_s6-list_4_link','field_60ee916b04ace'),(18955,1761,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(18956,1761,'_s6-list_5_link','field_60ee916b04ace'),(18957,1761,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(18958,1761,'_slider_0_webplink','field_60fa70c989e88'),(18959,1761,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(18960,1761,'_slider_1_webplink','field_60fa70c989e88'),(18961,1761,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(18962,1761,'_slider_2_webplink','field_60fa70c989e88'),(18963,1761,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(18964,1761,'_slider_3_webplink','field_60fa70c989e88'),(18965,1761,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(18966,1761,'_slider_4_webplink','field_60fa70c989e88'),(18967,1761,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(18968,1761,'_slider_5_webplink','field_60fa70c989e88'),(18969,1761,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(18970,1761,'_slider_6_webplink','field_60fa70c989e88'),(18971,1761,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(18972,1761,'_slider_7_webplink','field_60fa70c989e88'),(18973,1761,'slider_0_slide','50'),(18974,1761,'_slider_0_slide','field_60bf7688f46eb'),(18975,1761,'slider_1_slide','51'),(18976,1761,'_slider_1_slide','field_60bf7688f46eb'),(18977,1761,'slider_2_slide','52'),(18978,1761,'_slider_2_slide','field_60bf7688f46eb'),(18979,1761,'slider_3_slide','53'),(18980,1761,'_slider_3_slide','field_60bf7688f46eb'),(18981,1761,'slider_4_slide','54'),(18982,1761,'_slider_4_slide','field_60bf7688f46eb'),(18983,1761,'slider_5_slide','55'),(18984,1761,'_slider_5_slide','field_60bf7688f46eb'),(18985,1761,'slider_6_slide','56'),(18986,1761,'_slider_6_slide','field_60bf7688f46eb'),(18987,1761,'slider_7_slide','57'),(18988,1761,'_slider_7_slide','field_60bf7688f46eb'),(18989,1762,'slider','8'),(18990,1762,'_slider','field_60bf767ef46ea'),(18991,1762,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(18992,1762,'_s2-ttl','field_60bf76d1f46ed'),(18993,1762,'s2-list','6'),(18994,1762,'_s2-list','field_60bf76e0f46ee'),(18995,1762,'s2-list_0_icon','61'),(18996,1762,'_s2-list_0_icon','field_60bf76ecf46ef'),(18997,1762,'s2-list_0_icon-hover','62'),(18998,1762,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(18999,1762,'s2-list_0_text','Лихоманка'),(19000,1762,'_s2-list_0_text','field_60bf7712f46f1'),(19001,1762,'s2-list_1_icon','63'),(19002,1762,'_s2-list_1_icon','field_60bf76ecf46ef'),(19003,1762,'s2-list_1_icon-hover','64'),(19004,1762,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(19005,1762,'s2-list_1_text','Похмільний синдром'),(19006,1762,'_s2-list_1_text','field_60bf7712f46f1'),(19007,1762,'s2-list_2_icon','65'),(19008,1762,'_s2-list_2_icon','field_60bf76ecf46ef'),(19009,1762,'s2-list_2_icon-hover','66'),(19010,1762,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(19011,1762,'s2-list_2_text','Діарея'),(19012,1762,'_s2-list_2_text','field_60bf7712f46f1'),(19013,1762,'s2-list_3_icon','67'),(19014,1762,'_s2-list_3_icon','field_60bf76ecf46ef'),(19015,1762,'s2-list_3_icon-hover','68'),(19016,1762,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(19017,1762,'s2-list_3_text','Блювота'),(19018,1762,'_s2-list_3_text','field_60bf7712f46f1'),(19019,1762,'s2-list_4_icon','69'),(19020,1762,'_s2-list_4_icon','field_60bf76ecf46ef'),(19021,1762,'s2-list_4_icon-hover','70'),(19022,1762,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(19023,1762,'s2-list_4_text','Інтенсивні фізичні навантаження'),(19024,1762,'_s2-list_4_text','field_60bf7712f46f1'),(19025,1762,'s2-list_5_icon','71'),(19026,1762,'_s2-list_5_icon','field_60bf76ecf46ef'),(19027,1762,'s2-list_5_icon-hover','72'),(19028,1762,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(19029,1762,'s2-list_5_text','Перегрівання в спекотну погоду'),(19030,1762,'_s2-list_5_text','field_60bf7712f46f1'),(19031,1762,'s1-slogan','Коли звичайної води замало!'),(19032,1762,'_s1-slogan','field_60bf7ab4d9ba9'),(19033,1762,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(19034,1762,'_s3-text','field_60bf7bb5a7e2b'),(19035,1762,'s4-ttl','РеО – вода для медичних цілей'),(19036,1762,'_s4-ttl','field_60bf7c831f58c'),(19037,1762,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(19038,1762,'_s4-notes','field_60bf7ca31f58d'),(19039,1762,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(19040,1762,'_s5-video','field_60bf7ccfa01a5'),(19041,1762,'s6-ttl','Коли звичайної води замало!'),(19042,1762,'_s6-ttl','field_60bf7cfb10d31'),(19043,1762,'s6-list','6'),(19044,1762,'_s6-list','field_60bf7d0410d32'),(19045,1762,'s6-list_0_icon','92'),(19046,1762,'_s6-list_0_icon','field_60bf7d1810d33'),(19047,1762,'s6-list_0_text','При підвищеній температурі'),(19048,1762,'_s6-list_0_text','field_60bf7d2710d34'),(19049,1762,'s6-list_1_icon','93'),(19050,1762,'_s6-list_1_icon','field_60bf7d1810d33'),(19051,1762,'s6-list_1_text','При харчових отруєннях'),(19052,1762,'_s6-list_1_text','field_60bf7d2710d34'),(19053,1762,'s6-list_2_icon','94'),(19054,1762,'_s6-list_2_icon','field_60bf7d1810d33'),(19055,1762,'s6-list_2_text','При кишкових інфекціях'),(19056,1762,'_s6-list_2_text','field_60bf7d2710d34'),(19057,1762,'s6-list_3_icon','95'),(19058,1762,'_s6-list_3_icon','field_60bf7d1810d33'),(19059,1762,'s6-list_3_text','Під час вагітності'),(19060,1762,'_s6-list_3_text','field_60bf7d2710d34'),(19061,1762,'s6-list_4_icon','96'),(19062,1762,'_s6-list_4_icon','field_60bf7d1810d33'),(19063,1762,'s6-list_4_text','Під час заняття спортом'),(19064,1762,'_s6-list_4_text','field_60bf7d2710d34'),(19065,1762,'s6-list_5_icon','97'),(19066,1762,'_s6-list_5_icon','field_60bf7d1810d33'),(19067,1762,'s6-list_5_text','При похмільному синдромі'),(19068,1762,'_s6-list_5_text','field_60bf7d2710d34'),(19069,1762,'s4-list_0_ttl','Натрій'),(19070,1762,'_s4-list_0_ttl','field_60bf7fa95a92c'),(19071,1762,'s4-list_0_formula','Na<sup>+</sup>'),(19072,1762,'_s4-list_0_formula','field_60bf7fc65a92d'),(19073,1762,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(19074,1762,'_s4-list_0_text','field_60bf7fd35a92e'),(19075,1762,'s4-list_1_ttl','Вода'),(19076,1762,'_s4-list_1_ttl','field_60bf7fa95a92c'),(19077,1762,'s4-list_1_formula','H<sub>2</sub>O'),(19078,1762,'_s4-list_1_formula','field_60bf7fc65a92d'),(19079,1762,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(19080,1762,'_s4-list_1_text','field_60bf7fd35a92e'),(19081,1762,'s4-list','9'),(19082,1762,'_s4-list','field_60bf7f985a92b'),(19083,1762,'s4-list_2_ttl','Калій'),(19084,1762,'_s4-list_2_ttl','field_60bf7fa95a92c'),(19085,1762,'s4-list_2_formula','K<sup>+</sup>'),(19086,1762,'_s4-list_2_formula','field_60bf7fc65a92d'),(19087,1762,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(19088,1762,'_s4-list_2_text','field_60bf7fd35a92e'),(19089,1762,'s4-list_3_ttl','Гідрокарбонати'),(19090,1762,'_s4-list_3_ttl','field_60bf7fa95a92c'),(19091,1762,'s4-list_3_formula','HCO<sup>3+</sup>'),(19092,1762,'_s4-list_3_formula','field_60bf7fc65a92d'),(19093,1762,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(19094,1762,'_s4-list_3_text','field_60bf7fd35a92e'),(19095,1762,'s4-list_4_ttl','Магній'),(19096,1762,'_s4-list_4_ttl','field_60bf7fa95a92c'),(19097,1762,'s4-list_4_formula','Mg<sup>2+</sup>'),(19098,1762,'_s4-list_4_formula','field_60bf7fc65a92d'),(19099,1762,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(19100,1762,'_s4-list_4_text','field_60bf7fd35a92e'),(19101,1762,'s4-list_5_ttl','Вуглекислий газ'),(19102,1762,'_s4-list_5_ttl','field_60bf7fa95a92c'),(19103,1762,'s4-list_5_formula','CO<sup>2+</sup>'),(19104,1762,'_s4-list_5_formula','field_60bf7fc65a92d'),(19105,1762,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(19106,1762,'_s4-list_5_text','field_60bf7fd35a92e'),(19107,1762,'s4-list_6_ttl','Кальцій'),(19108,1762,'_s4-list_6_ttl','field_60bf7fa95a92c'),(19109,1762,'s4-list_6_formula','Ca<sup>2+</sup>'),(19110,1762,'_s4-list_6_formula','field_60bf7fc65a92d'),(19111,1762,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(19112,1762,'_s4-list_6_text','field_60bf7fd35a92e'),(19113,1762,'s4-list_7_ttl','Сорбіт'),(19114,1762,'_s4-list_7_ttl','field_60bf7fa95a92c'),(19115,1762,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(19116,1762,'_s4-list_7_formula','field_60bf7fc65a92d'),(19117,1762,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(19118,1762,'_s4-list_7_text','field_60bf7fd35a92e'),(19119,1762,'s4-list_8_ttl','Хлор'),(19120,1762,'_s4-list_8_ttl','field_60bf7fa95a92c'),(19121,1762,'s4-list_8_formula','Cl<sup>-</sup>'),(19122,1762,'_s4-list_8_formula','field_60bf7fc65a92d'),(19123,1762,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(19124,1762,'_s4-list_8_text','field_60bf7fd35a92e'),(19125,1762,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(19126,1762,'_s4-feature1','field_60bf80ca480ea'),(19127,1762,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(19128,1762,'_s4-feature2','field_60bf80de480eb'),(19129,1762,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(19130,1762,'_s4-feature3','field_60bf80e2480ec'),(19131,1762,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(19132,1762,'_s4-feature4','field_60bf80e5480ed'),(19133,1762,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(19134,1762,'_s2-list_0_link','field_60ee90d381a4e'),(19135,1762,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(19136,1762,'_s2-list_1_link','field_60ee90d381a4e'),(19137,1762,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(19138,1762,'_s2-list_2_link','field_60ee90d381a4e'),(19139,1762,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(19140,1762,'_s2-list_3_link','field_60ee90d381a4e'),(19141,1762,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(19142,1762,'_s2-list_4_link','field_60ee90d381a4e'),(19143,1762,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(19144,1762,'_s2-list_5_link','field_60ee90d381a4e'),(19145,1762,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(19146,1762,'_s6-list_0_link','field_60ee916b04ace'),(19147,1762,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(19148,1762,'_s6-list_1_link','field_60ee916b04ace'),(19149,1762,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(19150,1762,'_s6-list_2_link','field_60ee916b04ace'),(19151,1762,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(19152,1762,'_s6-list_3_link','field_60ee916b04ace'),(19153,1762,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(19154,1762,'_s6-list_4_link','field_60ee916b04ace'),(19155,1762,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(19156,1762,'_s6-list_5_link','field_60ee916b04ace'),(19157,1762,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(19158,1762,'_slider_0_webplink','field_60fa70c989e88'),(19159,1762,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(19160,1762,'_slider_1_webplink','field_60fa70c989e88'),(19161,1762,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(19162,1762,'_slider_2_webplink','field_60fa70c989e88'),(19163,1762,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(19164,1762,'_slider_3_webplink','field_60fa70c989e88'),(19165,1762,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(19166,1762,'_slider_4_webplink','field_60fa70c989e88'),(19167,1762,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(19168,1762,'_slider_5_webplink','field_60fa70c989e88'),(19169,1762,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(19170,1762,'_slider_6_webplink','field_60fa70c989e88'),(19171,1762,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(19172,1762,'_slider_7_webplink','field_60fa70c989e88'),(19173,1762,'slider_0_slide','50'),(19174,1762,'_slider_0_slide','field_60bf7688f46eb'),(19175,1762,'slider_1_slide','51'),(19176,1762,'_slider_1_slide','field_60bf7688f46eb'),(19177,1762,'slider_2_slide','52'),(19178,1762,'_slider_2_slide','field_60bf7688f46eb'),(19179,1762,'slider_3_slide','53'),(19180,1762,'_slider_3_slide','field_60bf7688f46eb'),(19181,1762,'slider_4_slide','54'),(19182,1762,'_slider_4_slide','field_60bf7688f46eb'),(19183,1762,'slider_5_slide','55'),(19184,1762,'_slider_5_slide','field_60bf7688f46eb'),(19185,1762,'slider_6_slide','56'),(19186,1762,'_slider_6_slide','field_60bf7688f46eb'),(19187,1762,'slider_7_slide','57'),(19188,1762,'_slider_7_slide','field_60bf7688f46eb'),(19189,1763,'s2-list','6'),(19190,1763,'_s2-list','field_60bf76e0f46ee'),(19191,1763,'s2-ttl','Тананинг сув-туз мувозанати бузилишига олиб келадиган ҳолатлар мавжуд'),(19192,1763,'_s2-ttl','field_60bf76d1f46ed'),(19193,1763,'slider','3'),(19194,1763,'_slider','field_60bf767ef46ea'),(19195,1763,'slider_0_slide','1663'),(19196,1763,'_slider_0_slide','field_60bf7688f46eb'),(19197,1763,'slider_1_slide','1666'),(19198,1763,'_slider_1_slide','field_60bf7688f46eb'),(19199,1763,'slider_2_slide','1669'),(19200,1763,'_slider_2_slide','field_60bf7688f46eb'),(19201,1763,'s2-list_0_icon','61'),(19202,1763,'_s2-list_0_icon','field_60bf76ecf46ef'),(19203,1763,'s2-list_0_icon-hover','62'),(19204,1763,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(19205,1763,'s2-list_0_text','Иситма'),(19206,1763,'_s2-list_0_text','field_60bf7712f46f1'),(19207,1763,'s2-list_1_icon','63'),(19208,1763,'_s2-list_1_icon','field_60bf76ecf46ef'),(19209,1763,'s2-list_1_icon-hover','64'),(19210,1763,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(19211,1763,'s2-list_1_text','Алкоголдан кейинги асоратлар'),(19212,1763,'_s2-list_1_text','field_60bf7712f46f1'),(19213,1763,'s2-list_2_icon','65'),(19214,1763,'_s2-list_2_icon','field_60bf76ecf46ef'),(19215,1763,'s2-list_2_icon-hover','66'),(19216,1763,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(19217,1763,'s2-list_2_text','Диарея'),(19218,1763,'_s2-list_2_text','field_60bf7712f46f1'),(19219,1763,'s2-list_3_icon','67'),(19220,1763,'_s2-list_3_icon','field_60bf76ecf46ef'),(19221,1763,'s2-list_3_icon-hover','68'),(19222,1763,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(19223,1763,'s2-list_3_text','Қайт қилиш'),(19224,1763,'_s2-list_3_text','field_60bf7712f46f1'),(19225,1763,'s2-list_4_icon','69'),(19226,1763,'_s2-list_4_icon','field_60bf76ecf46ef'),(19227,1763,'s2-list_4_icon-hover','70'),(19228,1763,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(19229,1763,'s2-list_4_text','Жадал жисмоний юкламалар'),(19230,1763,'_s2-list_4_text','field_60bf7712f46f1'),(19231,1763,'s2-list_5_icon','71'),(19232,1763,'_s2-list_5_icon','field_60bf76ecf46ef'),(19233,1763,'s2-list_5_icon-hover','72'),(19234,1763,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(19235,1763,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(19236,1763,'_s2-list_5_text','field_60bf7712f46f1'),(19237,1763,'s1-slogan','Оддий сув етарли бўлмаганда!'),(19238,1763,'_s1-slogan','field_60bf7ab4d9ba9'),(19239,1763,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(19240,1763,'_s3-text','field_60bf7bb5a7e2b'),(19241,1763,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(19242,1763,'_s4-ttl','field_60bf7c831f58c'),(19243,1763,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(19244,1763,'_s4-notes','field_60bf7ca31f58d'),(19245,1763,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(19246,1763,'_s5-video','field_60bf7ccfa01a5'),(19247,1763,'s6-ttl','Оддий сув етарли бўлмаганда!'),(19248,1763,'_s6-ttl','field_60bf7cfb10d31'),(19249,1763,'s6-list','6'),(19250,1763,'_s6-list','field_60bf7d0410d32'),(19251,1763,'s6-list_0_icon','92'),(19252,1763,'_s6-list_0_icon','field_60bf7d1810d33'),(19253,1763,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(19254,1763,'_s6-list_0_text','field_60bf7d2710d34'),(19255,1763,'s6-list_1_icon','93'),(19256,1763,'_s6-list_1_icon','field_60bf7d1810d33'),(19257,1763,'s6-list_1_text','Овқатдан заҳарланишларда'),(19258,1763,'_s6-list_1_text','field_60bf7d2710d34'),(19259,1763,'s6-list_2_icon','94'),(19260,1763,'_s6-list_2_icon','field_60bf7d1810d33'),(19261,1763,'s6-list_2_text','Ичак инфекцияларида'),(19262,1763,'_s6-list_2_text','field_60bf7d2710d34'),(19263,1763,'s6-list_3_icon','95'),(19264,1763,'_s6-list_3_icon','field_60bf7d1810d33'),(19265,1763,'s6-list_3_text','Ҳомиладорлик вақтида'),(19266,1763,'_s6-list_3_text','field_60bf7d2710d34'),(19267,1763,'s6-list_4_icon','96'),(19268,1763,'_s6-list_4_icon','field_60bf7d1810d33'),(19269,1763,'s6-list_4_text','Спорт билан шуғулланганда '),(19270,1763,'_s6-list_4_text','field_60bf7d2710d34'),(19271,1763,'s6-list_5_icon','97'),(19272,1763,'_s6-list_5_icon','field_60bf7d1810d33'),(19273,1763,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(19274,1763,'_s6-list_5_text','field_60bf7d2710d34'),(19275,1763,'s4-list_0_ttl','Натрий'),(19276,1763,'_s4-list_0_ttl','field_60bf7fa95a92c'),(19277,1763,'s4-list_0_formula','Na<sup>+</sup>'),(19278,1763,'_s4-list_0_formula','field_60bf7fc65a92d'),(19279,1763,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(19280,1763,'_s4-list_0_text','field_60bf7fd35a92e'),(19281,1763,'s4-list_1_ttl','Сув'),(19282,1763,'_s4-list_1_ttl','field_60bf7fa95a92c'),(19283,1763,'s4-list_1_formula','H<sub>2</sub>O'),(19284,1763,'_s4-list_1_formula','field_60bf7fc65a92d'),(19285,1763,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(19286,1763,'_s4-list_1_text','field_60bf7fd35a92e'),(19287,1763,'s4-list','9'),(19288,1763,'_s4-list','field_60bf7f985a92b'),(19289,1763,'s4-list_2_ttl','Калий'),(19290,1763,'_s4-list_2_ttl','field_60bf7fa95a92c'),(19291,1763,'s4-list_2_formula','K<sup>+</sup>'),(19292,1763,'_s4-list_2_formula','field_60bf7fc65a92d'),(19293,1763,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(19294,1763,'_s4-list_2_text','field_60bf7fd35a92e'),(19295,1763,'s4-list_3_ttl','Гидрокарбонатлар '),(19296,1763,'_s4-list_3_ttl','field_60bf7fa95a92c'),(19297,1763,'s4-list_3_formula','HCO<sup>3+</sup>'),(19298,1763,'_s4-list_3_formula','field_60bf7fc65a92d'),(19299,1763,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(19300,1763,'_s4-list_3_text','field_60bf7fd35a92e'),(19301,1763,'s4-list_4_ttl','Магний'),(19302,1763,'_s4-list_4_ttl','field_60bf7fa95a92c'),(19303,1763,'s4-list_4_formula','Mg<sup>2+</sup>'),(19304,1763,'_s4-list_4_formula','field_60bf7fc65a92d'),(19305,1763,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(19306,1763,'_s4-list_4_text','field_60bf7fd35a92e'),(19307,1763,'s4-list_5_ttl','Углекислый газ'),(19308,1763,'_s4-list_5_ttl','field_60bf7fa95a92c'),(19309,1763,'s4-list_5_formula','CO<sup>2</sup>+'),(19310,1763,'_s4-list_5_formula','field_60bf7fc65a92d'),(19311,1763,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(19312,1763,'_s4-list_5_text','field_60bf7fd35a92e'),(19313,1763,'s4-list_6_ttl','Кальций'),(19314,1763,'_s4-list_6_ttl','field_60bf7fa95a92c'),(19315,1763,'s4-list_6_formula','Ca<sup>2+</sup>'),(19316,1763,'_s4-list_6_formula','field_60bf7fc65a92d'),(19317,1763,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(19318,1763,'_s4-list_6_text','field_60bf7fd35a92e'),(19319,1763,'s4-list_7_ttl','Сорбитол'),(19320,1763,'_s4-list_7_ttl','field_60bf7fa95a92c'),(19321,1763,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(19322,1763,'_s4-list_7_formula','field_60bf7fc65a92d'),(19323,1763,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(19324,1763,'_s4-list_7_text','field_60bf7fd35a92e'),(19325,1763,'s4-list_8_ttl','Хлор'),(19326,1763,'_s4-list_8_ttl','field_60bf7fa95a92c'),(19327,1763,'s4-list_8_formula','Cl<sup>-</sup>'),(19328,1763,'_s4-list_8_formula','field_60bf7fc65a92d'),(19329,1763,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(19330,1763,'_s4-list_8_text','field_60bf7fd35a92e'),(19331,1763,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(19332,1763,'_s4-feature1','field_60bf80ca480ea'),(19333,1763,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(19334,1763,'_s4-feature2','field_60bf80de480eb'),(19335,1763,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(19336,1763,'_s4-feature3','field_60bf80e2480ec'),(19337,1763,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(19338,1763,'_s4-feature4','field_60bf80e5480ed'),(19339,1763,'s2-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(19340,1763,'_s2-list_0_link','field_60ee90d381a4e'),(19341,1763,'s2-list_1_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(19342,1763,'_s2-list_1_link','field_60ee90d381a4e'),(19343,1763,'s2-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(19344,1763,'_s2-list_2_link','field_60ee90d381a4e'),(19345,1763,'s2-list_3_link','/uz/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/қajt-қilish-suvsizlanish-sababi-sifatida/'),(19346,1763,'_s2-list_3_link','field_60ee90d381a4e'),(19347,1763,'s2-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(19348,1763,'_s2-list_4_link','field_60ee90d381a4e'),(19349,1763,'s2-list_5_link','/uz/istemolchi-uchun/reo-sport-bilan-shuғullanganda/yozgi-issiқda-қandaj-қilib-issiқlik-urishi-va-suvsizlanishning-oldini-olish-mumkin/'),(19350,1763,'_s2-list_5_link','field_60ee90d381a4e'),(19351,1763,'s6-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(19352,1763,'_s6-list_0_link','field_60ee916b04ace'),(19353,1763,'s6-list_1_link','/uz/category/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/'),(19354,1763,'_s6-list_1_link','field_60ee916b04ace'),(19355,1763,'s6-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(19356,1763,'_s6-list_2_link','field_60ee916b04ace'),(19357,1763,'s6-list_3_link','/uz/category/istemolchi-uchun/reo-ҳomiladorlik-vaқtida/'),(19358,1763,'_s6-list_3_link','field_60ee916b04ace'),(19359,1763,'s6-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(19360,1763,'_s6-list_4_link','field_60ee916b04ace'),(19361,1763,'s6-list_5_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(19362,1763,'_s6-list_5_link','field_60ee916b04ace'),(19363,1763,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(19364,1763,'_slider_0_webplink','field_60fa70c989e88'),(19365,1763,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(19366,1763,'_slider_1_webplink','field_60fa70c989e88'),(19367,1763,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(19368,1763,'_slider_2_webplink','field_60fa70c989e88'),(19369,1763,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(19370,1763,'_slider_3_webplink','field_60fa70c989e88'),(19371,1763,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(19372,1763,'_slider_4_webplink','field_60fa70c989e88'),(19373,1763,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(19374,1763,'_slider_5_webplink','field_60fa70c989e88'),(19375,1763,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(19376,1763,'_slider_6_webplink','field_60fa70c989e88'),(19377,1763,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(19378,1763,'_slider_7_webplink','field_60fa70c989e88'),(19379,1764,'s2-list','6'),(19380,1764,'_s2-list','field_60bf76e0f46ee'),(19381,1764,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(19382,1764,'_s2-ttl','field_60bf76d1f46ed'),(19383,1764,'slider','8'),(19384,1764,'_slider','field_60bf767ef46ea'),(19385,1764,'slider_0_slide','332'),(19386,1764,'_slider_0_slide','field_60bf7688f46eb'),(19387,1764,'slider_1_slide','334'),(19388,1764,'_slider_1_slide','field_60bf7688f46eb'),(19389,1764,'slider_2_slide','336'),(19390,1764,'_slider_2_slide','field_60bf7688f46eb'),(19391,1764,'slider_3_slide','338'),(19392,1764,'_slider_3_slide','field_60bf7688f46eb'),(19393,1764,'slider_4_slide','340'),(19394,1764,'_slider_4_slide','field_60bf7688f46eb'),(19395,1764,'slider_5_slide','342'),(19396,1764,'_slider_5_slide','field_60bf7688f46eb'),(19397,1764,'slider_6_slide','344'),(19398,1764,'_slider_6_slide','field_60bf7688f46eb'),(19399,1764,'slider_7_slide','346'),(19400,1764,'_slider_7_slide','field_60bf7688f46eb'),(19401,1764,'s2-list_0_icon','61'),(19402,1764,'_s2-list_0_icon','field_60bf76ecf46ef'),(19403,1764,'s2-list_0_icon-hover','62'),(19404,1764,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(19405,1764,'s2-list_0_text','Лихорадка'),(19406,1764,'_s2-list_0_text','field_60bf7712f46f1'),(19407,1764,'s2-list_1_icon','63'),(19408,1764,'_s2-list_1_icon','field_60bf76ecf46ef'),(19409,1764,'s2-list_1_icon-hover','64'),(19410,1764,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(19411,1764,'s2-list_1_text','Похмельный синдром'),(19412,1764,'_s2-list_1_text','field_60bf7712f46f1'),(19413,1764,'s2-list_2_icon','65'),(19414,1764,'_s2-list_2_icon','field_60bf76ecf46ef'),(19415,1764,'s2-list_2_icon-hover','66'),(19416,1764,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(19417,1764,'s2-list_2_text','Диарея'),(19418,1764,'_s2-list_2_text','field_60bf7712f46f1'),(19419,1764,'s2-list_3_icon','67'),(19420,1764,'_s2-list_3_icon','field_60bf76ecf46ef'),(19421,1764,'s2-list_3_icon-hover','68'),(19422,1764,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(19423,1764,'s2-list_3_text','Рвота'),(19424,1764,'_s2-list_3_text','field_60bf7712f46f1'),(19425,1764,'s2-list_4_icon','69'),(19426,1764,'_s2-list_4_icon','field_60bf76ecf46ef'),(19427,1764,'s2-list_4_icon-hover','70'),(19428,1764,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(19429,1764,'s2-list_4_text','Интенсивные физические нагрузки'),(19430,1764,'_s2-list_4_text','field_60bf7712f46f1'),(19431,1764,'s2-list_5_icon','71'),(19432,1764,'_s2-list_5_icon','field_60bf76ecf46ef'),(19433,1764,'s2-list_5_icon-hover','72'),(19434,1764,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(19435,1764,'s2-list_5_text','Перегрев в жаркую погоду'),(19436,1764,'_s2-list_5_text','field_60bf7712f46f1'),(19437,1764,'s1-slogan','Когда обычной воды недостаточно!'),(19438,1764,'_s1-slogan','field_60bf7ab4d9ba9'),(19439,1764,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(19440,1764,'_s3-text','field_60bf7bb5a7e2b'),(19441,1764,'s4-ttl','РеО – вода для медицинских целей!'),(19442,1764,'_s4-ttl','field_60bf7c831f58c'),(19443,1764,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(19444,1764,'_s4-notes','field_60bf7ca31f58d'),(19445,1764,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(19446,1764,'_s5-video','field_60bf7ccfa01a5'),(19447,1764,'s6-ttl','Когда обычной воды недостаточно!'),(19448,1764,'_s6-ttl','field_60bf7cfb10d31'),(19449,1764,'s6-list','6'),(19450,1764,'_s6-list','field_60bf7d0410d32'),(19451,1764,'s6-list_0_icon','92'),(19452,1764,'_s6-list_0_icon','field_60bf7d1810d33'),(19453,1764,'s6-list_0_text','При повышенной температуре'),(19454,1764,'_s6-list_0_text','field_60bf7d2710d34'),(19455,1764,'s6-list_1_icon','93'),(19456,1764,'_s6-list_1_icon','field_60bf7d1810d33'),(19457,1764,'s6-list_1_text','При пищевых отравлениях'),(19458,1764,'_s6-list_1_text','field_60bf7d2710d34'),(19459,1764,'s6-list_2_icon','94'),(19460,1764,'_s6-list_2_icon','field_60bf7d1810d33'),(19461,1764,'s6-list_2_text','При кишечных инфекциях'),(19462,1764,'_s6-list_2_text','field_60bf7d2710d34'),(19463,1764,'s6-list_3_icon','95'),(19464,1764,'_s6-list_3_icon','field_60bf7d1810d33'),(19465,1764,'s6-list_3_text','Во время беременности'),(19466,1764,'_s6-list_3_text','field_60bf7d2710d34'),(19467,1764,'s6-list_4_icon','96'),(19468,1764,'_s6-list_4_icon','field_60bf7d1810d33'),(19469,1764,'s6-list_4_text','Во время занятий спортом'),(19470,1764,'_s6-list_4_text','field_60bf7d2710d34'),(19471,1764,'s6-list_5_icon','97'),(19472,1764,'_s6-list_5_icon','field_60bf7d1810d33'),(19473,1764,'s6-list_5_text','При похмельном синдроме'),(19474,1764,'_s6-list_5_text','field_60bf7d2710d34'),(19475,1764,'s4-list_0_ttl','Натрий'),(19476,1764,'_s4-list_0_ttl','field_60bf7fa95a92c'),(19477,1764,'s4-list_0_formula','Na<sup>+</sup>'),(19478,1764,'_s4-list_0_formula','field_60bf7fc65a92d'),(19479,1764,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(19480,1764,'_s4-list_0_text','field_60bf7fd35a92e'),(19481,1764,'s4-list_1_ttl','Вода'),(19482,1764,'_s4-list_1_ttl','field_60bf7fa95a92c'),(19483,1764,'s4-list_1_formula','H<sub>2</sub>O'),(19484,1764,'_s4-list_1_formula','field_60bf7fc65a92d'),(19485,1764,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(19486,1764,'_s4-list_1_text','field_60bf7fd35a92e'),(19487,1764,'s4-list','9'),(19488,1764,'_s4-list','field_60bf7f985a92b'),(19489,1764,'s4-list_2_ttl','Калий'),(19490,1764,'_s4-list_2_ttl','field_60bf7fa95a92c'),(19491,1764,'s4-list_2_formula','K<sup>+</sup>'),(19492,1764,'_s4-list_2_formula','field_60bf7fc65a92d'),(19493,1764,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(19494,1764,'_s4-list_2_text','field_60bf7fd35a92e'),(19495,1764,'s4-list_3_ttl','Гидрокарбонаты'),(19496,1764,'_s4-list_3_ttl','field_60bf7fa95a92c'),(19497,1764,'s4-list_3_formula','HCO<sup>3+</sup>'),(19498,1764,'_s4-list_3_formula','field_60bf7fc65a92d'),(19499,1764,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(19500,1764,'_s4-list_3_text','field_60bf7fd35a92e'),(19501,1764,'s4-list_4_ttl','Магний'),(19502,1764,'_s4-list_4_ttl','field_60bf7fa95a92c'),(19503,1764,'s4-list_4_formula','Mg<sup>2+</sup>'),(19504,1764,'_s4-list_4_formula','field_60bf7fc65a92d'),(19505,1764,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(19506,1764,'_s4-list_4_text','field_60bf7fd35a92e'),(19507,1764,'s4-list_5_ttl','Углекислый газ'),(19508,1764,'_s4-list_5_ttl','field_60bf7fa95a92c'),(19509,1764,'s4-list_5_formula','CO<sup>2</sup>+'),(19510,1764,'_s4-list_5_formula','field_60bf7fc65a92d'),(19511,1764,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(19512,1764,'_s4-list_5_text','field_60bf7fd35a92e'),(19513,1764,'s4-list_6_ttl','Кальций'),(19514,1764,'_s4-list_6_ttl','field_60bf7fa95a92c'),(19515,1764,'s4-list_6_formula','Ca<sup>2+</sup>'),(19516,1764,'_s4-list_6_formula','field_60bf7fc65a92d'),(19517,1764,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(19518,1764,'_s4-list_6_text','field_60bf7fd35a92e'),(19519,1764,'s4-list_7_ttl','Сорбит'),(19520,1764,'_s4-list_7_ttl','field_60bf7fa95a92c'),(19521,1764,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(19522,1764,'_s4-list_7_formula','field_60bf7fc65a92d'),(19523,1764,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(19524,1764,'_s4-list_7_text','field_60bf7fd35a92e'),(19525,1764,'s4-list_8_ttl','Хлор'),(19526,1764,'_s4-list_8_ttl','field_60bf7fa95a92c'),(19527,1764,'s4-list_8_formula','Cl<sup>-</sup>'),(19528,1764,'_s4-list_8_formula','field_60bf7fc65a92d'),(19529,1764,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(19530,1764,'_s4-list_8_text','field_60bf7fd35a92e'),(19531,1764,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(19532,1764,'_s4-feature1','field_60bf80ca480ea'),(19533,1764,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(19534,1764,'_s4-feature2','field_60bf80de480eb'),(19535,1764,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(19536,1764,'_s4-feature3','field_60bf80e2480ec'),(19537,1764,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(19538,1764,'_s4-feature4','field_60bf80e5480ed'),(19539,1764,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(19540,1764,'_s2-list_0_link','field_60ee90d381a4e'),(19541,1764,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(19542,1764,'_s2-list_1_link','field_60ee90d381a4e'),(19543,1764,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(19544,1764,'_s2-list_2_link','field_60ee90d381a4e'),(19545,1764,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(19546,1764,'_s2-list_3_link','field_60ee90d381a4e'),(19547,1764,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(19548,1764,'_s2-list_4_link','field_60ee90d381a4e'),(19549,1764,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(19550,1764,'_s2-list_5_link','field_60ee90d381a4e'),(19551,1764,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(19552,1764,'_s6-list_0_link','field_60ee916b04ace'),(19553,1764,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(19554,1764,'_s6-list_1_link','field_60ee916b04ace'),(19555,1764,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(19556,1764,'_s6-list_2_link','field_60ee916b04ace'),(19557,1764,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(19558,1764,'_s6-list_3_link','field_60ee916b04ace'),(19559,1764,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(19560,1764,'_s6-list_4_link','field_60ee916b04ace'),(19561,1764,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(19562,1764,'_s6-list_5_link','field_60ee916b04ace'),(19563,1764,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(19564,1764,'_slider_0_webplink','field_60fa70c989e88'),(19565,1764,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(19566,1764,'_slider_1_webplink','field_60fa70c989e88'),(19567,1764,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(19568,1764,'_slider_2_webplink','field_60fa70c989e88'),(19569,1764,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(19570,1764,'_slider_3_webplink','field_60fa70c989e88'),(19571,1764,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(19572,1764,'_slider_4_webplink','field_60fa70c989e88'),(19573,1764,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(19574,1764,'_slider_5_webplink','field_60fa70c989e88'),(19575,1764,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(19576,1764,'_slider_6_webplink','field_60fa70c989e88'),(19577,1764,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(19578,1764,'_slider_7_webplink','field_60fa70c989e88'),(19579,1765,'s2-list','6'),(19580,1765,'_s2-list','field_60bf76e0f46ee'),(19581,1765,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(19582,1765,'_s2-ttl','field_60bf76d1f46ed'),(19583,1765,'slider','8'),(19584,1765,'_slider','field_60bf767ef46ea'),(19585,1765,'slider_0_slide','332'),(19586,1765,'_slider_0_slide','field_60bf7688f46eb'),(19587,1765,'slider_1_slide','334'),(19588,1765,'_slider_1_slide','field_60bf7688f46eb'),(19589,1765,'slider_2_slide','336'),(19590,1765,'_slider_2_slide','field_60bf7688f46eb'),(19591,1765,'slider_3_slide','338'),(19592,1765,'_slider_3_slide','field_60bf7688f46eb'),(19593,1765,'slider_4_slide','340'),(19594,1765,'_slider_4_slide','field_60bf7688f46eb'),(19595,1765,'slider_5_slide','342'),(19596,1765,'_slider_5_slide','field_60bf7688f46eb'),(19597,1765,'slider_6_slide','344'),(19598,1765,'_slider_6_slide','field_60bf7688f46eb'),(19599,1765,'slider_7_slide','346'),(19600,1765,'_slider_7_slide','field_60bf7688f46eb'),(19601,1765,'s2-list_0_icon','61'),(19602,1765,'_s2-list_0_icon','field_60bf76ecf46ef'),(19603,1765,'s2-list_0_icon-hover','62'),(19604,1765,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(19605,1765,'s2-list_0_text','Лихорадка'),(19606,1765,'_s2-list_0_text','field_60bf7712f46f1'),(19607,1765,'s2-list_1_icon','63'),(19608,1765,'_s2-list_1_icon','field_60bf76ecf46ef'),(19609,1765,'s2-list_1_icon-hover','64'),(19610,1765,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(19611,1765,'s2-list_1_text','Похмельный синдром'),(19612,1765,'_s2-list_1_text','field_60bf7712f46f1'),(19613,1765,'s2-list_2_icon','65'),(19614,1765,'_s2-list_2_icon','field_60bf76ecf46ef'),(19615,1765,'s2-list_2_icon-hover','66'),(19616,1765,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(19617,1765,'s2-list_2_text','Диарея'),(19618,1765,'_s2-list_2_text','field_60bf7712f46f1'),(19619,1765,'s2-list_3_icon','67'),(19620,1765,'_s2-list_3_icon','field_60bf76ecf46ef'),(19621,1765,'s2-list_3_icon-hover','68'),(19622,1765,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(19623,1765,'s2-list_3_text','Рвота'),(19624,1765,'_s2-list_3_text','field_60bf7712f46f1'),(19625,1765,'s2-list_4_icon','69'),(19626,1765,'_s2-list_4_icon','field_60bf76ecf46ef'),(19627,1765,'s2-list_4_icon-hover','70'),(19628,1765,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(19629,1765,'s2-list_4_text','Интенсивные физические нагрузки'),(19630,1765,'_s2-list_4_text','field_60bf7712f46f1'),(19631,1765,'s2-list_5_icon','71'),(19632,1765,'_s2-list_5_icon','field_60bf76ecf46ef'),(19633,1765,'s2-list_5_icon-hover','72'),(19634,1765,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(19635,1765,'s2-list_5_text','Перегрев в жаркую погоду'),(19636,1765,'_s2-list_5_text','field_60bf7712f46f1'),(19637,1765,'s1-slogan','Когда обычной воды недостаточно!'),(19638,1765,'_s1-slogan','field_60bf7ab4d9ba9'),(19639,1765,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(19640,1765,'_s3-text','field_60bf7bb5a7e2b'),(19641,1765,'s4-ttl','РеО – вода для медицинских целей!'),(19642,1765,'_s4-ttl','field_60bf7c831f58c'),(19643,1765,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(19644,1765,'_s4-notes','field_60bf7ca31f58d'),(19645,1765,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(19646,1765,'_s5-video','field_60bf7ccfa01a5'),(19647,1765,'s6-ttl','Когда обычной воды недостаточно!'),(19648,1765,'_s6-ttl','field_60bf7cfb10d31'),(19649,1765,'s6-list','6'),(19650,1765,'_s6-list','field_60bf7d0410d32'),(19651,1765,'s6-list_0_icon','92'),(19652,1765,'_s6-list_0_icon','field_60bf7d1810d33'),(19653,1765,'s6-list_0_text','При повышенной температуре'),(19654,1765,'_s6-list_0_text','field_60bf7d2710d34'),(19655,1765,'s6-list_1_icon','93'),(19656,1765,'_s6-list_1_icon','field_60bf7d1810d33'),(19657,1765,'s6-list_1_text','При пищевых отравлениях'),(19658,1765,'_s6-list_1_text','field_60bf7d2710d34'),(19659,1765,'s6-list_2_icon','94'),(19660,1765,'_s6-list_2_icon','field_60bf7d1810d33'),(19661,1765,'s6-list_2_text','При кишечных инфекциях'),(19662,1765,'_s6-list_2_text','field_60bf7d2710d34'),(19663,1765,'s6-list_3_icon','95'),(19664,1765,'_s6-list_3_icon','field_60bf7d1810d33'),(19665,1765,'s6-list_3_text','Во время беременности'),(19666,1765,'_s6-list_3_text','field_60bf7d2710d34'),(19667,1765,'s6-list_4_icon','96'),(19668,1765,'_s6-list_4_icon','field_60bf7d1810d33'),(19669,1765,'s6-list_4_text','Во время занятий спортом'),(19670,1765,'_s6-list_4_text','field_60bf7d2710d34'),(19671,1765,'s6-list_5_icon','97'),(19672,1765,'_s6-list_5_icon','field_60bf7d1810d33'),(19673,1765,'s6-list_5_text','При похмельном синдроме'),(19674,1765,'_s6-list_5_text','field_60bf7d2710d34'),(19675,1765,'s4-list_0_ttl','Натрий'),(19676,1765,'_s4-list_0_ttl','field_60bf7fa95a92c'),(19677,1765,'s4-list_0_formula','Na<sup>+</sup>'),(19678,1765,'_s4-list_0_formula','field_60bf7fc65a92d'),(19679,1765,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(19680,1765,'_s4-list_0_text','field_60bf7fd35a92e'),(19681,1765,'s4-list_1_ttl','Вода'),(19682,1765,'_s4-list_1_ttl','field_60bf7fa95a92c'),(19683,1765,'s4-list_1_formula','H<sub>2</sub>O'),(19684,1765,'_s4-list_1_formula','field_60bf7fc65a92d'),(19685,1765,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(19686,1765,'_s4-list_1_text','field_60bf7fd35a92e'),(19687,1765,'s4-list','9'),(19688,1765,'_s4-list','field_60bf7f985a92b'),(19689,1765,'s4-list_2_ttl','Калий'),(19690,1765,'_s4-list_2_ttl','field_60bf7fa95a92c'),(19691,1765,'s4-list_2_formula','K<sup>+</sup>'),(19692,1765,'_s4-list_2_formula','field_60bf7fc65a92d'),(19693,1765,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(19694,1765,'_s4-list_2_text','field_60bf7fd35a92e'),(19695,1765,'s4-list_3_ttl','Гидрокарбонаты'),(19696,1765,'_s4-list_3_ttl','field_60bf7fa95a92c'),(19697,1765,'s4-list_3_formula','HCO<sup>3+</sup>'),(19698,1765,'_s4-list_3_formula','field_60bf7fc65a92d'),(19699,1765,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(19700,1765,'_s4-list_3_text','field_60bf7fd35a92e'),(19701,1765,'s4-list_4_ttl','Магний'),(19702,1765,'_s4-list_4_ttl','field_60bf7fa95a92c'),(19703,1765,'s4-list_4_formula','Mg<sup>2+</sup>'),(19704,1765,'_s4-list_4_formula','field_60bf7fc65a92d'),(19705,1765,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(19706,1765,'_s4-list_4_text','field_60bf7fd35a92e'),(19707,1765,'s4-list_5_ttl','Углекислый газ'),(19708,1765,'_s4-list_5_ttl','field_60bf7fa95a92c'),(19709,1765,'s4-list_5_formula','CO<sup>2+</sup>'),(19710,1765,'_s4-list_5_formula','field_60bf7fc65a92d'),(19711,1765,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(19712,1765,'_s4-list_5_text','field_60bf7fd35a92e'),(19713,1765,'s4-list_6_ttl','Кальций'),(19714,1765,'_s4-list_6_ttl','field_60bf7fa95a92c'),(19715,1765,'s4-list_6_formula','Ca<sup>2+</sup>'),(19716,1765,'_s4-list_6_formula','field_60bf7fc65a92d'),(19717,1765,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(19718,1765,'_s4-list_6_text','field_60bf7fd35a92e'),(19719,1765,'s4-list_7_ttl','Сорбит'),(19720,1765,'_s4-list_7_ttl','field_60bf7fa95a92c'),(19721,1765,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(19722,1765,'_s4-list_7_formula','field_60bf7fc65a92d'),(19723,1765,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(19724,1765,'_s4-list_7_text','field_60bf7fd35a92e'),(19725,1765,'s4-list_8_ttl','Хлор'),(19726,1765,'_s4-list_8_ttl','field_60bf7fa95a92c'),(19727,1765,'s4-list_8_formula','Cl<sup>-</sup>'),(19728,1765,'_s4-list_8_formula','field_60bf7fc65a92d'),(19729,1765,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(19730,1765,'_s4-list_8_text','field_60bf7fd35a92e'),(19731,1765,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(19732,1765,'_s4-feature1','field_60bf80ca480ea'),(19733,1765,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(19734,1765,'_s4-feature2','field_60bf80de480eb'),(19735,1765,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(19736,1765,'_s4-feature3','field_60bf80e2480ec'),(19737,1765,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(19738,1765,'_s4-feature4','field_60bf80e5480ed'),(19739,1765,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(19740,1765,'_s2-list_0_link','field_60ee90d381a4e'),(19741,1765,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(19742,1765,'_s2-list_1_link','field_60ee90d381a4e'),(19743,1765,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(19744,1765,'_s2-list_2_link','field_60ee90d381a4e'),(19745,1765,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(19746,1765,'_s2-list_3_link','field_60ee90d381a4e'),(19747,1765,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(19748,1765,'_s2-list_4_link','field_60ee90d381a4e'),(19749,1765,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(19750,1765,'_s2-list_5_link','field_60ee90d381a4e'),(19751,1765,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(19752,1765,'_s6-list_0_link','field_60ee916b04ace'),(19753,1765,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(19754,1765,'_s6-list_1_link','field_60ee916b04ace'),(19755,1765,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(19756,1765,'_s6-list_2_link','field_60ee916b04ace'),(19757,1765,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(19758,1765,'_s6-list_3_link','field_60ee916b04ace'),(19759,1765,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(19760,1765,'_s6-list_4_link','field_60ee916b04ace'),(19761,1765,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(19762,1765,'_s6-list_5_link','field_60ee916b04ace'),(19763,1765,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(19764,1765,'_slider_0_webplink','field_60fa70c989e88'),(19765,1765,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(19766,1765,'_slider_1_webplink','field_60fa70c989e88'),(19767,1765,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(19768,1765,'_slider_2_webplink','field_60fa70c989e88'),(19769,1765,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(19770,1765,'_slider_3_webplink','field_60fa70c989e88'),(19771,1765,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(19772,1765,'_slider_4_webplink','field_60fa70c989e88'),(19773,1765,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(19774,1765,'_slider_5_webplink','field_60fa70c989e88'),(19775,1765,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(19776,1765,'_slider_6_webplink','field_60fa70c989e88'),(19777,1765,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(19778,1765,'_slider_7_webplink','field_60fa70c989e88'),(19779,1766,'s2-list','6'),(19780,1766,'_s2-list','field_60bf76e0f46ee'),(19781,1766,'s2-ttl','Тананинг 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асоратлар'),(19802,1766,'_s2-list_1_text','field_60bf7712f46f1'),(19803,1766,'s2-list_2_icon','65'),(19804,1766,'_s2-list_2_icon','field_60bf76ecf46ef'),(19805,1766,'s2-list_2_icon-hover','66'),(19806,1766,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(19807,1766,'s2-list_2_text','Диарея'),(19808,1766,'_s2-list_2_text','field_60bf7712f46f1'),(19809,1766,'s2-list_3_icon','67'),(19810,1766,'_s2-list_3_icon','field_60bf76ecf46ef'),(19811,1766,'s2-list_3_icon-hover','68'),(19812,1766,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(19813,1766,'s2-list_3_text','Қайт қилиш'),(19814,1766,'_s2-list_3_text','field_60bf7712f46f1'),(19815,1766,'s2-list_4_icon','69'),(19816,1766,'_s2-list_4_icon','field_60bf76ecf46ef'),(19817,1766,'s2-list_4_icon-hover','70'),(19818,1766,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(19819,1766,'s2-list_4_text','Жадал жисмоний юкламалар'),(19820,1766,'_s2-list_4_text','field_60bf7712f46f1'),(19821,1766,'s2-list_5_icon','71'),(19822,1766,'_s2-list_5_icon','field_60bf76ecf46ef'),(19823,1766,'s2-list_5_icon-hover','72'),(19824,1766,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(19825,1766,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(19826,1766,'_s2-list_5_text','field_60bf7712f46f1'),(19827,1766,'s1-slogan','Оддий сув етарли бўлмаганда!'),(19828,1766,'_s1-slogan','field_60bf7ab4d9ba9'),(19829,1766,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(19830,1766,'_s3-text','field_60bf7bb5a7e2b'),(19831,1766,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(19832,1766,'_s4-ttl','field_60bf7c831f58c'),(19833,1766,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(19834,1766,'_s4-notes','field_60bf7ca31f58d'),(19835,1766,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(19836,1766,'_s5-video','field_60bf7ccfa01a5'),(19837,1766,'s6-ttl','Оддий сув етарли бўлмаганда!'),(19838,1766,'_s6-ttl','field_60bf7cfb10d31'),(19839,1766,'s6-list','6'),(19840,1766,'_s6-list','field_60bf7d0410d32'),(19841,1766,'s6-list_0_icon','92'),(19842,1766,'_s6-list_0_icon','field_60bf7d1810d33'),(19843,1766,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(19844,1766,'_s6-list_0_text','field_60bf7d2710d34'),(19845,1766,'s6-list_1_icon','93'),(19846,1766,'_s6-list_1_icon','field_60bf7d1810d33'),(19847,1766,'s6-list_1_text','Овқатдан заҳарланишларда'),(19848,1766,'_s6-list_1_text','field_60bf7d2710d34'),(19849,1766,'s6-list_2_icon','94'),(19850,1766,'_s6-list_2_icon','field_60bf7d1810d33'),(19851,1766,'s6-list_2_text','Ичак инфекцияларида'),(19852,1766,'_s6-list_2_text','field_60bf7d2710d34'),(19853,1766,'s6-list_3_icon','95'),(19854,1766,'_s6-list_3_icon','field_60bf7d1810d33'),(19855,1766,'s6-list_3_text','Ҳомиладорлик вақтида'),(19856,1766,'_s6-list_3_text','field_60bf7d2710d34'),(19857,1766,'s6-list_4_icon','96'),(19858,1766,'_s6-list_4_icon','field_60bf7d1810d33'),(19859,1766,'s6-list_4_text','Спорт билан шуғулланганда '),(19860,1766,'_s6-list_4_text','field_60bf7d2710d34'),(19861,1766,'s6-list_5_icon','97'),(19862,1766,'_s6-list_5_icon','field_60bf7d1810d33'),(19863,1766,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(19864,1766,'_s6-list_5_text','field_60bf7d2710d34'),(19865,1766,'s4-list_0_ttl','Натрий'),(19866,1766,'_s4-list_0_ttl','field_60bf7fa95a92c'),(19867,1766,'s4-list_0_formula','Na<sup>+</sup>'),(19868,1766,'_s4-list_0_formula','field_60bf7fc65a92d'),(19869,1766,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(19870,1766,'_s4-list_0_text','field_60bf7fd35a92e'),(19871,1766,'s4-list_1_ttl','Сув'),(19872,1766,'_s4-list_1_ttl','field_60bf7fa95a92c'),(19873,1766,'s4-list_1_formula','H<sub>2</sub>O'),(19874,1766,'_s4-list_1_formula','field_60bf7fc65a92d'),(19875,1766,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. 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стани організму, що ведуть до порушень водно-сольового балансу:'),(19982,1770,'_s2-ttl','field_60bf76d1f46ed'),(19983,1770,'s2-list','6'),(19984,1770,'_s2-list','field_60bf76e0f46ee'),(19985,1770,'s2-list_0_icon','61'),(19986,1770,'_s2-list_0_icon','field_60bf76ecf46ef'),(19987,1770,'s2-list_0_icon-hover','62'),(19988,1770,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(19989,1770,'s2-list_0_text','Лихоманка'),(19990,1770,'_s2-list_0_text','field_60bf7712f46f1'),(19991,1770,'s2-list_1_icon','63'),(19992,1770,'_s2-list_1_icon','field_60bf76ecf46ef'),(19993,1770,'s2-list_1_icon-hover','64'),(19994,1770,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(19995,1770,'s2-list_1_text','Похмільний 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навантаження'),(20014,1770,'_s2-list_4_text','field_60bf7712f46f1'),(20015,1770,'s2-list_5_icon','71'),(20016,1770,'_s2-list_5_icon','field_60bf76ecf46ef'),(20017,1770,'s2-list_5_icon-hover','72'),(20018,1770,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(20019,1770,'s2-list_5_text','Перегрівання в спекотну погоду'),(20020,1770,'_s2-list_5_text','field_60bf7712f46f1'),(20021,1770,'s1-slogan','Коли звичайної води замало!'),(20022,1770,'_s1-slogan','field_60bf7ab4d9ba9'),(20023,1770,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(20024,1770,'_s3-text','field_60bf7bb5a7e2b'),(20025,1770,'s4-ttl','РеО – вода для медичних цілей'),(20026,1770,'_s4-ttl','field_60bf7c831f58c'),(20027,1770,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(20028,1770,'_s4-notes','field_60bf7ca31f58d'),(20029,1770,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(20030,1770,'_s5-video','field_60bf7ccfa01a5'),(20031,1770,'s6-ttl','Коли звичайної води замало!'),(20032,1770,'_s6-ttl','field_60bf7cfb10d31'),(20033,1770,'s6-list','6'),(20034,1770,'_s6-list','field_60bf7d0410d32'),(20035,1770,'s6-list_0_icon','92'),(20036,1770,'_s6-list_0_icon','field_60bf7d1810d33'),(20037,1770,'s6-list_0_text','При підвищеній температурі'),(20038,1770,'_s6-list_0_text','field_60bf7d2710d34'),(20039,1770,'s6-list_1_icon','93'),(20040,1770,'_s6-list_1_icon','field_60bf7d1810d33'),(20041,1770,'s6-list_1_text','При харчових отруєннях'),(20042,1770,'_s6-list_1_text','field_60bf7d2710d34'),(20043,1770,'s6-list_2_icon','94'),(20044,1770,'_s6-list_2_icon','field_60bf7d1810d33'),(20045,1770,'s6-list_2_text','При кишкових інфекціях'),(20046,1770,'_s6-list_2_text','field_60bf7d2710d34'),(20047,1770,'s6-list_3_icon','95'),(20048,1770,'_s6-list_3_icon','field_60bf7d1810d33'),(20049,1770,'s6-list_3_text','Під час вагітності'),(20050,1770,'_s6-list_3_text','field_60bf7d2710d34'),(20051,1770,'s6-list_4_icon','96'),(20052,1770,'_s6-list_4_icon','field_60bf7d1810d33'),(20053,1770,'s6-list_4_text','Під час заняття спортом'),(20054,1770,'_s6-list_4_text','field_60bf7d2710d34'),(20055,1770,'s6-list_5_icon','97'),(20056,1770,'_s6-list_5_icon','field_60bf7d1810d33'),(20057,1770,'s6-list_5_text','При похмільному синдромі'),(20058,1770,'_s6-list_5_text','field_60bf7d2710d34'),(20059,1770,'s4-list_0_ttl','Натрій'),(20060,1770,'_s4-list_0_ttl','field_60bf7fa95a92c'),(20061,1770,'s4-list_0_formula','Na<sup>+</sup>'),(20062,1770,'_s4-list_0_formula','field_60bf7fc65a92d'),(20063,1770,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(20064,1770,'_s4-list_0_text','field_60bf7fd35a92e'),(20065,1770,'s4-list_1_ttl','Вода'),(20066,1770,'_s4-list_1_ttl','field_60bf7fa95a92c'),(20067,1770,'s4-list_1_formula','H<sub>2</sub>O'),(20068,1770,'_s4-list_1_formula','field_60bf7fc65a92d'),(20069,1770,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(20070,1770,'_s4-list_1_text','field_60bf7fd35a92e'),(20071,1770,'s4-list','9'),(20072,1770,'_s4-list','field_60bf7f985a92b'),(20073,1770,'s4-list_2_ttl','Калій'),(20074,1770,'_s4-list_2_ttl','field_60bf7fa95a92c'),(20075,1770,'s4-list_2_formula','K<sup>+</sup>'),(20076,1770,'_s4-list_2_formula','field_60bf7fc65a92d'),(20077,1770,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(20078,1770,'_s4-list_2_text','field_60bf7fd35a92e'),(20079,1770,'s4-list_3_ttl','Гідрокарбонати'),(20080,1770,'_s4-list_3_ttl','field_60bf7fa95a92c'),(20081,1770,'s4-list_3_formula','HCO<sup>3+</sup>'),(20082,1770,'_s4-list_3_formula','field_60bf7fc65a92d'),(20083,1770,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(20084,1770,'_s4-list_3_text','field_60bf7fd35a92e'),(20085,1770,'s4-list_4_ttl','Магній'),(20086,1770,'_s4-list_4_ttl','field_60bf7fa95a92c'),(20087,1770,'s4-list_4_formula','Mg<sup>2+</sup>'),(20088,1770,'_s4-list_4_formula','field_60bf7fc65a92d'),(20089,1770,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(20090,1770,'_s4-list_4_text','field_60bf7fd35a92e'),(20091,1770,'s4-list_5_ttl','Вуглекислий газ'),(20092,1770,'_s4-list_5_ttl','field_60bf7fa95a92c'),(20093,1770,'s4-list_5_formula','CO<sup>2+</sup>'),(20094,1770,'_s4-list_5_formula','field_60bf7fc65a92d'),(20095,1770,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(20096,1770,'_s4-list_5_text','field_60bf7fd35a92e'),(20097,1770,'s4-list_6_ttl','Кальцій'),(20098,1770,'_s4-list_6_ttl','field_60bf7fa95a92c'),(20099,1770,'s4-list_6_formula','Ca<sup>2+</sup>'),(20100,1770,'_s4-list_6_formula','field_60bf7fc65a92d'),(20101,1770,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(20102,1770,'_s4-list_6_text','field_60bf7fd35a92e'),(20103,1770,'s4-list_7_ttl','Сорбіт'),(20104,1770,'_s4-list_7_ttl','field_60bf7fa95a92c'),(20105,1770,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(20106,1770,'_s4-list_7_formula','field_60bf7fc65a92d'),(20107,1770,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(20108,1770,'_s4-list_7_text','field_60bf7fd35a92e'),(20109,1770,'s4-list_8_ttl','Хлор'),(20110,1770,'_s4-list_8_ttl','field_60bf7fa95a92c'),(20111,1770,'s4-list_8_formula','Cl<sup>-</sup>'),(20112,1770,'_s4-list_8_formula','field_60bf7fc65a92d'),(20113,1770,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(20114,1770,'_s4-list_8_text','field_60bf7fd35a92e'),(20115,1770,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(20116,1770,'_s4-feature1','field_60bf80ca480ea'),(20117,1770,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(20118,1770,'_s4-feature2','field_60bf80de480eb'),(20119,1770,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(20120,1770,'_s4-feature3','field_60bf80e2480ec'),(20121,1770,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(20122,1770,'_s4-feature4','field_60bf80e5480ed'),(20123,1770,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(20124,1770,'_s2-list_0_link','field_60ee90d381a4e'),(20125,1770,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(20126,1770,'_s2-list_1_link','field_60ee90d381a4e'),(20127,1770,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(20128,1770,'_s2-list_2_link','field_60ee90d381a4e'),(20129,1770,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(20130,1770,'_s2-list_3_link','field_60ee90d381a4e'),(20131,1770,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(20132,1770,'_s2-list_4_link','field_60ee90d381a4e'),(20133,1770,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(20134,1770,'_s2-list_5_link','field_60ee90d381a4e'),(20135,1770,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(20136,1770,'_s6-list_0_link','field_60ee916b04ace'),(20137,1770,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(20138,1770,'_s6-list_1_link','field_60ee916b04ace'),(20139,1770,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(20140,1770,'_s6-list_2_link','field_60ee916b04ace'),(20141,1770,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(20142,1770,'_s6-list_3_link','field_60ee916b04ace'),(20143,1770,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(20144,1770,'_s6-list_4_link','field_60ee916b04ace'),(20145,1770,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(20146,1770,'_s6-list_5_link','field_60ee916b04ace'),(20147,1770,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(20148,1770,'_slider_0_webplink','field_60fa70c989e88'),(20149,1770,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(20150,1770,'_slider_1_webplink','field_60fa70c989e88'),(20151,1770,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(20152,1770,'_slider_2_webplink','field_60fa70c989e88'),(20153,1770,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(20154,1770,'_slider_3_webplink','field_60fa70c989e88'),(20155,1770,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(20156,1770,'_slider_4_webplink','field_60fa70c989e88'),(20157,1770,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(20158,1770,'_slider_5_webplink','field_60fa70c989e88'),(20159,1770,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(20160,1770,'_slider_6_webplink','field_60fa70c989e88'),(20161,1770,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(20162,1770,'_slider_7_webplink','field_60fa70c989e88'),(20163,1770,'slider_0_slide','1767'),(20164,1770,'_slider_0_slide','field_60bf7688f46eb'),(20165,1770,'slider_1_slide','50'),(20166,1770,'_slider_1_slide','field_60bf7688f46eb'),(20167,1770,'slider_2_slide','51'),(20168,1770,'_slider_2_slide','field_60bf7688f46eb'),(20169,1770,'slider_3_slide','52'),(20170,1770,'_slider_3_slide','field_60bf7688f46eb'),(20171,1770,'slider_4_slide','53'),(20172,1770,'_slider_4_slide','field_60bf7688f46eb'),(20173,1770,'slider_5_slide','54'),(20174,1770,'_slider_5_slide','field_60bf7688f46eb'),(20175,1770,'slider_6_slide','55'),(20176,1770,'_slider_6_slide','field_60bf7688f46eb'),(20177,1770,'slider_7_slide','56'),(20178,1770,'_slider_7_slide','field_60bf7688f46eb'),(20179,1770,'slider_8_slide','57'),(20180,1770,'_slider_8_slide','field_60bf7688f46eb'),(20181,176,'slider_8_slide','344'),(20182,176,'_slider_8_slide','field_60bf7688f46eb'),(20183,1772,'s2-list','6'),(20184,1772,'_s2-list','field_60bf76e0f46ee'),(20185,1772,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(20186,1772,'_s2-ttl','field_60bf76d1f46ed'),(20187,1772,'slider','9'),(20188,1772,'_slider','field_60bf767ef46ea'),(20189,1772,'slider_0_slide','1768'),(20190,1772,'_slider_0_slide','field_60bf7688f46eb'),(20191,1772,'slider_1_slide','332'),(20192,1772,'_slider_1_slide','field_60bf7688f46eb'),(20193,1772,'slider_2_slide','334'),(20194,1772,'_slider_2_slide','field_60bf7688f46eb'),(20195,1772,'slider_3_slide','336'),(20196,1772,'_slider_3_slide','field_60bf7688f46eb'),(20197,1772,'slider_4_slide','338'),(20198,1772,'_slider_4_slide','field_60bf7688f46eb'),(20199,1772,'slider_5_slide','340'),(20200,1772,'_slider_5_slide','field_60bf7688f46eb'),(20201,1772,'slider_6_slide','342'),(20202,1772,'_slider_6_slide','field_60bf7688f46eb'),(20203,1772,'slider_7_slide','344'),(20204,1772,'_slider_7_slide','field_60bf7688f46eb'),(20205,1772,'s2-list_0_icon','61'),(20206,1772,'_s2-list_0_icon','field_60bf76ecf46ef'),(20207,1772,'s2-list_0_icon-hover','62'),(20208,1772,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(20209,1772,'s2-list_0_text','Лихорадка'),(20210,1772,'_s2-list_0_text','field_60bf7712f46f1'),(20211,1772,'s2-list_1_icon','63'),(20212,1772,'_s2-list_1_icon','field_60bf76ecf46ef'),(20213,1772,'s2-list_1_icon-hover','64'),(20214,1772,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(20215,1772,'s2-list_1_text','Похмельный синдром'),(20216,1772,'_s2-list_1_text','field_60bf7712f46f1'),(20217,1772,'s2-list_2_icon','65'),(20218,1772,'_s2-list_2_icon','field_60bf76ecf46ef'),(20219,1772,'s2-list_2_icon-hover','66'),(20220,1772,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(20221,1772,'s2-list_2_text','Диарея'),(20222,1772,'_s2-list_2_text','field_60bf7712f46f1'),(20223,1772,'s2-list_3_icon','67'),(20224,1772,'_s2-list_3_icon','field_60bf76ecf46ef'),(20225,1772,'s2-list_3_icon-hover','68'),(20226,1772,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(20227,1772,'s2-list_3_text','Рвота'),(20228,1772,'_s2-list_3_text','field_60bf7712f46f1'),(20229,1772,'s2-list_4_icon','69'),(20230,1772,'_s2-list_4_icon','field_60bf76ecf46ef'),(20231,1772,'s2-list_4_icon-hover','70'),(20232,1772,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(20233,1772,'s2-list_4_text','Интенсивные физические нагрузки'),(20234,1772,'_s2-list_4_text','field_60bf7712f46f1'),(20235,1772,'s2-list_5_icon','71'),(20236,1772,'_s2-list_5_icon','field_60bf76ecf46ef'),(20237,1772,'s2-list_5_icon-hover','72'),(20238,1772,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(20239,1772,'s2-list_5_text','Перегрев в жаркую погоду'),(20240,1772,'_s2-list_5_text','field_60bf7712f46f1'),(20241,1772,'s1-slogan','Когда обычной воды недостаточно!'),(20242,1772,'_s1-slogan','field_60bf7ab4d9ba9'),(20243,1772,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(20244,1772,'_s3-text','field_60bf7bb5a7e2b'),(20245,1772,'s4-ttl','РеО – вода для медицинских целей!'),(20246,1772,'_s4-ttl','field_60bf7c831f58c'),(20247,1772,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(20248,1772,'_s4-notes','field_60bf7ca31f58d'),(20249,1772,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(20250,1772,'_s5-video','field_60bf7ccfa01a5'),(20251,1772,'s6-ttl','Когда обычной воды недостаточно!'),(20252,1772,'_s6-ttl','field_60bf7cfb10d31'),(20253,1772,'s6-list','6'),(20254,1772,'_s6-list','field_60bf7d0410d32'),(20255,1772,'s6-list_0_icon','92'),(20256,1772,'_s6-list_0_icon','field_60bf7d1810d33'),(20257,1772,'s6-list_0_text','При повышенной температуре'),(20258,1772,'_s6-list_0_text','field_60bf7d2710d34'),(20259,1772,'s6-list_1_icon','93'),(20260,1772,'_s6-list_1_icon','field_60bf7d1810d33'),(20261,1772,'s6-list_1_text','При пищевых отравлениях'),(20262,1772,'_s6-list_1_text','field_60bf7d2710d34'),(20263,1772,'s6-list_2_icon','94'),(20264,1772,'_s6-list_2_icon','field_60bf7d1810d33'),(20265,1772,'s6-list_2_text','При кишечных инфекциях'),(20266,1772,'_s6-list_2_text','field_60bf7d2710d34'),(20267,1772,'s6-list_3_icon','95'),(20268,1772,'_s6-list_3_icon','field_60bf7d1810d33'),(20269,1772,'s6-list_3_text','Во время беременности'),(20270,1772,'_s6-list_3_text','field_60bf7d2710d34'),(20271,1772,'s6-list_4_icon','96'),(20272,1772,'_s6-list_4_icon','field_60bf7d1810d33'),(20273,1772,'s6-list_4_text','Во время занятий спортом'),(20274,1772,'_s6-list_4_text','field_60bf7d2710d34'),(20275,1772,'s6-list_5_icon','97'),(20276,1772,'_s6-list_5_icon','field_60bf7d1810d33'),(20277,1772,'s6-list_5_text','При похмельном синдроме'),(20278,1772,'_s6-list_5_text','field_60bf7d2710d34'),(20279,1772,'s4-list_0_ttl','Натрий'),(20280,1772,'_s4-list_0_ttl','field_60bf7fa95a92c'),(20281,1772,'s4-list_0_formula','Na<sup>+</sup>'),(20282,1772,'_s4-list_0_formula','field_60bf7fc65a92d'),(20283,1772,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(20284,1772,'_s4-list_0_text','field_60bf7fd35a92e'),(20285,1772,'s4-list_1_ttl','Вода'),(20286,1772,'_s4-list_1_ttl','field_60bf7fa95a92c'),(20287,1772,'s4-list_1_formula','H<sub>2</sub>O'),(20288,1772,'_s4-list_1_formula','field_60bf7fc65a92d'),(20289,1772,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(20290,1772,'_s4-list_1_text','field_60bf7fd35a92e'),(20291,1772,'s4-list','9'),(20292,1772,'_s4-list','field_60bf7f985a92b'),(20293,1772,'s4-list_2_ttl','Калий'),(20294,1772,'_s4-list_2_ttl','field_60bf7fa95a92c'),(20295,1772,'s4-list_2_formula','K<sup>+</sup>'),(20296,1772,'_s4-list_2_formula','field_60bf7fc65a92d'),(20297,1772,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(20298,1772,'_s4-list_2_text','field_60bf7fd35a92e'),(20299,1772,'s4-list_3_ttl','Гидрокарбонаты'),(20300,1772,'_s4-list_3_ttl','field_60bf7fa95a92c'),(20301,1772,'s4-list_3_formula','HCO<sup>3+</sup>'),(20302,1772,'_s4-list_3_formula','field_60bf7fc65a92d'),(20303,1772,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(20304,1772,'_s4-list_3_text','field_60bf7fd35a92e'),(20305,1772,'s4-list_4_ttl','Магний'),(20306,1772,'_s4-list_4_ttl','field_60bf7fa95a92c'),(20307,1772,'s4-list_4_formula','Mg<sup>2+</sup>'),(20308,1772,'_s4-list_4_formula','field_60bf7fc65a92d'),(20309,1772,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(20310,1772,'_s4-list_4_text','field_60bf7fd35a92e'),(20311,1772,'s4-list_5_ttl','Углекислый газ'),(20312,1772,'_s4-list_5_ttl','field_60bf7fa95a92c'),(20313,1772,'s4-list_5_formula','CO<sup>2+</sup>'),(20314,1772,'_s4-list_5_formula','field_60bf7fc65a92d'),(20315,1772,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(20316,1772,'_s4-list_5_text','field_60bf7fd35a92e'),(20317,1772,'s4-list_6_ttl','Кальций'),(20318,1772,'_s4-list_6_ttl','field_60bf7fa95a92c'),(20319,1772,'s4-list_6_formula','Ca<sup>2+</sup>'),(20320,1772,'_s4-list_6_formula','field_60bf7fc65a92d'),(20321,1772,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(20322,1772,'_s4-list_6_text','field_60bf7fd35a92e'),(20323,1772,'s4-list_7_ttl','Сорбит'),(20324,1772,'_s4-list_7_ttl','field_60bf7fa95a92c'),(20325,1772,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(20326,1772,'_s4-list_7_formula','field_60bf7fc65a92d'),(20327,1772,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(20328,1772,'_s4-list_7_text','field_60bf7fd35a92e'),(20329,1772,'s4-list_8_ttl','Хлор'),(20330,1772,'_s4-list_8_ttl','field_60bf7fa95a92c'),(20331,1772,'s4-list_8_formula','Cl<sup>-</sup>'),(20332,1772,'_s4-list_8_formula','field_60bf7fc65a92d'),(20333,1772,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(20334,1772,'_s4-list_8_text','field_60bf7fd35a92e'),(20335,1772,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(20336,1772,'_s4-feature1','field_60bf80ca480ea'),(20337,1772,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(20338,1772,'_s4-feature2','field_60bf80de480eb'),(20339,1772,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(20340,1772,'_s4-feature3','field_60bf80e2480ec'),(20341,1772,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(20342,1772,'_s4-feature4','field_60bf80e5480ed'),(20343,1772,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(20344,1772,'_s2-list_0_link','field_60ee90d381a4e'),(20345,1772,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(20346,1772,'_s2-list_1_link','field_60ee90d381a4e'),(20347,1772,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(20348,1772,'_s2-list_2_link','field_60ee90d381a4e'),(20349,1772,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(20350,1772,'_s2-list_3_link','field_60ee90d381a4e'),(20351,1772,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(20352,1772,'_s2-list_4_link','field_60ee90d381a4e'),(20353,1772,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(20354,1772,'_s2-list_5_link','field_60ee90d381a4e'),(20355,1772,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(20356,1772,'_s6-list_0_link','field_60ee916b04ace'),(20357,1772,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(20358,1772,'_s6-list_1_link','field_60ee916b04ace'),(20359,1772,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(20360,1772,'_s6-list_2_link','field_60ee916b04ace'),(20361,1772,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(20362,1772,'_s6-list_3_link','field_60ee916b04ace'),(20363,1772,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(20364,1772,'_s6-list_4_link','field_60ee916b04ace'),(20365,1772,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(20366,1772,'_s6-list_5_link','field_60ee916b04ace'),(20367,1772,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(20368,1772,'_slider_0_webplink','field_60fa70c989e88'),(20369,1772,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(20370,1772,'_slider_1_webplink','field_60fa70c989e88'),(20371,1772,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(20372,1772,'_slider_2_webplink','field_60fa70c989e88'),(20373,1772,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(20374,1772,'_slider_3_webplink','field_60fa70c989e88'),(20375,1772,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(20376,1772,'_slider_4_webplink','field_60fa70c989e88'),(20377,1772,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(20378,1772,'_slider_5_webplink','field_60fa70c989e88'),(20379,1772,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(20380,1772,'_slider_6_webplink','field_60fa70c989e88'),(20381,1772,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(20382,1772,'_slider_7_webplink','field_60fa70c989e88'),(20383,1772,'slider_8_slide','346'),(20384,1772,'_slider_8_slide','field_60bf7688f46eb'),(20385,1331,'slider_3_slide','1666'),(20386,1331,'_slider_3_slide','field_60bf7688f46eb'),(20387,1773,'s2-list','6'),(20388,1773,'_s2-list','field_60bf76e0f46ee'),(20389,1773,'s2-ttl','Тананинг сув-туз мувозанати бузилишига олиб келадиган ҳолатлар мавжуд'),(20390,1773,'_s2-ttl','field_60bf76d1f46ed'),(20391,1773,'slider','4'),(20392,1773,'_slider','field_60bf767ef46ea'),(20393,1773,'slider_0_slide','1769'),(20394,1773,'_slider_0_slide','field_60bf7688f46eb'),(20395,1773,'slider_1_slide','1663'),(20396,1773,'_slider_1_slide','field_60bf7688f46eb'),(20397,1773,'slider_2_slide','1666'),(20398,1773,'_slider_2_slide','field_60bf7688f46eb'),(20399,1773,'s2-list_0_icon','61'),(20400,1773,'_s2-list_0_icon','field_60bf76ecf46ef'),(20401,1773,'s2-list_0_icon-hover','62'),(20402,1773,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(20403,1773,'s2-list_0_text','Иситма'),(20404,1773,'_s2-list_0_text','field_60bf7712f46f1'),(20405,1773,'s2-list_1_icon','63'),(20406,1773,'_s2-list_1_icon','field_60bf76ecf46ef'),(20407,1773,'s2-list_1_icon-hover','64'),(20408,1773,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(20409,1773,'s2-list_1_text','Алкоголдан кейинги асоратлар'),(20410,1773,'_s2-list_1_text','field_60bf7712f46f1'),(20411,1773,'s2-list_2_icon','65'),(20412,1773,'_s2-list_2_icon','field_60bf76ecf46ef'),(20413,1773,'s2-list_2_icon-hover','66'),(20414,1773,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(20415,1773,'s2-list_2_text','Диарея'),(20416,1773,'_s2-list_2_text','field_60bf7712f46f1'),(20417,1773,'s2-list_3_icon','67'),(20418,1773,'_s2-list_3_icon','field_60bf76ecf46ef'),(20419,1773,'s2-list_3_icon-hover','68'),(20420,1773,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(20421,1773,'s2-list_3_text','Қайт қилиш'),(20422,1773,'_s2-list_3_text','field_60bf7712f46f1'),(20423,1773,'s2-list_4_icon','69'),(20424,1773,'_s2-list_4_icon','field_60bf76ecf46ef'),(20425,1773,'s2-list_4_icon-hover','70'),(20426,1773,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(20427,1773,'s2-list_4_text','Жадал жисмоний юкламалар'),(20428,1773,'_s2-list_4_text','field_60bf7712f46f1'),(20429,1773,'s2-list_5_icon','71'),(20430,1773,'_s2-list_5_icon','field_60bf76ecf46ef'),(20431,1773,'s2-list_5_icon-hover','72'),(20432,1773,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(20433,1773,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(20434,1773,'_s2-list_5_text','field_60bf7712f46f1'),(20435,1773,'s1-slogan','Оддий сув етарли бўлмаганда!'),(20436,1773,'_s1-slogan','field_60bf7ab4d9ba9'),(20437,1773,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(20438,1773,'_s3-text','field_60bf7bb5a7e2b'),(20439,1773,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(20440,1773,'_s4-ttl','field_60bf7c831f58c'),(20441,1773,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(20442,1773,'_s4-notes','field_60bf7ca31f58d'),(20443,1773,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(20444,1773,'_s5-video','field_60bf7ccfa01a5'),(20445,1773,'s6-ttl','Оддий сув етарли бўлмаганда!'),(20446,1773,'_s6-ttl','field_60bf7cfb10d31'),(20447,1773,'s6-list','6'),(20448,1773,'_s6-list','field_60bf7d0410d32'),(20449,1773,'s6-list_0_icon','92'),(20450,1773,'_s6-list_0_icon','field_60bf7d1810d33'),(20451,1773,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(20452,1773,'_s6-list_0_text','field_60bf7d2710d34'),(20453,1773,'s6-list_1_icon','93'),(20454,1773,'_s6-list_1_icon','field_60bf7d1810d33'),(20455,1773,'s6-list_1_text','Овқатдан заҳарланишларда'),(20456,1773,'_s6-list_1_text','field_60bf7d2710d34'),(20457,1773,'s6-list_2_icon','94'),(20458,1773,'_s6-list_2_icon','field_60bf7d1810d33'),(20459,1773,'s6-list_2_text','Ичак инфекцияларида'),(20460,1773,'_s6-list_2_text','field_60bf7d2710d34'),(20461,1773,'s6-list_3_icon','95'),(20462,1773,'_s6-list_3_icon','field_60bf7d1810d33'),(20463,1773,'s6-list_3_text','Ҳомиладорлик вақтида'),(20464,1773,'_s6-list_3_text','field_60bf7d2710d34'),(20465,1773,'s6-list_4_icon','96'),(20466,1773,'_s6-list_4_icon','field_60bf7d1810d33'),(20467,1773,'s6-list_4_text','Спорт билан шуғулланганда '),(20468,1773,'_s6-list_4_text','field_60bf7d2710d34'),(20469,1773,'s6-list_5_icon','97'),(20470,1773,'_s6-list_5_icon','field_60bf7d1810d33'),(20471,1773,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(20472,1773,'_s6-list_5_text','field_60bf7d2710d34'),(20473,1773,'s4-list_0_ttl','Натрий'),(20474,1773,'_s4-list_0_ttl','field_60bf7fa95a92c'),(20475,1773,'s4-list_0_formula','Na<sup>+</sup>'),(20476,1773,'_s4-list_0_formula','field_60bf7fc65a92d'),(20477,1773,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(20478,1773,'_s4-list_0_text','field_60bf7fd35a92e'),(20479,1773,'s4-list_1_ttl','Сув'),(20480,1773,'_s4-list_1_ttl','field_60bf7fa95a92c'),(20481,1773,'s4-list_1_formula','H<sub>2</sub>O'),(20482,1773,'_s4-list_1_formula','field_60bf7fc65a92d'),(20483,1773,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(20484,1773,'_s4-list_1_text','field_60bf7fd35a92e'),(20485,1773,'s4-list','9'),(20486,1773,'_s4-list','field_60bf7f985a92b'),(20487,1773,'s4-list_2_ttl','Калий'),(20488,1773,'_s4-list_2_ttl','field_60bf7fa95a92c'),(20489,1773,'s4-list_2_formula','K<sup>+</sup>'),(20490,1773,'_s4-list_2_formula','field_60bf7fc65a92d'),(20491,1773,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(20492,1773,'_s4-list_2_text','field_60bf7fd35a92e'),(20493,1773,'s4-list_3_ttl','Гидрокарбонатлар '),(20494,1773,'_s4-list_3_ttl','field_60bf7fa95a92c'),(20495,1773,'s4-list_3_formula','HCO<sup>3+</sup>'),(20496,1773,'_s4-list_3_formula','field_60bf7fc65a92d'),(20497,1773,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(20498,1773,'_s4-list_3_text','field_60bf7fd35a92e'),(20499,1773,'s4-list_4_ttl','Магний'),(20500,1773,'_s4-list_4_ttl','field_60bf7fa95a92c'),(20501,1773,'s4-list_4_formula','Mg<sup>2+</sup>'),(20502,1773,'_s4-list_4_formula','field_60bf7fc65a92d'),(20503,1773,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(20504,1773,'_s4-list_4_text','field_60bf7fd35a92e'),(20505,1773,'s4-list_5_ttl','Углекислый газ'),(20506,1773,'_s4-list_5_ttl','field_60bf7fa95a92c'),(20507,1773,'s4-list_5_formula','CO<sup>2+</sup>'),(20508,1773,'_s4-list_5_formula','field_60bf7fc65a92d'),(20509,1773,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(20510,1773,'_s4-list_5_text','field_60bf7fd35a92e'),(20511,1773,'s4-list_6_ttl','Кальций'),(20512,1773,'_s4-list_6_ttl','field_60bf7fa95a92c'),(20513,1773,'s4-list_6_formula','Ca<sup>2+</sup>'),(20514,1773,'_s4-list_6_formula','field_60bf7fc65a92d'),(20515,1773,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(20516,1773,'_s4-list_6_text','field_60bf7fd35a92e'),(20517,1773,'s4-list_7_ttl','Сорбитол'),(20518,1773,'_s4-list_7_ttl','field_60bf7fa95a92c'),(20519,1773,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(20520,1773,'_s4-list_7_formula','field_60bf7fc65a92d'),(20521,1773,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(20522,1773,'_s4-list_7_text','field_60bf7fd35a92e'),(20523,1773,'s4-list_8_ttl','Хлор'),(20524,1773,'_s4-list_8_ttl','field_60bf7fa95a92c'),(20525,1773,'s4-list_8_formula','Cl<sup>-</sup>'),(20526,1773,'_s4-list_8_formula','field_60bf7fc65a92d'),(20527,1773,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(20528,1773,'_s4-list_8_text','field_60bf7fd35a92e'),(20529,1773,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(20530,1773,'_s4-feature1','field_60bf80ca480ea'),(20531,1773,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(20532,1773,'_s4-feature2','field_60bf80de480eb'),(20533,1773,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(20534,1773,'_s4-feature3','field_60bf80e2480ec'),(20535,1773,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(20536,1773,'_s4-feature4','field_60bf80e5480ed'),(20537,1773,'s2-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(20538,1773,'_s2-list_0_link','field_60ee90d381a4e'),(20539,1773,'s2-list_1_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(20540,1773,'_s2-list_1_link','field_60ee90d381a4e'),(20541,1773,'s2-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(20542,1773,'_s2-list_2_link','field_60ee90d381a4e'),(20543,1773,'s2-list_3_link','/uz/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/қajt-қilish-suvsizlanish-sababi-sifatida/'),(20544,1773,'_s2-list_3_link','field_60ee90d381a4e'),(20545,1773,'s2-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(20546,1773,'_s2-list_4_link','field_60ee90d381a4e'),(20547,1773,'s2-list_5_link','/uz/istemolchi-uchun/reo-sport-bilan-shuғullanganda/yozgi-issiқda-қandaj-қilib-issiқlik-urishi-va-suvsizlanishning-oldini-olish-mumkin/'),(20548,1773,'_s2-list_5_link','field_60ee90d381a4e'),(20549,1773,'s6-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(20550,1773,'_s6-list_0_link','field_60ee916b04ace'),(20551,1773,'s6-list_1_link','/uz/category/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/'),(20552,1773,'_s6-list_1_link','field_60ee916b04ace'),(20553,1773,'s6-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(20554,1773,'_s6-list_2_link','field_60ee916b04ace'),(20555,1773,'s6-list_3_link','/uz/category/istemolchi-uchun/reo-ҳomiladorlik-vaқtida/'),(20556,1773,'_s6-list_3_link','field_60ee916b04ace'),(20557,1773,'s6-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(20558,1773,'_s6-list_4_link','field_60ee916b04ace'),(20559,1773,'s6-list_5_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(20560,1773,'_s6-list_5_link','field_60ee916b04ace'),(20561,1773,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(20562,1773,'_slider_0_webplink','field_60fa70c989e88'),(20563,1773,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(20564,1773,'_slider_1_webplink','field_60fa70c989e88'),(20565,1773,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(20566,1773,'_slider_2_webplink','field_60fa70c989e88'),(20567,1773,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(20568,1773,'_slider_3_webplink','field_60fa70c989e88'),(20569,1773,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(20570,1773,'_slider_4_webplink','field_60fa70c989e88'),(20571,1773,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(20572,1773,'_slider_5_webplink','field_60fa70c989e88'),(20573,1773,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(20574,1773,'_slider_6_webplink','field_60fa70c989e88'),(20575,1773,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(20576,1773,'_slider_7_webplink','field_60fa70c989e88'),(20577,1773,'slider_3_slide','1669'),(20578,1773,'_slider_3_slide','field_60bf7688f46eb'),(20579,1775,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(20580,1775,'_s1-text','field_60c069d69838b'),(20581,1775,'s3-list','5'),(20582,1775,'_s3-list','field_60c06d9298394'),(20583,1775,'s3-list2','3'),(20584,1775,'_s3-list2','field_60c06dd498396'),(20585,1775,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(20586,1775,'_s4-ttl','field_60c06ba39838e'),(20587,1775,'s4-list','7'),(20588,1775,'_s4-list','field_60c06bb39838f'),(20589,1775,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(20590,1775,'_s4-slogan','field_60c06d6d98392'),(20591,1775,'s4-list_0_icon','127'),(20592,1775,'_s4-list_0_icon','field_60c06bc298390'),(20593,1775,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(20594,1775,'_s4-list_0_text','field_60c06bce98391'),(20595,1775,'s4-list_1_icon','128'),(20596,1775,'_s4-list_1_icon','field_60c06bc298390'),(20597,1775,'s4-list_1_text','<strong>головокружiння</strong>'),(20598,1775,'_s4-list_1_text','field_60c06bce98391'),(20599,1775,'s4-list_2_icon','68'),(20600,1775,'_s4-list_2_icon','field_60c06bc298390'),(20601,1775,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(20602,1775,'_s4-list_2_text','field_60c06bce98391'),(20603,1775,'s4-list_3_icon','64'),(20604,1775,'_s4-list_3_icon','field_60c06bc298390'),(20605,1775,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(20606,1775,'_s4-list_3_text','field_60c06bce98391'),(20607,1775,'s4-list_4_icon','129'),(20608,1775,'_s4-list_4_icon','field_60c06bc298390'),(20609,1775,'s4-list_4_text','<strong>дiарея</strong>'),(20610,1775,'_s4-list_4_text','field_60c06bce98391'),(20611,1775,'s4-list_5_icon','130'),(20612,1775,'_s4-list_5_icon','field_60c06bc298390'),(20613,1775,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(20614,1775,'_s4-list_5_text','field_60c06bce98391'),(20615,1775,'s4-list_6_icon','131'),(20616,1775,'_s4-list_6_icon','field_60c06bc298390'),(20617,1775,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(20618,1775,'_s4-list_6_text','field_60c06bce98391'),(20619,1775,'s3-list_0_li','має збалансований<br /> склад'),(20620,1775,'_s3-list_0_li','field_60c06db098395'),(20621,1775,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(20622,1775,'_s3-list_1_li','field_60c06db098395'),(20623,1775,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(20624,1775,'_s3-list_2_li','field_60c06db098395'),(20625,1775,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(20626,1775,'_s3-list_3_li','field_60c06db098395'),(20627,1775,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(20628,1775,'_s3-list_4_li','field_60c06db098395'),(20629,1775,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(20630,1775,'_s3-list2_0_li','field_60c06dd498397'),(20631,1775,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(20632,1775,'_s3-list2_1_li','field_60c06dd498397'),(20633,1775,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(20634,1775,'_s3-list2_2_li','field_60c06dd498397'),(20635,1775,'s2-list_0_ttl','Вуглекислота'),(20636,1775,'_s2-list_0_ttl','field_60c0745253144'),(20637,1775,'s2-list_0_formula','Вуглекислота'),(20638,1775,'_s2-list_0_formula','field_60c0747253145'),(20639,1775,'s2-list_0_size','- 0,05-0,3%'),(20640,1775,'_s2-list_0_size','field_60c0749553146'),(20641,1775,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(20642,1775,'_s2-list_0_text','field_60c0749d53147'),(20643,1775,'s2-list','9'),(20644,1775,'_s2-list','field_60c0743a53143'),(20645,1775,'s2-list_1_ttl','Мiнералiзацiя'),(20646,1775,'_s2-list_1_ttl','field_60c0745253144'),(20647,1775,'s2-list_1_formula','Мiнералiзацiя'),(20648,1775,'_s2-list_1_formula','field_60c0747253145'),(20649,1775,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(20650,1775,'_s2-list_1_size','field_60c0749553146'),(20651,1775,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(20652,1775,'_s2-list_1_text','field_60c0749d53147'),(20653,1775,'s2-list_2_ttl','Сорбітол'),(20654,1775,'_s2-list_2_ttl','field_60c0745253144'),(20655,1775,'s2-list_2_formula','Сорбітол'),(20656,1775,'_s2-list_2_formula','field_60c0747253145'),(20657,1775,'s2-list_2_size','до 900 мл/г'),(20658,1775,'_s2-list_2_size','field_60c0749553146'),(20659,1775,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(20660,1775,'_s2-list_2_text','field_60c0749d53147'),(20661,1775,'s2-list_3_ttl','Натрій'),(20662,1775,'_s2-list_3_ttl','field_60c0745253144'),(20663,1775,'s2-list_3_formula','Na<sup>+</sup>'),(20664,1775,'_s2-list_3_formula','field_60c0747253145'),(20665,1775,'s2-list_3_size','- 900 мл/г'),(20666,1775,'_s2-list_3_size','field_60c0749553146'),(20667,1775,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(20668,1775,'_s2-list_3_text','field_60c0749d53147'),(20669,1775,'s2-list_4_ttl','Магній'),(20670,1775,'_s2-list_4_ttl','field_60c0745253144'),(20671,1775,'s2-list_4_formula','Mg<sup>2+</sup>'),(20672,1775,'_s2-list_4_formula','field_60c0747253145'),(20673,1775,'s2-list_4_size','- 50 мл/г'),(20674,1775,'_s2-list_4_size','field_60c0749553146'),(20675,1775,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(20676,1775,'_s2-list_4_text','field_60c0749d53147'),(20677,1775,'s2-list_5_ttl','Хлор'),(20678,1775,'_s2-list_5_ttl','field_60c0745253144'),(20679,1775,'s2-list_5_formula','Cl<sup>-</sup>'),(20680,1775,'_s2-list_5_formula','field_60c0747253145'),(20681,1775,'s2-list_5_size','- 600 мл/г'),(20682,1775,'_s2-list_5_size','field_60c0749553146'),(20683,1775,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(20684,1775,'_s2-list_5_text','field_60c0749d53147'),(20685,1775,'s2-list_6_ttl','Калій'),(20686,1775,'_s2-list_6_ttl','field_60c0745253144'),(20687,1775,'s2-list_6_formula','K<sup>+</sup>'),(20688,1775,'_s2-list_6_formula','field_60c0747253145'),(20689,1775,'s2-list_6_size','- 160 мл/г'),(20690,1775,'_s2-list_6_size','field_60c0749553146'),(20691,1775,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(20692,1775,'_s2-list_6_text','field_60c0749d53147'),(20693,1775,'s2-list_7_ttl','Кальцій'),(20694,1775,'_s2-list_7_ttl','field_60c0745253144'),(20695,1775,'s2-list_7_formula','Ca<sup>2+</sup>'),(20696,1775,'_s2-list_7_formula','field_60c0747253145'),(20697,1775,'s2-list_7_size','- 50 мл/г'),(20698,1775,'_s2-list_7_size','field_60c0749553146'),(20699,1775,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(20700,1775,'_s2-list_7_text','field_60c0749d53147'),(20701,1775,'s2-list_8_ttl','Гідрокарбонати'),(20702,1775,'_s2-list_8_ttl','field_60c0745253144'),(20703,1775,'s2-list_8_formula','HCO3<sup>+</sup>'),(20704,1775,'_s2-list_8_formula','field_60c0747253145'),(20705,1775,'s2-list_8_size','- 300 мл/г'),(20706,1775,'_s2-list_8_size','field_60c0749553146'),(20707,1775,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(20708,1775,'_s2-list_8_text','field_60c0749d53147'),(20709,1776,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(20710,1776,'_s1-text','field_60c069d69838b'),(20711,1776,'s3-list','5'),(20712,1776,'_s3-list','field_60c06d9298394'),(20713,1776,'s3-list2','3'),(20714,1776,'_s3-list2','field_60c06dd498396'),(20715,1776,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(20716,1776,'_s4-ttl','field_60c06ba39838e'),(20717,1776,'s4-list','7'),(20718,1776,'_s4-list','field_60c06bb39838f'),(20719,1776,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(20720,1776,'_s4-slogan','field_60c06d6d98392'),(20721,1776,'s4-list_0_icon','127'),(20722,1776,'_s4-list_0_icon','field_60c06bc298390'),(20723,1776,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(20724,1776,'_s4-list_0_text','field_60c06bce98391'),(20725,1776,'s4-list_1_icon','128'),(20726,1776,'_s4-list_1_icon','field_60c06bc298390'),(20727,1776,'s4-list_1_text','<strong>головокружiння</strong>'),(20728,1776,'_s4-list_1_text','field_60c06bce98391'),(20729,1776,'s4-list_2_icon','68'),(20730,1776,'_s4-list_2_icon','field_60c06bc298390'),(20731,1776,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(20732,1776,'_s4-list_2_text','field_60c06bce98391'),(20733,1776,'s4-list_3_icon','64'),(20734,1776,'_s4-list_3_icon','field_60c06bc298390'),(20735,1776,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(20736,1776,'_s4-list_3_text','field_60c06bce98391'),(20737,1776,'s4-list_4_icon','129'),(20738,1776,'_s4-list_4_icon','field_60c06bc298390'),(20739,1776,'s4-list_4_text','<strong>дiарея</strong>'),(20740,1776,'_s4-list_4_text','field_60c06bce98391'),(20741,1776,'s4-list_5_icon','130'),(20742,1776,'_s4-list_5_icon','field_60c06bc298390'),(20743,1776,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(20744,1776,'_s4-list_5_text','field_60c06bce98391'),(20745,1776,'s4-list_6_icon','131'),(20746,1776,'_s4-list_6_icon','field_60c06bc298390'),(20747,1776,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(20748,1776,'_s4-list_6_text','field_60c06bce98391'),(20749,1776,'s3-list_0_li','має збалансований<br /> склад'),(20750,1776,'_s3-list_0_li','field_60c06db098395'),(20751,1776,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(20752,1776,'_s3-list_1_li','field_60c06db098395'),(20753,1776,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(20754,1776,'_s3-list_2_li','field_60c06db098395'),(20755,1776,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(20756,1776,'_s3-list_3_li','field_60c06db098395'),(20757,1776,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(20758,1776,'_s3-list_4_li','field_60c06db098395'),(20759,1776,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(20760,1776,'_s3-list2_0_li','field_60c06dd498397'),(20761,1776,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(20762,1776,'_s3-list2_1_li','field_60c06dd498397'),(20763,1776,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(20764,1776,'_s3-list2_2_li','field_60c06dd498397'),(20765,1776,'s2-list_0_ttl','Вуглекислота'),(20766,1776,'_s2-list_0_ttl','field_60c0745253144'),(20767,1776,'s2-list_0_formula','Вуглекислота'),(20768,1776,'_s2-list_0_formula','field_60c0747253145'),(20769,1776,'s2-list_0_size','- 0,05-0,3%'),(20770,1776,'_s2-list_0_size','field_60c0749553146'),(20771,1776,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(20772,1776,'_s2-list_0_text','field_60c0749d53147'),(20773,1776,'s2-list','9'),(20774,1776,'_s2-list','field_60c0743a53143'),(20775,1776,'s2-list_1_ttl','Мiнералiзацiя'),(20776,1776,'_s2-list_1_ttl','field_60c0745253144'),(20777,1776,'s2-list_1_formula','Мiнералiзацiя'),(20778,1776,'_s2-list_1_formula','field_60c0747253145'),(20779,1776,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(20780,1776,'_s2-list_1_size','field_60c0749553146'),(20781,1776,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(20782,1776,'_s2-list_1_text','field_60c0749d53147'),(20783,1776,'s2-list_2_ttl','Сорбітол'),(20784,1776,'_s2-list_2_ttl','field_60c0745253144'),(20785,1776,'s2-list_2_formula','Сорбітол'),(20786,1776,'_s2-list_2_formula','field_60c0747253145'),(20787,1776,'s2-list_2_size','до 900 мл/г'),(20788,1776,'_s2-list_2_size','field_60c0749553146'),(20789,1776,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(20790,1776,'_s2-list_2_text','field_60c0749d53147'),(20791,1776,'s2-list_3_ttl','Натрій'),(20792,1776,'_s2-list_3_ttl','field_60c0745253144'),(20793,1776,'s2-list_3_formula','Na<sup>+</sup>'),(20794,1776,'_s2-list_3_formula','field_60c0747253145'),(20795,1776,'s2-list_3_size','- 900 мл/г'),(20796,1776,'_s2-list_3_size','field_60c0749553146'),(20797,1776,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(20798,1776,'_s2-list_3_text','field_60c0749d53147'),(20799,1776,'s2-list_4_ttl','Магній'),(20800,1776,'_s2-list_4_ttl','field_60c0745253144'),(20801,1776,'s2-list_4_formula','Mg<sup>2+</sup>'),(20802,1776,'_s2-list_4_formula','field_60c0747253145'),(20803,1776,'s2-list_4_size','- 50 мл/г'),(20804,1776,'_s2-list_4_size','field_60c0749553146'),(20805,1776,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(20806,1776,'_s2-list_4_text','field_60c0749d53147'),(20807,1776,'s2-list_5_ttl','Хлор'),(20808,1776,'_s2-list_5_ttl','field_60c0745253144'),(20809,1776,'s2-list_5_formula','Cl<sup>-</sup>'),(20810,1776,'_s2-list_5_formula','field_60c0747253145'),(20811,1776,'s2-list_5_size','- 600 мл/г'),(20812,1776,'_s2-list_5_size','field_60c0749553146'),(20813,1776,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(20814,1776,'_s2-list_5_text','field_60c0749d53147'),(20815,1776,'s2-list_6_ttl','Калій'),(20816,1776,'_s2-list_6_ttl','field_60c0745253144'),(20817,1776,'s2-list_6_formula','K<sup>+</sup>'),(20818,1776,'_s2-list_6_formula','field_60c0747253145'),(20819,1776,'s2-list_6_size','- 160 мл/г'),(20820,1776,'_s2-list_6_size','field_60c0749553146'),(20821,1776,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(20822,1776,'_s2-list_6_text','field_60c0749d53147'),(20823,1776,'s2-list_7_ttl','Кальцій'),(20824,1776,'_s2-list_7_ttl','field_60c0745253144'),(20825,1776,'s2-list_7_formula','Ca<sup>2+</sup>'),(20826,1776,'_s2-list_7_formula','field_60c0747253145'),(20827,1776,'s2-list_7_size','- 50 мл/г'),(20828,1776,'_s2-list_7_size','field_60c0749553146'),(20829,1776,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(20830,1776,'_s2-list_7_text','field_60c0749d53147'),(20831,1776,'s2-list_8_ttl','Гідрокарбонати'),(20832,1776,'_s2-list_8_ttl','field_60c0745253144'),(20833,1776,'s2-list_8_formula','HCO<sub>3</sub><sup>+</sup>'),(20834,1776,'_s2-list_8_formula','field_60c0747253145'),(20835,1776,'s2-list_8_size','- 300 мл/г'),(20836,1776,'_s2-list_8_size','field_60c0749553146'),(20837,1776,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(20838,1776,'_s2-list_8_text','field_60c0749d53147'),(20839,1777,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(20840,1777,'_s1-text','field_60c069d69838b'),(20841,1777,'s3-list','5'),(20842,1777,'_s3-list','field_60c06d9298394'),(20843,1777,'s3-list2','3'),(20844,1777,'_s3-list2','field_60c06dd498396'),(20845,1777,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(20846,1777,'_s4-ttl','field_60c06ba39838e'),(20847,1777,'s4-list','7'),(20848,1777,'_s4-list','field_60c06bb39838f'),(20849,1777,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(20850,1777,'_s4-slogan','field_60c06d6d98392'),(20851,1777,'s4-list_0_icon','127'),(20852,1777,'_s4-list_0_icon','field_60c06bc298390'),(20853,1777,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(20854,1777,'_s4-list_0_text','field_60c06bce98391'),(20855,1777,'s4-list_1_icon','128'),(20856,1777,'_s4-list_1_icon','field_60c06bc298390'),(20857,1777,'s4-list_1_text','<strong>головокружение</strong>'),(20858,1777,'_s4-list_1_text','field_60c06bce98391'),(20859,1777,'s4-list_2_icon','68'),(20860,1777,'_s4-list_2_icon','field_60c06bc298390'),(20861,1777,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(20862,1777,'_s4-list_2_text','field_60c06bce98391'),(20863,1777,'s4-list_3_icon','64'),(20864,1777,'_s4-list_3_icon','field_60c06bc298390'),(20865,1777,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(20866,1777,'_s4-list_3_text','field_60c06bce98391'),(20867,1777,'s4-list_4_icon','129'),(20868,1777,'_s4-list_4_icon','field_60c06bc298390'),(20869,1777,'s4-list_4_text','<strong>диарея</strong>'),(20870,1777,'_s4-list_4_text','field_60c06bce98391'),(20871,1777,'s4-list_5_icon','130'),(20872,1777,'_s4-list_5_icon','field_60c06bc298390'),(20873,1777,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(20874,1777,'_s4-list_5_text','field_60c06bce98391'),(20875,1777,'s4-list_6_icon','131'),(20876,1777,'_s4-list_6_icon','field_60c06bc298390'),(20877,1777,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(20878,1777,'_s4-list_6_text','field_60c06bce98391'),(20879,1777,'s3-list_0_li','имеет сбалансированный<br /> состав'),(20880,1777,'_s3-list_0_li','field_60c06db098395'),(20881,1777,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(20882,1777,'_s3-list_1_li','field_60c06db098395'),(20883,1777,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(20884,1777,'_s3-list_2_li','field_60c06db098395'),(20885,1777,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(20886,1777,'_s3-list_3_li','field_60c06db098395'),(20887,1777,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(20888,1777,'_s3-list_4_li','field_60c06db098395'),(20889,1777,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(20890,1777,'_s3-list2_0_li','field_60c06dd498397'),(20891,1777,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(20892,1777,'_s3-list2_1_li','field_60c06dd498397'),(20893,1777,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(20894,1777,'_s3-list2_2_li','field_60c06dd498397'),(20895,1777,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(20896,1777,'_s2-list_3_text','field_60c0749d53147'),(20897,1777,'s2-list_3_size','- 900 мл/г'),(20898,1777,'_s2-list_3_size','field_60c0749553146'),(20899,1777,'s2-list_3_formula','Na<sup>+</sup>'),(20900,1777,'_s2-list_3_formula','field_60c0747253145'),(20901,1777,'s2-list_3_ttl','Натрий'),(20902,1777,'_s2-list_3_ttl','field_60c0745253144'),(20903,1777,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(20904,1777,'_s2-list_2_text','field_60c0749d53147'),(20905,1777,'s2-list_2_size','до 900 мл/г'),(20906,1777,'_s2-list_2_size','field_60c0749553146'),(20907,1777,'s2-list_2_formula','Сорбитол'),(20908,1777,'_s2-list_2_formula','field_60c0747253145'),(20909,1777,'s2-list_2_ttl','Сорбитол'),(20910,1777,'_s2-list_2_ttl','field_60c0745253144'),(20911,1777,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(20912,1777,'_s2-list_1_text','field_60c0749d53147'),(20913,1777,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(20914,1777,'_s2-list_1_size','field_60c0749553146'),(20915,1777,'s2-list_1_formula','Минерализация'),(20916,1777,'_s2-list_1_formula','field_60c0747253145'),(20917,1777,'s2-list_1_ttl','Минерализация'),(20918,1777,'_s2-list_1_ttl','field_60c0745253144'),(20919,1777,'s2-list_0_ttl','Углекислота'),(20920,1777,'_s2-list_0_ttl','field_60c0745253144'),(20921,1777,'s2-list_0_formula','Углекислота'),(20922,1777,'_s2-list_0_formula','field_60c0747253145'),(20923,1777,'s2-list_0_size','- 0,05-0,3%'),(20924,1777,'_s2-list_0_size','field_60c0749553146'),(20925,1777,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(20926,1777,'_s2-list_0_text','field_60c0749d53147'),(20927,1777,'s2-list','9'),(20928,1777,'_s2-list','field_60c0743a53143'),(20929,1777,'s2-list_4_ttl','Магний'),(20930,1777,'_s2-list_4_ttl','field_60c0745253144'),(20931,1777,'s2-list_4_formula','Mg<sup>2+</sup>'),(20932,1777,'_s2-list_4_formula','field_60c0747253145'),(20933,1777,'s2-list_4_size','- 50 мл/г'),(20934,1777,'_s2-list_4_size','field_60c0749553146'),(20935,1777,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(20936,1777,'_s2-list_4_text','field_60c0749d53147'),(20937,1777,'s2-list_5_ttl','Хлор'),(20938,1777,'_s2-list_5_ttl','field_60c0745253144'),(20939,1777,'s2-list_5_formula','Cl<sup>-</sup>'),(20940,1777,'_s2-list_5_formula','field_60c0747253145'),(20941,1777,'s2-list_5_size','- 600 мл/г'),(20942,1777,'_s2-list_5_size','field_60c0749553146'),(20943,1777,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(20944,1777,'_s2-list_5_text','field_60c0749d53147'),(20945,1777,'s2-list_6_ttl','Калий'),(20946,1777,'_s2-list_6_ttl','field_60c0745253144'),(20947,1777,'s2-list_6_formula','K<sup>+</sup>'),(20948,1777,'_s2-list_6_formula','field_60c0747253145'),(20949,1777,'s2-list_6_size','- 160 мл/г'),(20950,1777,'_s2-list_6_size','field_60c0749553146'),(20951,1777,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(20952,1777,'_s2-list_6_text','field_60c0749d53147'),(20953,1777,'s2-list_7_ttl','Кальций'),(20954,1777,'_s2-list_7_ttl','field_60c0745253144'),(20955,1777,'s2-list_7_formula','Ca<sup>2+</sup>'),(20956,1777,'_s2-list_7_formula','field_60c0747253145'),(20957,1777,'s2-list_7_size','- 50 мл/г'),(20958,1777,'_s2-list_7_size','field_60c0749553146'),(20959,1777,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(20960,1777,'_s2-list_7_text','field_60c0749d53147'),(20961,1777,'s2-list_8_ttl','Гидрокарбонаты'),(20962,1777,'_s2-list_8_ttl','field_60c0745253144'),(20963,1777,'s2-list_8_formula','HCO<sub>3</sub><sup>+</sup>'),(20964,1777,'_s2-list_8_formula','field_60c0747253145'),(20965,1777,'s2-list_8_size','- 300 мл/г'),(20966,1777,'_s2-list_8_size','field_60c0749553146'),(20967,1777,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(20968,1777,'_s2-list_8_text','field_60c0749d53147'),(20969,1779,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(20970,1779,'_s1-text','field_60c069d69838b'),(20971,1779,'s3-list','5'),(20972,1779,'_s3-list','field_60c06d9298394'),(20973,1779,'s3-list2','3'),(20974,1779,'_s3-list2','field_60c06dd498396'),(20975,1779,'s4-ttl','ReO суви дегидратация ва интоксикация белгиларини камайтиради'),(20976,1779,'_s4-ttl','field_60c06ba39838e'),(20977,1779,'s4-list','7'),(20978,1779,'_s4-list','field_60c06bb39838f'),(20979,1779,'s4-slogan','ReO сув-туз мувозанатини тиклайди ва умумий аҳволни яхшилайди'),(20980,1779,'_s4-slogan','field_60c06d6d98392'),(20981,1779,'s4-list_0_icon','127'),(20982,1779,'_s4-list_0_icon','field_60c06bc298390'),(20983,1779,'s4-list_0_text','<strong>Тана ҳарорати</strong> кўтарилиши ва/ёки'),(20984,1779,'_s4-list_0_text','field_60c06bce98391'),(20985,1779,'s4-list_1_icon','128'),(20986,1779,'_s4-list_1_icon','field_60c06bc298390'),(20987,1779,'s4-list_1_text','<strong>бош айланиши</strong>'),(20988,1779,'_s4-list_1_text','field_60c06bce98391'),(20989,1779,'s4-list_2_icon','68'),(20990,1779,'_s4-list_2_icon','field_60c06bc298390'),(20991,1779,'s4-list_2_text','<strong>кўнгил айниши,</strong>\r\nқайт қилиш\r\nва/ёки'),(20992,1779,'_s4-list_2_text','field_60c06bce98391'),(20993,1779,'s4-list_3_icon','64'),(20994,1779,'_s4-list_3_icon','field_60c06bc298390'),(20995,1779,'s4-list_3_text','умумий\r\n<strong>ҳолсизлик</strong>'),(20996,1779,'_s4-list_3_text','field_60c06bce98391'),(20997,1779,'s4-list_4_icon','129'),(20998,1779,'_s4-list_4_icon','field_60c06bc298390'),(20999,1779,'s4-list_4_text','<strong>ич кетиши</strong>'),(21000,1779,'_s4-list_4_text','field_60c06bce98391'),(21001,1779,'s4-list_5_icon','130'),(21002,1779,'_s4-list_5_icon','field_60c06bc298390'),(21003,1779,'s4-list_5_text','қуриши\r\n<strong>оғиз</strong>'),(21004,1779,'_s4-list_5_text','field_60c06bce98391'),(21005,1779,'s4-list_6_icon','131'),(21006,1779,'_s4-list_6_icon','field_60c06bc298390'),(21007,1779,'s4-list_6_text','<strong>бош</strong>\r\nоғриғи'),(21008,1779,'_s4-list_6_text','field_60c06bce98391'),(21009,1779,'s3-list_0_li','мувозанатлаштирилган таркибга эга'),(21010,1779,'_s3-list_0_li','field_60c06db098395'),(21011,1779,'s3-list_1_li','таркибида қўшимча энергия манбаи – сорбитол бор'),(21012,1779,'_s3-list_1_li','field_60c06db098395'),(21013,1779,'s3-list_2_li','сув ва электролитларни тез сўрилишини таъминлайди'),(21014,1779,'_s3-list_2_li','field_60c06db098395'),(21015,1779,'s3-list_3_li','ёқимли таъмга эга бўлиб, ҳатто кўнгил айниганда ҳам осон ичилади '),(21016,1779,'_s3-list_3_li','field_60c06db098395'),(21017,1779,'s3-list_4_li','консервант, бўёқлар ва углеводларсиз'),(21018,1779,'_s3-list_4_li','field_60c06db098395'),(21019,1779,'s3-list2_0_li','Сувсизланиш белгиларини бартараф этади'),(21020,1779,'_s3-list2_0_li','field_60c06dd498397'),(21021,1779,'s3-list2_1_li','Диурезни нормаллаштиради, интоксикацияни камайтиради'),(21022,1779,'_s3-list2_1_li','field_60c06dd498397'),(21023,1779,'s3-list2_2_li','Стационарда даволаниш вақтида ва уйга чиққандан сўнг сув-электролит мувозанатини тиклашга ёрдам беради'),(21024,1779,'_s3-list2_2_li','field_60c06dd498397'),(21025,1779,'s2-list_3_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(21026,1779,'_s2-list_3_text','field_60c0749d53147'),(21027,1779,'s2-list_3_size','- 900 мл/л'),(21028,1779,'_s2-list_3_size','field_60c0749553146'),(21029,1779,'s2-list_3_formula','Na<sup>+</sup>'),(21030,1779,'_s2-list_3_formula','field_60c0747253145'),(21031,1779,'s2-list_3_ttl','Натрий'),(21032,1779,'_s2-list_3_ttl','field_60c0745253144'),(21033,1779,'s2-list_2_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(21034,1779,'_s2-list_2_text','field_60c0749d53147'),(21035,1779,'s2-list_2_size','до 900 мл/л'),(21036,1779,'_s2-list_2_size','field_60c0749553146'),(21037,1779,'s2-list_2_formula','Сорбитол'),(21038,1779,'_s2-list_2_formula','field_60c0747253145'),(21039,1779,'s2-list_2_ttl','Сорбитол'),(21040,1779,'_s2-list_2_ttl','field_60c0745253144'),(21041,1779,'s2-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(21042,1779,'_s2-list_1_text','field_60c0749d53147'),(21043,1779,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(21044,1779,'_s2-list_1_size','field_60c0749553146'),(21045,1779,'s2-list_1_formula','Минерализация'),(21046,1779,'_s2-list_1_formula','field_60c0747253145'),(21047,1779,'s2-list_1_ttl','Минерализация'),(21048,1779,'_s2-list_1_ttl','field_60c0745253144'),(21049,1779,'s2-list_0_ttl','Углекислота'),(21050,1779,'_s2-list_0_ttl','field_60c0745253144'),(21051,1779,'s2-list_0_formula','Углекислота'),(21052,1779,'_s2-list_0_formula','field_60c0747253145'),(21053,1779,'s2-list_0_size','- 0,05-0,3%'),(21054,1779,'_s2-list_0_size','field_60c0749553146'),(21055,1779,'s2-list_0_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(21056,1779,'_s2-list_0_text','field_60c0749d53147'),(21057,1779,'s2-list','9'),(21058,1779,'_s2-list','field_60c0743a53143'),(21059,1779,'s2-list_4_ttl','Магний'),(21060,1779,'_s2-list_4_ttl','field_60c0745253144'),(21061,1779,'s2-list_4_formula','Mg<sup>2+</sup>'),(21062,1779,'_s2-list_4_formula','field_60c0747253145'),(21063,1779,'s2-list_4_size','- 50 мл/л'),(21064,1779,'_s2-list_4_size','field_60c0749553146'),(21065,1779,'s2-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(21066,1779,'_s2-list_4_text','field_60c0749d53147'),(21067,1779,'s2-list_5_ttl','Хлор'),(21068,1779,'_s2-list_5_ttl','field_60c0745253144'),(21069,1779,'s2-list_5_formula','Cl<sup>-</sup>'),(21070,1779,'_s2-list_5_formula','field_60c0747253145'),(21071,1779,'s2-list_5_size','- 600 мл/л'),(21072,1779,'_s2-list_5_size','field_60c0749553146'),(21073,1779,'s2-list_5_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(21074,1779,'_s2-list_5_text','field_60c0749d53147'),(21075,1779,'s2-list_6_ttl','Калий'),(21076,1779,'_s2-list_6_ttl','field_60c0745253144'),(21077,1779,'s2-list_6_formula','K<sup>+</sup>'),(21078,1779,'_s2-list_6_formula','field_60c0747253145'),(21079,1779,'s2-list_6_size','- 160 мл/л'),(21080,1779,'_s2-list_6_size','field_60c0749553146'),(21081,1779,'s2-list_6_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(21082,1779,'_s2-list_6_text','field_60c0749d53147'),(21083,1779,'s2-list_7_ttl','Кальций'),(21084,1779,'_s2-list_7_ttl','field_60c0745253144'),(21085,1779,'s2-list_7_formula','Ca<sup>2+</sup>'),(21086,1779,'_s2-list_7_formula','field_60c0747253145'),(21087,1779,'s2-list_7_size','- 50 мл/л'),(21088,1779,'_s2-list_7_size','field_60c0749553146'),(21089,1779,'s2-list_7_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(21090,1779,'_s2-list_7_text','field_60c0749d53147'),(21091,1779,'s2-list_8_ttl','Гидрокарбонатлар '),(21092,1779,'_s2-list_8_ttl','field_60c0745253144'),(21093,1779,'s2-list_8_formula','HCO<sub>3</sub><sup>+</sup>'),(21094,1779,'_s2-list_8_formula','field_60c0747253145'),(21095,1779,'s2-list_8_size','- 300 мл/л'),(21096,1779,'_s2-list_8_size','field_60c0749553146'),(21097,1779,'s2-list_8_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(21098,1779,'_s2-list_8_text','field_60c0749d53147'),(21099,1780,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(21100,1780,'_s1-text','field_60c069d69838b'),(21101,1780,'s3-list','5'),(21102,1780,'_s3-list','field_60c06d9298394'),(21103,1780,'s3-list2','3'),(21104,1780,'_s3-list2','field_60c06dd498396'),(21105,1780,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(21106,1780,'_s4-ttl','field_60c06ba39838e'),(21107,1780,'s4-list','7'),(21108,1780,'_s4-list','field_60c06bb39838f'),(21109,1780,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(21110,1780,'_s4-slogan','field_60c06d6d98392'),(21111,1780,'s4-list_0_icon','127'),(21112,1780,'_s4-list_0_icon','field_60c06bc298390'),(21113,1780,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(21114,1780,'_s4-list_0_text','field_60c06bce98391'),(21115,1780,'s4-list_1_icon','128'),(21116,1780,'_s4-list_1_icon','field_60c06bc298390'),(21117,1780,'s4-list_1_text','<strong>головокружiння</strong>'),(21118,1780,'_s4-list_1_text','field_60c06bce98391'),(21119,1780,'s4-list_2_icon','68'),(21120,1780,'_s4-list_2_icon','field_60c06bc298390'),(21121,1780,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(21122,1780,'_s4-list_2_text','field_60c06bce98391'),(21123,1780,'s4-list_3_icon','64'),(21124,1780,'_s4-list_3_icon','field_60c06bc298390'),(21125,1780,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(21126,1780,'_s4-list_3_text','field_60c06bce98391'),(21127,1780,'s4-list_4_icon','129'),(21128,1780,'_s4-list_4_icon','field_60c06bc298390'),(21129,1780,'s4-list_4_text','<strong>дiарея</strong>'),(21130,1780,'_s4-list_4_text','field_60c06bce98391'),(21131,1780,'s4-list_5_icon','130'),(21132,1780,'_s4-list_5_icon','field_60c06bc298390'),(21133,1780,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(21134,1780,'_s4-list_5_text','field_60c06bce98391'),(21135,1780,'s4-list_6_icon','131'),(21136,1780,'_s4-list_6_icon','field_60c06bc298390'),(21137,1780,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(21138,1780,'_s4-list_6_text','field_60c06bce98391'),(21139,1780,'s3-list_0_li','має збалансований<br /> склад'),(21140,1780,'_s3-list_0_li','field_60c06db098395'),(21141,1780,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(21142,1780,'_s3-list_1_li','field_60c06db098395'),(21143,1780,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(21144,1780,'_s3-list_2_li','field_60c06db098395'),(21145,1780,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(21146,1780,'_s3-list_3_li','field_60c06db098395'),(21147,1780,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(21148,1780,'_s3-list_4_li','field_60c06db098395'),(21149,1780,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(21150,1780,'_s3-list2_0_li','field_60c06dd498397'),(21151,1780,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(21152,1780,'_s3-list2_1_li','field_60c06dd498397'),(21153,1780,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(21154,1780,'_s3-list2_2_li','field_60c06dd498397'),(21155,1780,'s2-list_0_ttl','Вуглекислота'),(21156,1780,'_s2-list_0_ttl','field_60c0745253144'),(21157,1780,'s2-list_0_formula','Вуглекислота'),(21158,1780,'_s2-list_0_formula','field_60c0747253145'),(21159,1780,'s2-list_0_size','- 0,05-0,3%'),(21160,1780,'_s2-list_0_size','field_60c0749553146'),(21161,1780,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(21162,1780,'_s2-list_0_text','field_60c0749d53147'),(21163,1780,'s2-list','9'),(21164,1780,'_s2-list','field_60c0743a53143'),(21165,1780,'s2-list_1_ttl','Мiнералiзацiя'),(21166,1780,'_s2-list_1_ttl','field_60c0745253144'),(21167,1780,'s2-list_1_formula','Мiнералiзацiя'),(21168,1780,'_s2-list_1_formula','field_60c0747253145'),(21169,1780,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(21170,1780,'_s2-list_1_size','field_60c0749553146'),(21171,1780,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(21172,1780,'_s2-list_1_text','field_60c0749d53147'),(21173,1780,'s2-list_2_ttl','Сорбітол'),(21174,1780,'_s2-list_2_ttl','field_60c0745253144'),(21175,1780,'s2-list_2_formula','Сорбітол'),(21176,1780,'_s2-list_2_formula','field_60c0747253145'),(21177,1780,'s2-list_2_size','до 900 мл/г'),(21178,1780,'_s2-list_2_size','field_60c0749553146'),(21179,1780,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(21180,1780,'_s2-list_2_text','field_60c0749d53147'),(21181,1780,'s2-list_3_ttl','Натрій'),(21182,1780,'_s2-list_3_ttl','field_60c0745253144'),(21183,1780,'s2-list_3_formula','Na<sup>+</sup>'),(21184,1780,'_s2-list_3_formula','field_60c0747253145'),(21185,1780,'s2-list_3_size','- 900 мл/г'),(21186,1780,'_s2-list_3_size','field_60c0749553146'),(21187,1780,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(21188,1780,'_s2-list_3_text','field_60c0749d53147'),(21189,1780,'s2-list_4_ttl','Магній'),(21190,1780,'_s2-list_4_ttl','field_60c0745253144'),(21191,1780,'s2-list_4_formula','Mg<sup>2+</sup>'),(21192,1780,'_s2-list_4_formula','field_60c0747253145'),(21193,1780,'s2-list_4_size','- 50 мл/г'),(21194,1780,'_s2-list_4_size','field_60c0749553146'),(21195,1780,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(21196,1780,'_s2-list_4_text','field_60c0749d53147'),(21197,1780,'s2-list_5_ttl','Хлор'),(21198,1780,'_s2-list_5_ttl','field_60c0745253144'),(21199,1780,'s2-list_5_formula','Cl<sup>-</sup>'),(21200,1780,'_s2-list_5_formula','field_60c0747253145'),(21201,1780,'s2-list_5_size','- 600 мл/г'),(21202,1780,'_s2-list_5_size','field_60c0749553146'),(21203,1780,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(21204,1780,'_s2-list_5_text','field_60c0749d53147'),(21205,1780,'s2-list_6_ttl','Калій'),(21206,1780,'_s2-list_6_ttl','field_60c0745253144'),(21207,1780,'s2-list_6_formula','K<sup>+</sup>'),(21208,1780,'_s2-list_6_formula','field_60c0747253145'),(21209,1780,'s2-list_6_size','- 160 мл/г'),(21210,1780,'_s2-list_6_size','field_60c0749553146'),(21211,1780,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(21212,1780,'_s2-list_6_text','field_60c0749d53147'),(21213,1780,'s2-list_7_ttl','Кальцій'),(21214,1780,'_s2-list_7_ttl','field_60c0745253144'),(21215,1780,'s2-list_7_formula','Ca<sup>2+</sup>'),(21216,1780,'_s2-list_7_formula','field_60c0747253145'),(21217,1780,'s2-list_7_size','- 50 мл/г'),(21218,1780,'_s2-list_7_size','field_60c0749553146'),(21219,1780,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(21220,1780,'_s2-list_7_text','field_60c0749d53147'),(21221,1780,'s2-list_8_ttl','Гідрокарбонати'),(21222,1780,'_s2-list_8_ttl','field_60c0745253144'),(21223,1780,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(21224,1780,'_s2-list_8_formula','field_60c0747253145'),(21225,1780,'s2-list_8_size','- 300 мл/г'),(21226,1780,'_s2-list_8_size','field_60c0749553146'),(21227,1780,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(21228,1780,'_s2-list_8_text','field_60c0749d53147'),(21229,1781,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(21230,1781,'_s1-text','field_60c069d69838b'),(21231,1781,'s3-list','5'),(21232,1781,'_s3-list','field_60c06d9298394'),(21233,1781,'s3-list2','3'),(21234,1781,'_s3-list2','field_60c06dd498396'),(21235,1781,'s4-ttl','ReO суви дегидратация ва интоксикация белгиларини камайтиради'),(21236,1781,'_s4-ttl','field_60c06ba39838e'),(21237,1781,'s4-list','7'),(21238,1781,'_s4-list','field_60c06bb39838f'),(21239,1781,'s4-slogan','ReO сув-туз мувозанатини тиклайди ва умумий аҳволни яхшилайди'),(21240,1781,'_s4-slogan','field_60c06d6d98392'),(21241,1781,'s4-list_0_icon','127'),(21242,1781,'_s4-list_0_icon','field_60c06bc298390'),(21243,1781,'s4-list_0_text','<strong>Тана ҳарорати</strong> кўтарилиши ва/ёки'),(21244,1781,'_s4-list_0_text','field_60c06bce98391'),(21245,1781,'s4-list_1_icon','128'),(21246,1781,'_s4-list_1_icon','field_60c06bc298390'),(21247,1781,'s4-list_1_text','<strong>бош айланиши</strong>'),(21248,1781,'_s4-list_1_text','field_60c06bce98391'),(21249,1781,'s4-list_2_icon','68'),(21250,1781,'_s4-list_2_icon','field_60c06bc298390'),(21251,1781,'s4-list_2_text','<strong>кўнгил айниши,</strong>\r\nқайт қилиш\r\nва/ёки'),(21252,1781,'_s4-list_2_text','field_60c06bce98391'),(21253,1781,'s4-list_3_icon','64'),(21254,1781,'_s4-list_3_icon','field_60c06bc298390'),(21255,1781,'s4-list_3_text','умумий\r\n<strong>ҳолсизлик</strong>'),(21256,1781,'_s4-list_3_text','field_60c06bce98391'),(21257,1781,'s4-list_4_icon','129'),(21258,1781,'_s4-list_4_icon','field_60c06bc298390'),(21259,1781,'s4-list_4_text','<strong>ич кетиши</strong>'),(21260,1781,'_s4-list_4_text','field_60c06bce98391'),(21261,1781,'s4-list_5_icon','130'),(21262,1781,'_s4-list_5_icon','field_60c06bc298390'),(21263,1781,'s4-list_5_text','қуриши\r\n<strong>оғиз</strong>'),(21264,1781,'_s4-list_5_text','field_60c06bce98391'),(21265,1781,'s4-list_6_icon','131'),(21266,1781,'_s4-list_6_icon','field_60c06bc298390'),(21267,1781,'s4-list_6_text','<strong>бош</strong>\r\nоғриғи'),(21268,1781,'_s4-list_6_text','field_60c06bce98391'),(21269,1781,'s3-list_0_li','мувозанатлаштирилган таркибга эга'),(21270,1781,'_s3-list_0_li','field_60c06db098395'),(21271,1781,'s3-list_1_li','таркибида қўшимча энергия манбаи – сорбитол бор'),(21272,1781,'_s3-list_1_li','field_60c06db098395'),(21273,1781,'s3-list_2_li','сув ва электролитларни тез сўрилишини таъминлайди'),(21274,1781,'_s3-list_2_li','field_60c06db098395'),(21275,1781,'s3-list_3_li','ёқимли таъмга эга бўлиб, ҳатто кўнгил айниганда ҳам осон ичилади '),(21276,1781,'_s3-list_3_li','field_60c06db098395'),(21277,1781,'s3-list_4_li','консервант, бўёқлар ва углеводларсиз'),(21278,1781,'_s3-list_4_li','field_60c06db098395'),(21279,1781,'s3-list2_0_li','Сувсизланиш белгиларини бартараф этади'),(21280,1781,'_s3-list2_0_li','field_60c06dd498397'),(21281,1781,'s3-list2_1_li','Диурезни нормаллаштиради, интоксикацияни камайтиради'),(21282,1781,'_s3-list2_1_li','field_60c06dd498397'),(21283,1781,'s3-list2_2_li','Стационарда даволаниш вақтида ва уйга чиққандан сўнг сув-электролит мувозанатини тиклашга ёрдам беради'),(21284,1781,'_s3-list2_2_li','field_60c06dd498397'),(21285,1781,'s2-list_3_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(21286,1781,'_s2-list_3_text','field_60c0749d53147'),(21287,1781,'s2-list_3_size','- 900 мл/л'),(21288,1781,'_s2-list_3_size','field_60c0749553146'),(21289,1781,'s2-list_3_formula','Na<sup>+</sup>'),(21290,1781,'_s2-list_3_formula','field_60c0747253145'),(21291,1781,'s2-list_3_ttl','Натрий'),(21292,1781,'_s2-list_3_ttl','field_60c0745253144'),(21293,1781,'s2-list_2_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(21294,1781,'_s2-list_2_text','field_60c0749d53147'),(21295,1781,'s2-list_2_size','до 900 мл/л'),(21296,1781,'_s2-list_2_size','field_60c0749553146'),(21297,1781,'s2-list_2_formula','Сорбитол'),(21298,1781,'_s2-list_2_formula','field_60c0747253145'),(21299,1781,'s2-list_2_ttl','Сорбитол'),(21300,1781,'_s2-list_2_ttl','field_60c0745253144'),(21301,1781,'s2-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(21302,1781,'_s2-list_1_text','field_60c0749d53147'),(21303,1781,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(21304,1781,'_s2-list_1_size','field_60c0749553146'),(21305,1781,'s2-list_1_formula','Минерализация'),(21306,1781,'_s2-list_1_formula','field_60c0747253145'),(21307,1781,'s2-list_1_ttl','Минерализация'),(21308,1781,'_s2-list_1_ttl','field_60c0745253144'),(21309,1781,'s2-list_0_ttl','Углекислота'),(21310,1781,'_s2-list_0_ttl','field_60c0745253144'),(21311,1781,'s2-list_0_formula','Углекислота'),(21312,1781,'_s2-list_0_formula','field_60c0747253145'),(21313,1781,'s2-list_0_size','- 0,05-0,3%'),(21314,1781,'_s2-list_0_size','field_60c0749553146'),(21315,1781,'s2-list_0_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(21316,1781,'_s2-list_0_text','field_60c0749d53147'),(21317,1781,'s2-list','9'),(21318,1781,'_s2-list','field_60c0743a53143'),(21319,1781,'s2-list_4_ttl','Магний'),(21320,1781,'_s2-list_4_ttl','field_60c0745253144'),(21321,1781,'s2-list_4_formula','Mg<sup>2+</sup>'),(21322,1781,'_s2-list_4_formula','field_60c0747253145'),(21323,1781,'s2-list_4_size','- 50 мл/л'),(21324,1781,'_s2-list_4_size','field_60c0749553146'),(21325,1781,'s2-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(21326,1781,'_s2-list_4_text','field_60c0749d53147'),(21327,1781,'s2-list_5_ttl','Хлор'),(21328,1781,'_s2-list_5_ttl','field_60c0745253144'),(21329,1781,'s2-list_5_formula','Cl<sup>-</sup>'),(21330,1781,'_s2-list_5_formula','field_60c0747253145'),(21331,1781,'s2-list_5_size','- 600 мл/л'),(21332,1781,'_s2-list_5_size','field_60c0749553146'),(21333,1781,'s2-list_5_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(21334,1781,'_s2-list_5_text','field_60c0749d53147'),(21335,1781,'s2-list_6_ttl','Калий'),(21336,1781,'_s2-list_6_ttl','field_60c0745253144'),(21337,1781,'s2-list_6_formula','K<sup>+</sup>'),(21338,1781,'_s2-list_6_formula','field_60c0747253145'),(21339,1781,'s2-list_6_size','- 160 мл/л'),(21340,1781,'_s2-list_6_size','field_60c0749553146'),(21341,1781,'s2-list_6_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(21342,1781,'_s2-list_6_text','field_60c0749d53147'),(21343,1781,'s2-list_7_ttl','Кальций'),(21344,1781,'_s2-list_7_ttl','field_60c0745253144'),(21345,1781,'s2-list_7_formula','Ca<sup>2+</sup>'),(21346,1781,'_s2-list_7_formula','field_60c0747253145'),(21347,1781,'s2-list_7_size','- 50 мл/л'),(21348,1781,'_s2-list_7_size','field_60c0749553146'),(21349,1781,'s2-list_7_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(21350,1781,'_s2-list_7_text','field_60c0749d53147'),(21351,1781,'s2-list_8_ttl','Гидрокарбонатлар '),(21352,1781,'_s2-list_8_ttl','field_60c0745253144'),(21353,1781,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(21354,1781,'_s2-list_8_formula','field_60c0747253145'),(21355,1781,'s2-list_8_size','- 300 мл/л'),(21356,1781,'_s2-list_8_size','field_60c0749553146'),(21357,1781,'s2-list_8_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(21358,1781,'_s2-list_8_text','field_60c0749d53147'),(21359,1782,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(21360,1782,'_s1-text','field_60c069d69838b'),(21361,1782,'s3-list','5'),(21362,1782,'_s3-list','field_60c06d9298394'),(21363,1782,'s3-list2','3'),(21364,1782,'_s3-list2','field_60c06dd498396'),(21365,1782,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(21366,1782,'_s4-ttl','field_60c06ba39838e'),(21367,1782,'s4-list','7'),(21368,1782,'_s4-list','field_60c06bb39838f'),(21369,1782,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(21370,1782,'_s4-slogan','field_60c06d6d98392'),(21371,1782,'s4-list_0_icon','127'),(21372,1782,'_s4-list_0_icon','field_60c06bc298390'),(21373,1782,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(21374,1782,'_s4-list_0_text','field_60c06bce98391'),(21375,1782,'s4-list_1_icon','128'),(21376,1782,'_s4-list_1_icon','field_60c06bc298390'),(21377,1782,'s4-list_1_text','<strong>головокружение</strong>'),(21378,1782,'_s4-list_1_text','field_60c06bce98391'),(21379,1782,'s4-list_2_icon','68'),(21380,1782,'_s4-list_2_icon','field_60c06bc298390'),(21381,1782,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(21382,1782,'_s4-list_2_text','field_60c06bce98391'),(21383,1782,'s4-list_3_icon','64'),(21384,1782,'_s4-list_3_icon','field_60c06bc298390'),(21385,1782,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(21386,1782,'_s4-list_3_text','field_60c06bce98391'),(21387,1782,'s4-list_4_icon','129'),(21388,1782,'_s4-list_4_icon','field_60c06bc298390'),(21389,1782,'s4-list_4_text','<strong>диарея</strong>'),(21390,1782,'_s4-list_4_text','field_60c06bce98391'),(21391,1782,'s4-list_5_icon','130'),(21392,1782,'_s4-list_5_icon','field_60c06bc298390'),(21393,1782,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(21394,1782,'_s4-list_5_text','field_60c06bce98391'),(21395,1782,'s4-list_6_icon','131'),(21396,1782,'_s4-list_6_icon','field_60c06bc298390'),(21397,1782,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(21398,1782,'_s4-list_6_text','field_60c06bce98391'),(21399,1782,'s3-list_0_li','имеет сбалансированный<br /> состав'),(21400,1782,'_s3-list_0_li','field_60c06db098395'),(21401,1782,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(21402,1782,'_s3-list_1_li','field_60c06db098395'),(21403,1782,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(21404,1782,'_s3-list_2_li','field_60c06db098395'),(21405,1782,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(21406,1782,'_s3-list_3_li','field_60c06db098395'),(21407,1782,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(21408,1782,'_s3-list_4_li','field_60c06db098395'),(21409,1782,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(21410,1782,'_s3-list2_0_li','field_60c06dd498397'),(21411,1782,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(21412,1782,'_s3-list2_1_li','field_60c06dd498397'),(21413,1782,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(21414,1782,'_s3-list2_2_li','field_60c06dd498397'),(21415,1782,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(21416,1782,'_s2-list_3_text','field_60c0749d53147'),(21417,1782,'s2-list_3_size','- 900 мл/г'),(21418,1782,'_s2-list_3_size','field_60c0749553146'),(21419,1782,'s2-list_3_formula','Na<sup>+</sup>'),(21420,1782,'_s2-list_3_formula','field_60c0747253145'),(21421,1782,'s2-list_3_ttl','Натрий'),(21422,1782,'_s2-list_3_ttl','field_60c0745253144'),(21423,1782,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(21424,1782,'_s2-list_2_text','field_60c0749d53147'),(21425,1782,'s2-list_2_size','до 900 мл/г'),(21426,1782,'_s2-list_2_size','field_60c0749553146'),(21427,1782,'s2-list_2_formula','Сорбитол'),(21428,1782,'_s2-list_2_formula','field_60c0747253145'),(21429,1782,'s2-list_2_ttl','Сорбитол'),(21430,1782,'_s2-list_2_ttl','field_60c0745253144'),(21431,1782,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. 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нагрузки'),(21558,1789,'_s2-list_4_text','field_60bf7712f46f1'),(21559,1789,'s2-list_5_icon','71'),(21560,1789,'_s2-list_5_icon','field_60bf76ecf46ef'),(21561,1789,'s2-list_5_icon-hover','72'),(21562,1789,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(21563,1789,'s2-list_5_text','Перегрев в жаркую погоду'),(21564,1789,'_s2-list_5_text','field_60bf7712f46f1'),(21565,1789,'s1-slogan','Когда обычной воды недостаточно!'),(21566,1789,'_s1-slogan','field_60bf7ab4d9ba9'),(21567,1789,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(21568,1789,'_s3-text','field_60bf7bb5a7e2b'),(21569,1789,'s4-ttl','РеО – вода для медицинских целей!'),(21570,1789,'_s4-ttl','field_60bf7c831f58c'),(21571,1789,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(21572,1789,'_s4-notes','field_60bf7ca31f58d'),(21573,1789,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(21574,1789,'_s5-video','field_60bf7ccfa01a5'),(21575,1789,'s6-ttl','Когда обычной воды недостаточно!'),(21576,1789,'_s6-ttl','field_60bf7cfb10d31'),(21577,1789,'s6-list','6'),(21578,1789,'_s6-list','field_60bf7d0410d32'),(21579,1789,'s6-list_0_icon','92'),(21580,1789,'_s6-list_0_icon','field_60bf7d1810d33'),(21581,1789,'s6-list_0_text','При повышенной температуре'),(21582,1789,'_s6-list_0_text','field_60bf7d2710d34'),(21583,1789,'s6-list_1_icon','93'),(21584,1789,'_s6-list_1_icon','field_60bf7d1810d33'),(21585,1789,'s6-list_1_text','При пищевых отравлениях'),(21586,1789,'_s6-list_1_text','field_60bf7d2710d34'),(21587,1789,'s6-list_2_icon','94'),(21588,1789,'_s6-list_2_icon','field_60bf7d1810d33'),(21589,1789,'s6-list_2_text','При кишечных инфекциях'),(21590,1789,'_s6-list_2_text','field_60bf7d2710d34'),(21591,1789,'s6-list_3_icon','95'),(21592,1789,'_s6-list_3_icon','field_60bf7d1810d33'),(21593,1789,'s6-list_3_text','Во время беременности'),(21594,1789,'_s6-list_3_text','field_60bf7d2710d34'),(21595,1789,'s6-list_4_icon','96'),(21596,1789,'_s6-list_4_icon','field_60bf7d1810d33'),(21597,1789,'s6-list_4_text','Во время занятий спортом'),(21598,1789,'_s6-list_4_text','field_60bf7d2710d34'),(21599,1789,'s6-list_5_icon','97'),(21600,1789,'_s6-list_5_icon','field_60bf7d1810d33'),(21601,1789,'s6-list_5_text','При похмельном синдроме'),(21602,1789,'_s6-list_5_text','field_60bf7d2710d34'),(21603,1789,'s4-list_0_ttl','Натрий'),(21604,1789,'_s4-list_0_ttl','field_60bf7fa95a92c'),(21605,1789,'s4-list_0_formula','Na<sup>+</sup>'),(21606,1789,'_s4-list_0_formula','field_60bf7fc65a92d'),(21607,1789,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(21608,1789,'_s4-list_0_text','field_60bf7fd35a92e'),(21609,1789,'s4-list_1_ttl','Вода'),(21610,1789,'_s4-list_1_ttl','field_60bf7fa95a92c'),(21611,1789,'s4-list_1_formula','H<sub>2</sub>O'),(21612,1789,'_s4-list_1_formula','field_60bf7fc65a92d'),(21613,1789,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(21614,1789,'_s4-list_1_text','field_60bf7fd35a92e'),(21615,1789,'s4-list','9'),(21616,1789,'_s4-list','field_60bf7f985a92b'),(21617,1789,'s4-list_2_ttl','Калий'),(21618,1789,'_s4-list_2_ttl','field_60bf7fa95a92c'),(21619,1789,'s4-list_2_formula','K<sup>+</sup>'),(21620,1789,'_s4-list_2_formula','field_60bf7fc65a92d'),(21621,1789,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(21622,1789,'_s4-list_2_text','field_60bf7fd35a92e'),(21623,1789,'s4-list_3_ttl','Гидрокарбонаты'),(21624,1789,'_s4-list_3_ttl','field_60bf7fa95a92c'),(21625,1789,'s4-list_3_formula','HCO<sup>3+</sup>'),(21626,1789,'_s4-list_3_formula','field_60bf7fc65a92d'),(21627,1789,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(21628,1789,'_s4-list_3_text','field_60bf7fd35a92e'),(21629,1789,'s4-list_4_ttl','Магний'),(21630,1789,'_s4-list_4_ttl','field_60bf7fa95a92c'),(21631,1789,'s4-list_4_formula','Mg<sup>2+</sup>'),(21632,1789,'_s4-list_4_formula','field_60bf7fc65a92d'),(21633,1789,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(21634,1789,'_s4-list_4_text','field_60bf7fd35a92e'),(21635,1789,'s4-list_5_ttl','Углекислый газ'),(21636,1789,'_s4-list_5_ttl','field_60bf7fa95a92c'),(21637,1789,'s4-list_5_formula','CO<sup>2+</sup>'),(21638,1789,'_s4-list_5_formula','field_60bf7fc65a92d'),(21639,1789,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(21640,1789,'_s4-list_5_text','field_60bf7fd35a92e'),(21641,1789,'s4-list_6_ttl','Кальций'),(21642,1789,'_s4-list_6_ttl','field_60bf7fa95a92c'),(21643,1789,'s4-list_6_formula','Ca<sup>2+</sup>'),(21644,1789,'_s4-list_6_formula','field_60bf7fc65a92d'),(21645,1789,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(21646,1789,'_s4-list_6_text','field_60bf7fd35a92e'),(21647,1789,'s4-list_7_ttl','Сорбит'),(21648,1789,'_s4-list_7_ttl','field_60bf7fa95a92c'),(21649,1789,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(21650,1789,'_s4-list_7_formula','field_60bf7fc65a92d'),(21651,1789,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(21652,1789,'_s4-list_7_text','field_60bf7fd35a92e'),(21653,1789,'s4-list_8_ttl','Хлор'),(21654,1789,'_s4-list_8_ttl','field_60bf7fa95a92c'),(21655,1789,'s4-list_8_formula','Cl<sup>-</sup>'),(21656,1789,'_s4-list_8_formula','field_60bf7fc65a92d'),(21657,1789,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(21658,1789,'_s4-list_8_text','field_60bf7fd35a92e'),(21659,1789,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(21660,1789,'_s4-feature1','field_60bf80ca480ea'),(21661,1789,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(21662,1789,'_s4-feature2','field_60bf80de480eb'),(21663,1789,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(21664,1789,'_s4-feature3','field_60bf80e2480ec'),(21665,1789,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(21666,1789,'_s4-feature4','field_60bf80e5480ed'),(21667,1789,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(21668,1789,'_s2-list_0_link','field_60ee90d381a4e'),(21669,1789,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(21670,1789,'_s2-list_1_link','field_60ee90d381a4e'),(21671,1789,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(21672,1789,'_s2-list_2_link','field_60ee90d381a4e'),(21673,1789,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(21674,1789,'_s2-list_3_link','field_60ee90d381a4e'),(21675,1789,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(21676,1789,'_s2-list_4_link','field_60ee90d381a4e'),(21677,1789,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(21678,1789,'_s2-list_5_link','field_60ee90d381a4e'),(21679,1789,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(21680,1789,'_s6-list_0_link','field_60ee916b04ace'),(21681,1789,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(21682,1789,'_s6-list_1_link','field_60ee916b04ace'),(21683,1789,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(21684,1789,'_s6-list_2_link','field_60ee916b04ace'),(21685,1789,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(21686,1789,'_s6-list_3_link','field_60ee916b04ace'),(21687,1789,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(21688,1789,'_s6-list_4_link','field_60ee916b04ace'),(21689,1789,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(21690,1789,'_s6-list_5_link','field_60ee916b04ace'),(21691,1789,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(21692,1789,'_slider_0_webplink','field_60fa70c989e88'),(21693,1789,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(21694,1789,'_slider_1_webplink','field_60fa70c989e88'),(21695,1789,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(21696,1789,'_slider_2_webplink','field_60fa70c989e88'),(21697,1789,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(21698,1789,'_slider_3_webplink','field_60fa70c989e88'),(21699,1789,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(21700,1789,'_slider_4_webplink','field_60fa70c989e88'),(21701,1789,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(21702,1789,'_slider_5_webplink','field_60fa70c989e88'),(21703,1789,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(21704,1789,'_slider_6_webplink','field_60fa70c989e88'),(21705,1789,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(21706,1789,'_slider_7_webplink','field_60fa70c989e88'),(21707,1789,'slider_8_slide','344'),(21708,1789,'_slider_8_slide','field_60bf7688f46eb'),(21709,1789,'slider_9_slide','346'),(21710,1789,'_slider_9_slide','field_60bf7688f46eb'),(21711,8,'slider_9_slide','57'),(21712,8,'_slider_9_slide','field_60bf7688f46eb'),(21713,1790,'slider','10'),(21714,1790,'_slider','field_60bf767ef46ea'),(21715,1790,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(21716,1790,'_s2-ttl','field_60bf76d1f46ed'),(21717,1790,'s2-list','6'),(21718,1790,'_s2-list','field_60bf76e0f46ee'),(21719,1790,'s2-list_0_icon','61'),(21720,1790,'_s2-list_0_icon','field_60bf76ecf46ef'),(21721,1790,'s2-list_0_icon-hover','62'),(21722,1790,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(21723,1790,'s2-list_0_text','Лихоманка'),(21724,1790,'_s2-list_0_text','field_60bf7712f46f1'),(21725,1790,'s2-list_1_icon','63'),(21726,1790,'_s2-list_1_icon','field_60bf76ecf46ef'),(21727,1790,'s2-list_1_icon-hover','64'),(21728,1790,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(21729,1790,'s2-list_1_text','Похмільний синдром'),(21730,1790,'_s2-list_1_text','field_60bf7712f46f1'),(21731,1790,'s2-list_2_icon','65'),(21732,1790,'_s2-list_2_icon','field_60bf76ecf46ef'),(21733,1790,'s2-list_2_icon-hover','66'),(21734,1790,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(21735,1790,'s2-list_2_text','Діарея'),(21736,1790,'_s2-list_2_text','field_60bf7712f46f1'),(21737,1790,'s2-list_3_icon','67'),(21738,1790,'_s2-list_3_icon','field_60bf76ecf46ef'),(21739,1790,'s2-list_3_icon-hover','68'),(21740,1790,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(21741,1790,'s2-list_3_text','Блювота'),(21742,1790,'_s2-list_3_text','field_60bf7712f46f1'),(21743,1790,'s2-list_4_icon','69'),(21744,1790,'_s2-list_4_icon','field_60bf76ecf46ef'),(21745,1790,'s2-list_4_icon-hover','70'),(21746,1790,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(21747,1790,'s2-list_4_text','Інтенсивні фізичні навантаження'),(21748,1790,'_s2-list_4_text','field_60bf7712f46f1'),(21749,1790,'s2-list_5_icon','71'),(21750,1790,'_s2-list_5_icon','field_60bf76ecf46ef'),(21751,1790,'s2-list_5_icon-hover','72'),(21752,1790,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(21753,1790,'s2-list_5_text','Перегрівання в спекотну погоду'),(21754,1790,'_s2-list_5_text','field_60bf7712f46f1'),(21755,1790,'s1-slogan','Коли звичайної води замало!'),(21756,1790,'_s1-slogan','field_60bf7ab4d9ba9'),(21757,1790,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(21758,1790,'_s3-text','field_60bf7bb5a7e2b'),(21759,1790,'s4-ttl','РеО – вода для медичних цілей'),(21760,1790,'_s4-ttl','field_60bf7c831f58c'),(21761,1790,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(21762,1790,'_s4-notes','field_60bf7ca31f58d'),(21763,1790,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(21764,1790,'_s5-video','field_60bf7ccfa01a5'),(21765,1790,'s6-ttl','Коли звичайної води замало!'),(21766,1790,'_s6-ttl','field_60bf7cfb10d31'),(21767,1790,'s6-list','6'),(21768,1790,'_s6-list','field_60bf7d0410d32'),(21769,1790,'s6-list_0_icon','92'),(21770,1790,'_s6-list_0_icon','field_60bf7d1810d33'),(21771,1790,'s6-list_0_text','При підвищеній температурі'),(21772,1790,'_s6-list_0_text','field_60bf7d2710d34'),(21773,1790,'s6-list_1_icon','93'),(21774,1790,'_s6-list_1_icon','field_60bf7d1810d33'),(21775,1790,'s6-list_1_text','При харчових отруєннях'),(21776,1790,'_s6-list_1_text','field_60bf7d2710d34'),(21777,1790,'s6-list_2_icon','94'),(21778,1790,'_s6-list_2_icon','field_60bf7d1810d33'),(21779,1790,'s6-list_2_text','При кишкових інфекціях'),(21780,1790,'_s6-list_2_text','field_60bf7d2710d34'),(21781,1790,'s6-list_3_icon','95'),(21782,1790,'_s6-list_3_icon','field_60bf7d1810d33'),(21783,1790,'s6-list_3_text','Під час вагітності'),(21784,1790,'_s6-list_3_text','field_60bf7d2710d34'),(21785,1790,'s6-list_4_icon','96'),(21786,1790,'_s6-list_4_icon','field_60bf7d1810d33'),(21787,1790,'s6-list_4_text','Під час заняття спортом'),(21788,1790,'_s6-list_4_text','field_60bf7d2710d34'),(21789,1790,'s6-list_5_icon','97'),(21790,1790,'_s6-list_5_icon','field_60bf7d1810d33'),(21791,1790,'s6-list_5_text','При похмільному синдромі'),(21792,1790,'_s6-list_5_text','field_60bf7d2710d34'),(21793,1790,'s4-list_0_ttl','Натрій'),(21794,1790,'_s4-list_0_ttl','field_60bf7fa95a92c'),(21795,1790,'s4-list_0_formula','Na<sup>+</sup>'),(21796,1790,'_s4-list_0_formula','field_60bf7fc65a92d'),(21797,1790,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(21798,1790,'_s4-list_0_text','field_60bf7fd35a92e'),(21799,1790,'s4-list_1_ttl','Вода'),(21800,1790,'_s4-list_1_ttl','field_60bf7fa95a92c'),(21801,1790,'s4-list_1_formula','H<sub>2</sub>O'),(21802,1790,'_s4-list_1_formula','field_60bf7fc65a92d'),(21803,1790,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(21804,1790,'_s4-list_1_text','field_60bf7fd35a92e'),(21805,1790,'s4-list','9'),(21806,1790,'_s4-list','field_60bf7f985a92b'),(21807,1790,'s4-list_2_ttl','Калій'),(21808,1790,'_s4-list_2_ttl','field_60bf7fa95a92c'),(21809,1790,'s4-list_2_formula','K<sup>+</sup>'),(21810,1790,'_s4-list_2_formula','field_60bf7fc65a92d'),(21811,1790,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(21812,1790,'_s4-list_2_text','field_60bf7fd35a92e'),(21813,1790,'s4-list_3_ttl','Гідрокарбонати'),(21814,1790,'_s4-list_3_ttl','field_60bf7fa95a92c'),(21815,1790,'s4-list_3_formula','HCO<sup>3+</sup>'),(21816,1790,'_s4-list_3_formula','field_60bf7fc65a92d'),(21817,1790,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(21818,1790,'_s4-list_3_text','field_60bf7fd35a92e'),(21819,1790,'s4-list_4_ttl','Магній'),(21820,1790,'_s4-list_4_ttl','field_60bf7fa95a92c'),(21821,1790,'s4-list_4_formula','Mg<sup>2+</sup>'),(21822,1790,'_s4-list_4_formula','field_60bf7fc65a92d'),(21823,1790,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(21824,1790,'_s4-list_4_text','field_60bf7fd35a92e'),(21825,1790,'s4-list_5_ttl','Вуглекислий газ'),(21826,1790,'_s4-list_5_ttl','field_60bf7fa95a92c'),(21827,1790,'s4-list_5_formula','CO<sup>2+</sup>'),(21828,1790,'_s4-list_5_formula','field_60bf7fc65a92d'),(21829,1790,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(21830,1790,'_s4-list_5_text','field_60bf7fd35a92e'),(21831,1790,'s4-list_6_ttl','Кальцій'),(21832,1790,'_s4-list_6_ttl','field_60bf7fa95a92c'),(21833,1790,'s4-list_6_formula','Ca<sup>2+</sup>'),(21834,1790,'_s4-list_6_formula','field_60bf7fc65a92d'),(21835,1790,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(21836,1790,'_s4-list_6_text','field_60bf7fd35a92e'),(21837,1790,'s4-list_7_ttl','Сорбіт'),(21838,1790,'_s4-list_7_ttl','field_60bf7fa95a92c'),(21839,1790,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(21840,1790,'_s4-list_7_formula','field_60bf7fc65a92d'),(21841,1790,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(21842,1790,'_s4-list_7_text','field_60bf7fd35a92e'),(21843,1790,'s4-list_8_ttl','Хлор'),(21844,1790,'_s4-list_8_ttl','field_60bf7fa95a92c'),(21845,1790,'s4-list_8_formula','Cl<sup>-</sup>'),(21846,1790,'_s4-list_8_formula','field_60bf7fc65a92d'),(21847,1790,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(21848,1790,'_s4-list_8_text','field_60bf7fd35a92e'),(21849,1790,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(21850,1790,'_s4-feature1','field_60bf80ca480ea'),(21851,1790,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(21852,1790,'_s4-feature2','field_60bf80de480eb'),(21853,1790,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(21854,1790,'_s4-feature3','field_60bf80e2480ec'),(21855,1790,'s4-feature4','Приємна на смак та легко пити навіть при відчутті нудоти<sup>1,3</sup>'),(21856,1790,'_s4-feature4','field_60bf80e5480ed'),(21857,1790,'s2-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(21858,1790,'_s2-list_0_link','field_60ee90d381a4e'),(21859,1790,'s2-list_1_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(21860,1790,'_s2-list_1_link','field_60ee90d381a4e'),(21861,1790,'s2-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(21862,1790,'_s2-list_2_link','field_60ee90d381a4e'),(21863,1790,'s2-list_3_link','/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/blyuvannya-yak-prichina-znevodnennya/'),(21864,1790,'_s2-list_3_link','field_60ee90d381a4e'),(21865,1790,'s2-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(21866,1790,'_s2-list_4_link','field_60ee90d381a4e'),(21867,1790,'s2-list_5_link','/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/'),(21868,1790,'_s2-list_5_link','field_60ee90d381a4e'),(21869,1790,'s6-list_0_link','/category/dlya-spozhivacha/reo-pri-pidvishhenij-temperaturi/'),(21870,1790,'_s6-list_0_link','field_60ee916b04ace'),(21871,1790,'s6-list_1_link','/category/dlya-spozhivacha/reo-pri-harchovih-otruennyah/'),(21872,1790,'_s6-list_1_link','field_60ee916b04ace'),(21873,1790,'s6-list_2_link','/category/dlya-spozhivacha/reo-pri-kishkovih-infekcziyah/'),(21874,1790,'_s6-list_2_link','field_60ee916b04ace'),(21875,1790,'s6-list_3_link','/category/dlya-spozhivacha/reo-pid-chas-vagitnosti/'),(21876,1790,'_s6-list_3_link','field_60ee916b04ace'),(21877,1790,'s6-list_4_link','/category/dlya-spozhivacha/reo-pid-chas-zajnyat-sportom/'),(21878,1790,'_s6-list_4_link','field_60ee916b04ace'),(21879,1790,'s6-list_5_link','/category/dlya-spozhivacha/reo-pri-pohmilnomu-sindromi/'),(21880,1790,'_s6-list_5_link','field_60ee916b04ace'),(21881,1790,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(21882,1790,'_slider_0_webplink','field_60fa70c989e88'),(21883,1790,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(21884,1790,'_slider_1_webplink','field_60fa70c989e88'),(21885,1790,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(21886,1790,'_slider_2_webplink','field_60fa70c989e88'),(21887,1790,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(21888,1790,'_slider_3_webplink','field_60fa70c989e88'),(21889,1790,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(21890,1790,'_slider_4_webplink','field_60fa70c989e88'),(21891,1790,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(21892,1790,'_slider_5_webplink','field_60fa70c989e88'),(21893,1790,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(21894,1790,'_slider_6_webplink','field_60fa70c989e88'),(21895,1790,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(21896,1790,'_slider_7_webplink','field_60fa70c989e88'),(21897,1790,'slider_0_slide','1787'),(21898,1790,'_slider_0_slide','field_60bf7688f46eb'),(21899,1790,'slider_1_slide','1767'),(21900,1790,'_slider_1_slide','field_60bf7688f46eb'),(21901,1790,'slider_2_slide','50'),(21902,1790,'_slider_2_slide','field_60bf7688f46eb'),(21903,1790,'slider_3_slide','51'),(21904,1790,'_slider_3_slide','field_60bf7688f46eb'),(21905,1790,'slider_4_slide','52'),(21906,1790,'_slider_4_slide','field_60bf7688f46eb'),(21907,1790,'slider_5_slide','53'),(21908,1790,'_slider_5_slide','field_60bf7688f46eb'),(21909,1790,'slider_6_slide','54'),(21910,1790,'_slider_6_slide','field_60bf7688f46eb'),(21911,1790,'slider_7_slide','55'),(21912,1790,'_slider_7_slide','field_60bf7688f46eb'),(21913,1790,'slider_8_slide','56'),(21914,1790,'_slider_8_slide','field_60bf7688f46eb'),(21915,1790,'slider_9_slide','57'),(21916,1790,'_slider_9_slide','field_60bf7688f46eb'),(21917,1331,'slider_4_slide','1669'),(21918,1331,'_slider_4_slide','field_60bf7688f46eb'),(21919,1791,'s2-list','6'),(21920,1791,'_s2-list','field_60bf76e0f46ee'),(21921,1791,'s2-ttl','Тананинг сув-туз мувозанати бузилишига олиб келадиган ҳолатлар мавжуд'),(21922,1791,'_s2-ttl','field_60bf76d1f46ed'),(21923,1791,'slider','5'),(21924,1791,'_slider','field_60bf767ef46ea'),(21925,1791,'slider_0_slide','1788'),(21926,1791,'_slider_0_slide','field_60bf7688f46eb'),(21927,1791,'slider_1_slide','1769'),(21928,1791,'_slider_1_slide','field_60bf7688f46eb'),(21929,1791,'slider_2_slide','1663'),(21930,1791,'_slider_2_slide','field_60bf7688f46eb'),(21931,1791,'s2-list_0_icon','61'),(21932,1791,'_s2-list_0_icon','field_60bf76ecf46ef'),(21933,1791,'s2-list_0_icon-hover','62'),(21934,1791,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(21935,1791,'s2-list_0_text','Иситма'),(21936,1791,'_s2-list_0_text','field_60bf7712f46f1'),(21937,1791,'s2-list_1_icon','63'),(21938,1791,'_s2-list_1_icon','field_60bf76ecf46ef'),(21939,1791,'s2-list_1_icon-hover','64'),(21940,1791,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(21941,1791,'s2-list_1_text','Алкоголдан кейинги асоратлар'),(21942,1791,'_s2-list_1_text','field_60bf7712f46f1'),(21943,1791,'s2-list_2_icon','65'),(21944,1791,'_s2-list_2_icon','field_60bf76ecf46ef'),(21945,1791,'s2-list_2_icon-hover','66'),(21946,1791,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(21947,1791,'s2-list_2_text','Диарея'),(21948,1791,'_s2-list_2_text','field_60bf7712f46f1'),(21949,1791,'s2-list_3_icon','67'),(21950,1791,'_s2-list_3_icon','field_60bf76ecf46ef'),(21951,1791,'s2-list_3_icon-hover','68'),(21952,1791,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(21953,1791,'s2-list_3_text','Қайт қилиш'),(21954,1791,'_s2-list_3_text','field_60bf7712f46f1'),(21955,1791,'s2-list_4_icon','69'),(21956,1791,'_s2-list_4_icon','field_60bf76ecf46ef'),(21957,1791,'s2-list_4_icon-hover','70'),(21958,1791,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(21959,1791,'s2-list_4_text','Жадал жисмоний юкламалар'),(21960,1791,'_s2-list_4_text','field_60bf7712f46f1'),(21961,1791,'s2-list_5_icon','71'),(21962,1791,'_s2-list_5_icon','field_60bf76ecf46ef'),(21963,1791,'s2-list_5_icon-hover','72'),(21964,1791,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(21965,1791,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(21966,1791,'_s2-list_5_text','field_60bf7712f46f1'),(21967,1791,'s1-slogan','Оддий сув етарли бўлмаганда!'),(21968,1791,'_s1-slogan','field_60bf7ab4d9ba9'),(21969,1791,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(21970,1791,'_s3-text','field_60bf7bb5a7e2b'),(21971,1791,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(21972,1791,'_s4-ttl','field_60bf7c831f58c'),(21973,1791,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(21974,1791,'_s4-notes','field_60bf7ca31f58d'),(21975,1791,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(21976,1791,'_s5-video','field_60bf7ccfa01a5'),(21977,1791,'s6-ttl','Оддий сув етарли бўлмаганда!'),(21978,1791,'_s6-ttl','field_60bf7cfb10d31'),(21979,1791,'s6-list','6'),(21980,1791,'_s6-list','field_60bf7d0410d32'),(21981,1791,'s6-list_0_icon','92'),(21982,1791,'_s6-list_0_icon','field_60bf7d1810d33'),(21983,1791,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(21984,1791,'_s6-list_0_text','field_60bf7d2710d34'),(21985,1791,'s6-list_1_icon','93'),(21986,1791,'_s6-list_1_icon','field_60bf7d1810d33'),(21987,1791,'s6-list_1_text','Овқатдан заҳарланишларда'),(21988,1791,'_s6-list_1_text','field_60bf7d2710d34'),(21989,1791,'s6-list_2_icon','94'),(21990,1791,'_s6-list_2_icon','field_60bf7d1810d33'),(21991,1791,'s6-list_2_text','Ичак инфекцияларида'),(21992,1791,'_s6-list_2_text','field_60bf7d2710d34'),(21993,1791,'s6-list_3_icon','95'),(21994,1791,'_s6-list_3_icon','field_60bf7d1810d33'),(21995,1791,'s6-list_3_text','Ҳомиладорлик вақтида'),(21996,1791,'_s6-list_3_text','field_60bf7d2710d34'),(21997,1791,'s6-list_4_icon','96'),(21998,1791,'_s6-list_4_icon','field_60bf7d1810d33'),(21999,1791,'s6-list_4_text','Спорт билан шуғулланганда '),(22000,1791,'_s6-list_4_text','field_60bf7d2710d34'),(22001,1791,'s6-list_5_icon','97'),(22002,1791,'_s6-list_5_icon','field_60bf7d1810d33'),(22003,1791,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(22004,1791,'_s6-list_5_text','field_60bf7d2710d34'),(22005,1791,'s4-list_0_ttl','Натрий'),(22006,1791,'_s4-list_0_ttl','field_60bf7fa95a92c'),(22007,1791,'s4-list_0_formula','Na<sup>+</sup>'),(22008,1791,'_s4-list_0_formula','field_60bf7fc65a92d'),(22009,1791,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(22010,1791,'_s4-list_0_text','field_60bf7fd35a92e'),(22011,1791,'s4-list_1_ttl','Сув'),(22012,1791,'_s4-list_1_ttl','field_60bf7fa95a92c'),(22013,1791,'s4-list_1_formula','H<sub>2</sub>O'),(22014,1791,'_s4-list_1_formula','field_60bf7fc65a92d'),(22015,1791,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(22016,1791,'_s4-list_1_text','field_60bf7fd35a92e'),(22017,1791,'s4-list','9'),(22018,1791,'_s4-list','field_60bf7f985a92b'),(22019,1791,'s4-list_2_ttl','Калий'),(22020,1791,'_s4-list_2_ttl','field_60bf7fa95a92c'),(22021,1791,'s4-list_2_formula','K<sup>+</sup>'),(22022,1791,'_s4-list_2_formula','field_60bf7fc65a92d'),(22023,1791,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(22024,1791,'_s4-list_2_text','field_60bf7fd35a92e'),(22025,1791,'s4-list_3_ttl','Гидрокарбонатлар '),(22026,1791,'_s4-list_3_ttl','field_60bf7fa95a92c'),(22027,1791,'s4-list_3_formula','HCO<sup>3+</sup>'),(22028,1791,'_s4-list_3_formula','field_60bf7fc65a92d'),(22029,1791,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(22030,1791,'_s4-list_3_text','field_60bf7fd35a92e'),(22031,1791,'s4-list_4_ttl','Магний'),(22032,1791,'_s4-list_4_ttl','field_60bf7fa95a92c'),(22033,1791,'s4-list_4_formula','Mg<sup>2+</sup>'),(22034,1791,'_s4-list_4_formula','field_60bf7fc65a92d'),(22035,1791,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(22036,1791,'_s4-list_4_text','field_60bf7fd35a92e'),(22037,1791,'s4-list_5_ttl','Углекислый газ'),(22038,1791,'_s4-list_5_ttl','field_60bf7fa95a92c'),(22039,1791,'s4-list_5_formula','CO<sup>2+</sup>'),(22040,1791,'_s4-list_5_formula','field_60bf7fc65a92d'),(22041,1791,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(22042,1791,'_s4-list_5_text','field_60bf7fd35a92e'),(22043,1791,'s4-list_6_ttl','Кальций'),(22044,1791,'_s4-list_6_ttl','field_60bf7fa95a92c'),(22045,1791,'s4-list_6_formula','Ca<sup>2+</sup>'),(22046,1791,'_s4-list_6_formula','field_60bf7fc65a92d'),(22047,1791,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(22048,1791,'_s4-list_6_text','field_60bf7fd35a92e'),(22049,1791,'s4-list_7_ttl','Сорбитол'),(22050,1791,'_s4-list_7_ttl','field_60bf7fa95a92c'),(22051,1791,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(22052,1791,'_s4-list_7_formula','field_60bf7fc65a92d'),(22053,1791,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(22054,1791,'_s4-list_7_text','field_60bf7fd35a92e'),(22055,1791,'s4-list_8_ttl','Хлор'),(22056,1791,'_s4-list_8_ttl','field_60bf7fa95a92c'),(22057,1791,'s4-list_8_formula','Cl<sup>-</sup>'),(22058,1791,'_s4-list_8_formula','field_60bf7fc65a92d'),(22059,1791,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(22060,1791,'_s4-list_8_text','field_60bf7fd35a92e'),(22061,1791,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(22062,1791,'_s4-feature1','field_60bf80ca480ea'),(22063,1791,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(22064,1791,'_s4-feature2','field_60bf80de480eb'),(22065,1791,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(22066,1791,'_s4-feature3','field_60bf80e2480ec'),(22067,1791,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(22068,1791,'_s4-feature4','field_60bf80e5480ed'),(22069,1791,'s2-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(22070,1791,'_s2-list_0_link','field_60ee90d381a4e'),(22071,1791,'s2-list_1_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(22072,1791,'_s2-list_1_link','field_60ee90d381a4e'),(22073,1791,'s2-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(22074,1791,'_s2-list_2_link','field_60ee90d381a4e'),(22075,1791,'s2-list_3_link','/uz/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/қajt-қilish-suvsizlanish-sababi-sifatida/'),(22076,1791,'_s2-list_3_link','field_60ee90d381a4e'),(22077,1791,'s2-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(22078,1791,'_s2-list_4_link','field_60ee90d381a4e'),(22079,1791,'s2-list_5_link','/uz/istemolchi-uchun/reo-sport-bilan-shuғullanganda/yozgi-issiқda-қandaj-қilib-issiқlik-urishi-va-suvsizlanishning-oldini-olish-mumkin/'),(22080,1791,'_s2-list_5_link','field_60ee90d381a4e'),(22081,1791,'s6-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(22082,1791,'_s6-list_0_link','field_60ee916b04ace'),(22083,1791,'s6-list_1_link','/uz/category/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/'),(22084,1791,'_s6-list_1_link','field_60ee916b04ace'),(22085,1791,'s6-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(22086,1791,'_s6-list_2_link','field_60ee916b04ace'),(22087,1791,'s6-list_3_link','/uz/category/istemolchi-uchun/reo-ҳomiladorlik-vaқtida/'),(22088,1791,'_s6-list_3_link','field_60ee916b04ace'),(22089,1791,'s6-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(22090,1791,'_s6-list_4_link','field_60ee916b04ace'),(22091,1791,'s6-list_5_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(22092,1791,'_s6-list_5_link','field_60ee916b04ace'),(22093,1791,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(22094,1791,'_slider_0_webplink','field_60fa70c989e88'),(22095,1791,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(22096,1791,'_slider_1_webplink','field_60fa70c989e88'),(22097,1791,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(22098,1791,'_slider_2_webplink','field_60fa70c989e88'),(22099,1791,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(22100,1791,'_slider_3_webplink','field_60fa70c989e88'),(22101,1791,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(22102,1791,'_slider_4_webplink','field_60fa70c989e88'),(22103,1791,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(22104,1791,'_slider_5_webplink','field_60fa70c989e88'),(22105,1791,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(22106,1791,'_slider_6_webplink','field_60fa70c989e88'),(22107,1791,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(22108,1791,'_slider_7_webplink','field_60fa70c989e88'),(22109,1791,'slider_3_slide','1666'),(22110,1791,'_slider_3_slide','field_60bf7688f46eb'),(22111,1791,'slider_4_slide','1669'),(22112,1791,'_slider_4_slide','field_60bf7688f46eb'),(22113,1792,'s2-list','6'),(22114,1792,'_s2-list','field_60bf76e0f46ee'),(22115,1792,'s2-ttl','Есть состояния организма, которые приводят к нарушению водно-солевого баланса:'),(22116,1792,'_s2-ttl','field_60bf76d1f46ed'),(22117,1792,'slider','10'),(22118,1792,'_slider','field_60bf767ef46ea'),(22119,1792,'slider_0_slide','1786'),(22120,1792,'_slider_0_slide','field_60bf7688f46eb'),(22121,1792,'slider_1_slide','1768'),(22122,1792,'_slider_1_slide','field_60bf7688f46eb'),(22123,1792,'slider_2_slide','332'),(22124,1792,'_slider_2_slide','field_60bf7688f46eb'),(22125,1792,'slider_3_slide','334'),(22126,1792,'_slider_3_slide','field_60bf7688f46eb'),(22127,1792,'slider_4_slide','336'),(22128,1792,'_slider_4_slide','field_60bf7688f46eb'),(22129,1792,'slider_5_slide','338'),(22130,1792,'_slider_5_slide','field_60bf7688f46eb'),(22131,1792,'slider_6_slide','340'),(22132,1792,'_slider_6_slide','field_60bf7688f46eb'),(22133,1792,'slider_7_slide','342'),(22134,1792,'_slider_7_slide','field_60bf7688f46eb'),(22135,1792,'s2-list_0_icon','61'),(22136,1792,'_s2-list_0_icon','field_60bf76ecf46ef'),(22137,1792,'s2-list_0_icon-hover','62'),(22138,1792,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(22139,1792,'s2-list_0_text','Лихорадка'),(22140,1792,'_s2-list_0_text','field_60bf7712f46f1'),(22141,1792,'s2-list_1_icon','63'),(22142,1792,'_s2-list_1_icon','field_60bf76ecf46ef'),(22143,1792,'s2-list_1_icon-hover','64'),(22144,1792,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(22145,1792,'s2-list_1_text','Похмельный синдром'),(22146,1792,'_s2-list_1_text','field_60bf7712f46f1'),(22147,1792,'s2-list_2_icon','65'),(22148,1792,'_s2-list_2_icon','field_60bf76ecf46ef'),(22149,1792,'s2-list_2_icon-hover','66'),(22150,1792,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(22151,1792,'s2-list_2_text','Диарея'),(22152,1792,'_s2-list_2_text','field_60bf7712f46f1'),(22153,1792,'s2-list_3_icon','67'),(22154,1792,'_s2-list_3_icon','field_60bf76ecf46ef'),(22155,1792,'s2-list_3_icon-hover','68'),(22156,1792,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(22157,1792,'s2-list_3_text','Рвота'),(22158,1792,'_s2-list_3_text','field_60bf7712f46f1'),(22159,1792,'s2-list_4_icon','69'),(22160,1792,'_s2-list_4_icon','field_60bf76ecf46ef'),(22161,1792,'s2-list_4_icon-hover','70'),(22162,1792,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(22163,1792,'s2-list_4_text','Интенсивные физические нагрузки'),(22164,1792,'_s2-list_4_text','field_60bf7712f46f1'),(22165,1792,'s2-list_5_icon','71'),(22166,1792,'_s2-list_5_icon','field_60bf76ecf46ef'),(22167,1792,'s2-list_5_icon-hover','72'),(22168,1792,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(22169,1792,'s2-list_5_text','Перегрев в жаркую погоду'),(22170,1792,'_s2-list_5_text','field_60bf7712f46f1'),(22171,1792,'s1-slogan','Когда обычной воды недостаточно!'),(22172,1792,'_s1-slogan','field_60bf7ab4d9ba9'),(22173,1792,'s3-text','При нарушении водно-солевого баланса обычная вода не способна удовлетворить все потребности организма и быстро вернуть нормальное самочувствие. А специальные средства для регидратации могут оказаться неприятными на вкус.\r\n\r\nНУЖНА ВОДА ДЛЯ МЕДИЦИНСКИХ ЦЕЛЕЙ!'),(22174,1792,'_s3-text','field_60bf7bb5a7e2b'),(22175,1792,'s4-ttl','РеО – вода для медицинских целей!'),(22176,1792,'_s4-ttl','field_60bf7c831f58c'),(22177,1792,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(22178,1792,'_s4-notes','field_60bf7ca31f58d'),(22179,1792,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(22180,1792,'_s5-video','field_60bf7ccfa01a5'),(22181,1792,'s6-ttl','Когда обычной воды недостаточно!'),(22182,1792,'_s6-ttl','field_60bf7cfb10d31'),(22183,1792,'s6-list','6'),(22184,1792,'_s6-list','field_60bf7d0410d32'),(22185,1792,'s6-list_0_icon','92'),(22186,1792,'_s6-list_0_icon','field_60bf7d1810d33'),(22187,1792,'s6-list_0_text','При повышенной температуре'),(22188,1792,'_s6-list_0_text','field_60bf7d2710d34'),(22189,1792,'s6-list_1_icon','93'),(22190,1792,'_s6-list_1_icon','field_60bf7d1810d33'),(22191,1792,'s6-list_1_text','При пищевых отравлениях'),(22192,1792,'_s6-list_1_text','field_60bf7d2710d34'),(22193,1792,'s6-list_2_icon','94'),(22194,1792,'_s6-list_2_icon','field_60bf7d1810d33'),(22195,1792,'s6-list_2_text','При кишечных инфекциях'),(22196,1792,'_s6-list_2_text','field_60bf7d2710d34'),(22197,1792,'s6-list_3_icon','95'),(22198,1792,'_s6-list_3_icon','field_60bf7d1810d33'),(22199,1792,'s6-list_3_text','Во время беременности'),(22200,1792,'_s6-list_3_text','field_60bf7d2710d34'),(22201,1792,'s6-list_4_icon','96'),(22202,1792,'_s6-list_4_icon','field_60bf7d1810d33'),(22203,1792,'s6-list_4_text','Во время занятий спортом'),(22204,1792,'_s6-list_4_text','field_60bf7d2710d34'),(22205,1792,'s6-list_5_icon','97'),(22206,1792,'_s6-list_5_icon','field_60bf7d1810d33'),(22207,1792,'s6-list_5_text','При похмельном синдроме'),(22208,1792,'_s6-list_5_text','field_60bf7d2710d34'),(22209,1792,'s4-list_0_ttl','Натрий'),(22210,1792,'_s4-list_0_ttl','field_60bf7fa95a92c'),(22211,1792,'s4-list_0_formula','Na<sup>+</sup>'),(22212,1792,'_s4-list_0_formula','field_60bf7fc65a92d'),(22213,1792,'s4-list_0_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(22214,1792,'_s4-list_0_text','field_60bf7fd35a92e'),(22215,1792,'s4-list_1_ttl','Вода'),(22216,1792,'_s4-list_1_ttl','field_60bf7fa95a92c'),(22217,1792,'s4-list_1_formula','H<sub>2</sub>O'),(22218,1792,'_s4-list_1_formula','field_60bf7fc65a92d'),(22219,1792,'s4-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(22220,1792,'_s4-list_1_text','field_60bf7fd35a92e'),(22221,1792,'s4-list','9'),(22222,1792,'_s4-list','field_60bf7f985a92b'),(22223,1792,'s4-list_2_ttl','Калий'),(22224,1792,'_s4-list_2_ttl','field_60bf7fa95a92c'),(22225,1792,'s4-list_2_formula','K<sup>+</sup>'),(22226,1792,'_s4-list_2_formula','field_60bf7fc65a92d'),(22227,1792,'s4-list_2_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(22228,1792,'_s4-list_2_text','field_60bf7fd35a92e'),(22229,1792,'s4-list_3_ttl','Гидрокарбонаты'),(22230,1792,'_s4-list_3_ttl','field_60bf7fa95a92c'),(22231,1792,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(22232,1792,'_s4-list_3_formula','field_60bf7fc65a92d'),(22233,1792,'s4-list_3_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(22234,1792,'_s4-list_3_text','field_60bf7fd35a92e'),(22235,1792,'s4-list_4_ttl','Магний'),(22236,1792,'_s4-list_4_ttl','field_60bf7fa95a92c'),(22237,1792,'s4-list_4_formula','Mg<sup>2+</sup>'),(22238,1792,'_s4-list_4_formula','field_60bf7fc65a92d'),(22239,1792,'s4-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(22240,1792,'_s4-list_4_text','field_60bf7fd35a92e'),(22241,1792,'s4-list_5_ttl','Углекислый газ'),(22242,1792,'_s4-list_5_ttl','field_60bf7fa95a92c'),(22243,1792,'s4-list_5_formula','CO<sup>2+</sup>'),(22244,1792,'_s4-list_5_formula','field_60bf7fc65a92d'),(22245,1792,'s4-list_5_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(22246,1792,'_s4-list_5_text','field_60bf7fd35a92e'),(22247,1792,'s4-list_6_ttl','Кальций'),(22248,1792,'_s4-list_6_ttl','field_60bf7fa95a92c'),(22249,1792,'s4-list_6_formula','Ca<sup>2+</sup>'),(22250,1792,'_s4-list_6_formula','field_60bf7fc65a92d'),(22251,1792,'s4-list_6_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(22252,1792,'_s4-list_6_text','field_60bf7fd35a92e'),(22253,1792,'s4-list_7_ttl','Сорбит'),(22254,1792,'_s4-list_7_ttl','field_60bf7fa95a92c'),(22255,1792,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(22256,1792,'_s4-list_7_formula','field_60bf7fc65a92d'),(22257,1792,'s4-list_7_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(22258,1792,'_s4-list_7_text','field_60bf7fd35a92e'),(22259,1792,'s4-list_8_ttl','Хлор'),(22260,1792,'_s4-list_8_ttl','field_60bf7fa95a92c'),(22261,1792,'s4-list_8_formula','Cl<sup>-</sup>'),(22262,1792,'_s4-list_8_formula','field_60bf7fc65a92d'),(22263,1792,'s4-list_8_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(22264,1792,'_s4-list_8_text','field_60bf7fd35a92e'),(22265,1792,'s4-feature1','Имеет сбалансированный состав<sup>1-3</sup>'),(22266,1792,'_s4-feature1','field_60bf80ca480ea'),(22267,1792,'s4-feature2','Содержит самые главные электролиты<sup>4</sup>'),(22268,1792,'_s4-feature2','field_60bf80de480eb'),(22269,1792,'s4-feature3','Без консервантов, красителей и углеводов<sup>1</sup>'),(22270,1792,'_s4-feature3','field_60bf80e2480ec'),(22271,1792,'s4-feature4','Приятная на вкус и легко пьется даже при чувстве рвоты<sup>1,3</sup>'),(22272,1792,'_s4-feature4','field_60bf80e5480ed'),(22273,1792,'s2-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(22274,1792,'_s2-list_0_link','field_60ee90d381a4e'),(22275,1792,'s2-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(22276,1792,'_s2-list_1_link','field_60ee90d381a4e'),(22277,1792,'s2-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(22278,1792,'_s2-list_2_link','field_60ee90d381a4e'),(22279,1792,'s2-list_3_link','/ru/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/rvota-kak-prichina-obezvozhivaniya/'),(22280,1792,'_s2-list_3_link','field_60ee90d381a4e'),(22281,1792,'s2-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(22282,1792,'_s2-list_4_link','field_60ee90d381a4e'),(22283,1792,'s2-list_5_link','/ru/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/'),(22284,1792,'_s2-list_5_link','field_60ee90d381a4e'),(22285,1792,'s6-list_0_link','/ru/category/dlya-potrebitelya/reo-pri-povyshennoj-temperature/'),(22286,1792,'_s6-list_0_link','field_60ee916b04ace'),(22287,1792,'s6-list_1_link','/ru/category/dlya-potrebitelya/reo-pri-pishhevyh-otravleniyah/'),(22288,1792,'_s6-list_1_link','field_60ee916b04ace'),(22289,1792,'s6-list_2_link','/ru/category/dlya-potrebitelya/reo-pri-kishechnyh-infekcziyah/'),(22290,1792,'_s6-list_2_link','field_60ee916b04ace'),(22291,1792,'s6-list_3_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-beremennosti/'),(22292,1792,'_s6-list_3_link','field_60ee916b04ace'),(22293,1792,'s6-list_4_link','/ru/category/dlya-potrebitelya/reo-vo-vremya-zanyatij-sportom/'),(22294,1792,'_s6-list_4_link','field_60ee916b04ace'),(22295,1792,'s6-list_5_link','/ru/category/dlya-potrebitelya/reo-pri-pohmelnom-sindrome/'),(22296,1792,'_s6-list_5_link','field_60ee916b04ace'),(22297,1792,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(22298,1792,'_slider_0_webplink','field_60fa70c989e88'),(22299,1792,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(22300,1792,'_slider_1_webplink','field_60fa70c989e88'),(22301,1792,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(22302,1792,'_slider_2_webplink','field_60fa70c989e88'),(22303,1792,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(22304,1792,'_slider_3_webplink','field_60fa70c989e88'),(22305,1792,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(22306,1792,'_slider_4_webplink','field_60fa70c989e88'),(22307,1792,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(22308,1792,'_slider_5_webplink','field_60fa70c989e88'),(22309,1792,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(22310,1792,'_slider_6_webplink','field_60fa70c989e88'),(22311,1792,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(22312,1792,'_slider_7_webplink','field_60fa70c989e88'),(22313,1792,'slider_8_slide','344'),(22314,1792,'_slider_8_slide','field_60bf7688f46eb'),(22315,1792,'slider_9_slide','346'),(22316,1792,'_slider_9_slide','field_60bf7688f46eb'),(22317,1793,'slider','10'),(22318,1793,'_slider','field_60bf767ef46ea'),(22319,1793,'s2-ttl','Існують стани організму, що ведуть до порушень водно-сольового балансу:'),(22320,1793,'_s2-ttl','field_60bf76d1f46ed'),(22321,1793,'s2-list','6'),(22322,1793,'_s2-list','field_60bf76e0f46ee'),(22323,1793,'s2-list_0_icon','61'),(22324,1793,'_s2-list_0_icon','field_60bf76ecf46ef'),(22325,1793,'s2-list_0_icon-hover','62'),(22326,1793,'_s2-list_0_icon-hover','field_60bf7701f46f0'),(22327,1793,'s2-list_0_text','Лихоманка'),(22328,1793,'_s2-list_0_text','field_60bf7712f46f1'),(22329,1793,'s2-list_1_icon','63'),(22330,1793,'_s2-list_1_icon','field_60bf76ecf46ef'),(22331,1793,'s2-list_1_icon-hover','64'),(22332,1793,'_s2-list_1_icon-hover','field_60bf7701f46f0'),(22333,1793,'s2-list_1_text','Похмільний синдром'),(22334,1793,'_s2-list_1_text','field_60bf7712f46f1'),(22335,1793,'s2-list_2_icon','65'),(22336,1793,'_s2-list_2_icon','field_60bf76ecf46ef'),(22337,1793,'s2-list_2_icon-hover','66'),(22338,1793,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(22339,1793,'s2-list_2_text','Діарея'),(22340,1793,'_s2-list_2_text','field_60bf7712f46f1'),(22341,1793,'s2-list_3_icon','67'),(22342,1793,'_s2-list_3_icon','field_60bf76ecf46ef'),(22343,1793,'s2-list_3_icon-hover','68'),(22344,1793,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(22345,1793,'s2-list_3_text','Блювота'),(22346,1793,'_s2-list_3_text','field_60bf7712f46f1'),(22347,1793,'s2-list_4_icon','69'),(22348,1793,'_s2-list_4_icon','field_60bf76ecf46ef'),(22349,1793,'s2-list_4_icon-hover','70'),(22350,1793,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(22351,1793,'s2-list_4_text','Інтенсивні фізичні навантаження'),(22352,1793,'_s2-list_4_text','field_60bf7712f46f1'),(22353,1793,'s2-list_5_icon','71'),(22354,1793,'_s2-list_5_icon','field_60bf76ecf46ef'),(22355,1793,'s2-list_5_icon-hover','72'),(22356,1793,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(22357,1793,'s2-list_5_text','Перегрівання в спекотну погоду'),(22358,1793,'_s2-list_5_text','field_60bf7712f46f1'),(22359,1793,'s1-slogan','Коли звичайної води замало!'),(22360,1793,'_s1-slogan','field_60bf7ab4d9ba9'),(22361,1793,'s3-text','При порушенні водно-сольового балансу звичайна вода не здатна задовольнити усі потреби організму та швидко повернути нормальне самопочуття. А спеціальні засоби для регідратації можуть виявитись неприємними на смак.\r\n\r\nПОТРІБНА ВОДА ДЛЯ МЕДИЧНИХ ЦІЛЕЙ!'),(22362,1793,'_s3-text','field_60bf7bb5a7e2b'),(22363,1793,'s4-ttl','РеО – вода для медичних цілей'),(22364,1793,'_s4-ttl','field_60bf7c831f58c'),(22365,1793,'s4-notes','<ol>\r\n 	<li>Вибір аптечної води. Що порадити відвідувачу аптеки? Навигатор Фармации 2021.</li>\r\n 	<li>Цюпа І. Зневоднення у дітей: як запобігти, а не боротися з наслідками? «Здоров’я України» No3 2020.</li>\r\n 	<li>Ешимбетова Г. З. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Матеріали доповідей IV Міжнародного конгресу з інфузійної терапії. Київ 2020р.</li>\r\n 	<li>Мається на увазі, що до складу води РеО входять електроліти (натрій, калій, хлор, магній, кальцій), які у фізіологічному стані містяться в організмі людини у більшій кількості, порівняно з іншими електролітами.</li>\r\n</ol>'),(22366,1793,'_s4-notes','field_60bf7ca31f58d'),(22367,1793,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(22368,1793,'_s5-video','field_60bf7ccfa01a5'),(22369,1793,'s6-ttl','Коли звичайної води замало!'),(22370,1793,'_s6-ttl','field_60bf7cfb10d31'),(22371,1793,'s6-list','6'),(22372,1793,'_s6-list','field_60bf7d0410d32'),(22373,1793,'s6-list_0_icon','92'),(22374,1793,'_s6-list_0_icon','field_60bf7d1810d33'),(22375,1793,'s6-list_0_text','При підвищеній температурі'),(22376,1793,'_s6-list_0_text','field_60bf7d2710d34'),(22377,1793,'s6-list_1_icon','93'),(22378,1793,'_s6-list_1_icon','field_60bf7d1810d33'),(22379,1793,'s6-list_1_text','При харчових отруєннях'),(22380,1793,'_s6-list_1_text','field_60bf7d2710d34'),(22381,1793,'s6-list_2_icon','94'),(22382,1793,'_s6-list_2_icon','field_60bf7d1810d33'),(22383,1793,'s6-list_2_text','При кишкових інфекціях'),(22384,1793,'_s6-list_2_text','field_60bf7d2710d34'),(22385,1793,'s6-list_3_icon','95'),(22386,1793,'_s6-list_3_icon','field_60bf7d1810d33'),(22387,1793,'s6-list_3_text','Під час вагітності'),(22388,1793,'_s6-list_3_text','field_60bf7d2710d34'),(22389,1793,'s6-list_4_icon','96'),(22390,1793,'_s6-list_4_icon','field_60bf7d1810d33'),(22391,1793,'s6-list_4_text','Під час заняття спортом'),(22392,1793,'_s6-list_4_text','field_60bf7d2710d34'),(22393,1793,'s6-list_5_icon','97'),(22394,1793,'_s6-list_5_icon','field_60bf7d1810d33'),(22395,1793,'s6-list_5_text','При похмільному синдромі'),(22396,1793,'_s6-list_5_text','field_60bf7d2710d34'),(22397,1793,'s4-list_0_ttl','Натрій'),(22398,1793,'_s4-list_0_ttl','field_60bf7fa95a92c'),(22399,1793,'s4-list_0_formula','Na<sup>+</sup>'),(22400,1793,'_s4-list_0_formula','field_60bf7fc65a92d'),(22401,1793,'s4-list_0_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(22402,1793,'_s4-list_0_text','field_60bf7fd35a92e'),(22403,1793,'s4-list_1_ttl','Вода'),(22404,1793,'_s4-list_1_ttl','field_60bf7fa95a92c'),(22405,1793,'s4-list_1_formula','H<sub>2</sub>O'),(22406,1793,'_s4-list_1_formula','field_60bf7fc65a92d'),(22407,1793,'s4-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(22408,1793,'_s4-list_1_text','field_60bf7fd35a92e'),(22409,1793,'s4-list','9'),(22410,1793,'_s4-list','field_60bf7f985a92b'),(22411,1793,'s4-list_2_ttl','Калій'),(22412,1793,'_s4-list_2_ttl','field_60bf7fa95a92c'),(22413,1793,'s4-list_2_formula','K<sup>+</sup>'),(22414,1793,'_s4-list_2_formula','field_60bf7fc65a92d'),(22415,1793,'s4-list_2_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(22416,1793,'_s4-list_2_text','field_60bf7fd35a92e'),(22417,1793,'s4-list_3_ttl','Гідрокарбонати'),(22418,1793,'_s4-list_3_ttl','field_60bf7fa95a92c'),(22419,1793,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(22420,1793,'_s4-list_3_formula','field_60bf7fc65a92d'),(22421,1793,'s4-list_3_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(22422,1793,'_s4-list_3_text','field_60bf7fd35a92e'),(22423,1793,'s4-list_4_ttl','Магній'),(22424,1793,'_s4-list_4_ttl','field_60bf7fa95a92c'),(22425,1793,'s4-list_4_formula','Mg<sup>2+</sup>'),(22426,1793,'_s4-list_4_formula','field_60bf7fc65a92d'),(22427,1793,'s4-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(22428,1793,'_s4-list_4_text','field_60bf7fd35a92e'),(22429,1793,'s4-list_5_ttl','Вуглекислий газ'),(22430,1793,'_s4-list_5_ttl','field_60bf7fa95a92c'),(22431,1793,'s4-list_5_formula','CO<sup>2+</sup>'),(22432,1793,'_s4-list_5_formula','field_60bf7fc65a92d'),(22433,1793,'s4-list_5_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(22434,1793,'_s4-list_5_text','field_60bf7fd35a92e'),(22435,1793,'s4-list_6_ttl','Кальцій'),(22436,1793,'_s4-list_6_ttl','field_60bf7fa95a92c'),(22437,1793,'s4-list_6_formula','Ca<sup>2+</sup>'),(22438,1793,'_s4-list_6_formula','field_60bf7fc65a92d'),(22439,1793,'s4-list_6_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної тканини, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(22440,1793,'_s4-list_6_text','field_60bf7fd35a92e'),(22441,1793,'s4-list_7_ttl','Сорбіт'),(22442,1793,'_s4-list_7_ttl','field_60bf7fa95a92c'),(22443,1793,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(22444,1793,'_s4-list_7_formula','field_60bf7fc65a92d'),(22445,1793,'s4-list_7_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(22446,1793,'_s4-list_7_text','field_60bf7fd35a92e'),(22447,1793,'s4-list_8_ttl','Хлор'),(22448,1793,'_s4-list_8_ttl','field_60bf7fa95a92c'),(22449,1793,'s4-list_8_formula','Cl<sup>-</sup>'),(22450,1793,'_s4-list_8_formula','field_60bf7fc65a92d'),(22451,1793,'s4-list_8_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(22452,1793,'_s4-list_8_text','field_60bf7fd35a92e'),(22453,1793,'s4-feature1','Має збалансований склад<sup>1-3</sup>'),(22454,1793,'_s4-feature1','field_60bf80ca480ea'),(22455,1793,'s4-feature2','Містить «найголовніші» електроліти<sup>4</sup>'),(22456,1793,'_s4-feature2','field_60bf80de480eb'),(22457,1793,'s4-feature3','Без консервантів, барвників та вуглеводів<sup>1</sup>'),(22458,1793,'_s4-feature3','field_60bf80e2480ec'),(22459,1793,'s4-feature4','Приємна на смак та легко пити навіть при відчутті 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асоратлар'),(22544,1794,'_s2-list_1_text','field_60bf7712f46f1'),(22545,1794,'s2-list_2_icon','65'),(22546,1794,'_s2-list_2_icon','field_60bf76ecf46ef'),(22547,1794,'s2-list_2_icon-hover','66'),(22548,1794,'_s2-list_2_icon-hover','field_60bf7701f46f0'),(22549,1794,'s2-list_2_text','Диарея'),(22550,1794,'_s2-list_2_text','field_60bf7712f46f1'),(22551,1794,'s2-list_3_icon','67'),(22552,1794,'_s2-list_3_icon','field_60bf76ecf46ef'),(22553,1794,'s2-list_3_icon-hover','68'),(22554,1794,'_s2-list_3_icon-hover','field_60bf7701f46f0'),(22555,1794,'s2-list_3_text','Қайт қилиш'),(22556,1794,'_s2-list_3_text','field_60bf7712f46f1'),(22557,1794,'s2-list_4_icon','69'),(22558,1794,'_s2-list_4_icon','field_60bf76ecf46ef'),(22559,1794,'s2-list_4_icon-hover','70'),(22560,1794,'_s2-list_4_icon-hover','field_60bf7701f46f0'),(22561,1794,'s2-list_4_text','Жадал жисмоний юкламалар'),(22562,1794,'_s2-list_4_text','field_60bf7712f46f1'),(22563,1794,'s2-list_5_icon','71'),(22564,1794,'_s2-list_5_icon','field_60bf76ecf46ef'),(22565,1794,'s2-list_5_icon-hover','72'),(22566,1794,'_s2-list_5_icon-hover','field_60bf7701f46f0'),(22567,1794,'s2-list_5_text','Иссиқ ҳавода қизиб кетиш'),(22568,1794,'_s2-list_5_text','field_60bf7712f46f1'),(22569,1794,'s1-slogan','Оддий сув етарли бўлмаганда!'),(22570,1794,'_s1-slogan','field_60bf7ab4d9ba9'),(22571,1794,'s3-text','Сув-туз мувозанати бузилганда оддий сув тананинг барча эҳтиёжларини қондира олмайди ва соғлом ҳолатга тез қайтара олмайди.\r\nРегидратация учун мўлжалланган махсус эритмалар эса ёқимсиз таъмга эга.\r\n\r\nТИББИЙ МАҚСАДЛАР УЧУН СУВ КЕРАК!'),(22572,1794,'_s3-text','field_60bf7bb5a7e2b'),(22573,1794,'s4-ttl','РЕО – тиббий мақсадлар учун сув!'),(22574,1794,'_s4-ttl','field_60bf7c831f58c'),(22575,1794,'s4-notes','<ol>\r\n 	<li>Выбор аптечной воды. Что посоветовать посетителю аптеки? Навигатор Фармация 2021.</li>\r\n 	<li>Цюпа И. Обезвоживание у детей Как предотвратить, а не бороться с наслидками? «Здоровье Украины» No3 2020.</li>\r\n 	<li>Ешимбетова Г. С. \"Тошнота и рвота беременных. Тактика ведения на основе патогенеза\". Материалы докладов IV Международного конгресса по инфузионной терапии. Киев 2020г.</li>\r\n 	<li>Имеется в виду, что в состав воды Рео входят электролиты (натрий, калий, хлор, магний, кальций), которые в физиологическом состоянии содержатся в организме человека в большем количестве по сравнению с другими електролитами.</li>\r\n</ol>'),(22576,1794,'_s4-notes','field_60bf7ca31f58d'),(22577,1794,'s5-video','<div class=\"embed-youtube\" data-video-id=\"ohrVkaOn9Z0\">\r\n         <div class=\"embed-youtube-play\"></div>\r\n</div>'),(22578,1794,'_s5-video','field_60bf7ccfa01a5'),(22579,1794,'s6-ttl','Оддий сув етарли бўлмаганда!'),(22580,1794,'_s6-ttl','field_60bf7cfb10d31'),(22581,1794,'s6-list','6'),(22582,1794,'_s6-list','field_60bf7d0410d32'),(22583,1794,'s6-list_0_icon','92'),(22584,1794,'_s6-list_0_icon','field_60bf7d1810d33'),(22585,1794,'s6-list_0_text','Тана ҳарорати кўтарилганда '),(22586,1794,'_s6-list_0_text','field_60bf7d2710d34'),(22587,1794,'s6-list_1_icon','93'),(22588,1794,'_s6-list_1_icon','field_60bf7d1810d33'),(22589,1794,'s6-list_1_text','Овқатдан заҳарланишларда'),(22590,1794,'_s6-list_1_text','field_60bf7d2710d34'),(22591,1794,'s6-list_2_icon','94'),(22592,1794,'_s6-list_2_icon','field_60bf7d1810d33'),(22593,1794,'s6-list_2_text','Ичак инфекцияларида'),(22594,1794,'_s6-list_2_text','field_60bf7d2710d34'),(22595,1794,'s6-list_3_icon','95'),(22596,1794,'_s6-list_3_icon','field_60bf7d1810d33'),(22597,1794,'s6-list_3_text','Ҳомиладорлик вақтида'),(22598,1794,'_s6-list_3_text','field_60bf7d2710d34'),(22599,1794,'s6-list_4_icon','96'),(22600,1794,'_s6-list_4_icon','field_60bf7d1810d33'),(22601,1794,'s6-list_4_text','Спорт билан шуғулланганда '),(22602,1794,'_s6-list_4_text','field_60bf7d2710d34'),(22603,1794,'s6-list_5_icon','97'),(22604,1794,'_s6-list_5_icon','field_60bf7d1810d33'),(22605,1794,'s6-list_5_text','Алкоголь ичилгандан кейинги асоратларда'),(22606,1794,'_s6-list_5_text','field_60bf7d2710d34'),(22607,1794,'s4-list_0_ttl','Натрий'),(22608,1794,'_s4-list_0_ttl','field_60bf7fa95a92c'),(22609,1794,'s4-list_0_formula','Na<sup>+</sup>'),(22610,1794,'_s4-list_0_formula','field_60bf7fc65a92d'),(22611,1794,'s4-list_0_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(22612,1794,'_s4-list_0_text','field_60bf7fd35a92e'),(22613,1794,'s4-list_1_ttl','Сув'),(22614,1794,'_s4-list_1_ttl','field_60bf7fa95a92c'),(22615,1794,'s4-list_1_formula','H<sub>2</sub>O'),(22616,1794,'_s4-list_1_formula','field_60bf7fc65a92d'),(22617,1794,'s4-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(22618,1794,'_s4-list_1_text','field_60bf7fd35a92e'),(22619,1794,'s4-list','9'),(22620,1794,'_s4-list','field_60bf7f985a92b'),(22621,1794,'s4-list_2_ttl','Калий'),(22622,1794,'_s4-list_2_ttl','field_60bf7fa95a92c'),(22623,1794,'s4-list_2_formula','K<sup>+</sup>'),(22624,1794,'_s4-list_2_formula','field_60bf7fc65a92d'),(22625,1794,'s4-list_2_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(22626,1794,'_s4-list_2_text','field_60bf7fd35a92e'),(22627,1794,'s4-list_3_ttl','Гидрокарбонатлар '),(22628,1794,'_s4-list_3_ttl','field_60bf7fa95a92c'),(22629,1794,'s4-list_3_formula','HCO<sub>3</sub><sup>-</sup>'),(22630,1794,'_s4-list_3_formula','field_60bf7fc65a92d'),(22631,1794,'s4-list_3_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(22632,1794,'_s4-list_3_text','field_60bf7fd35a92e'),(22633,1794,'s4-list_4_ttl','Магний'),(22634,1794,'_s4-list_4_ttl','field_60bf7fa95a92c'),(22635,1794,'s4-list_4_formula','Mg<sup>2+</sup>'),(22636,1794,'_s4-list_4_formula','field_60bf7fc65a92d'),(22637,1794,'s4-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(22638,1794,'_s4-list_4_text','field_60bf7fd35a92e'),(22639,1794,'s4-list_5_ttl','Углекислый газ'),(22640,1794,'_s4-list_5_ttl','field_60bf7fa95a92c'),(22641,1794,'s4-list_5_formula','CO<sup>2+</sup>'),(22642,1794,'_s4-list_5_formula','field_60bf7fc65a92d'),(22643,1794,'s4-list_5_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(22644,1794,'_s4-list_5_text','field_60bf7fd35a92e'),(22645,1794,'s4-list_6_ttl','Кальций'),(22646,1794,'_s4-list_6_ttl','field_60bf7fa95a92c'),(22647,1794,'s4-list_6_formula','Ca<sup>2+</sup>'),(22648,1794,'_s4-list_6_formula','field_60bf7fc65a92d'),(22649,1794,'s4-list_6_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(22650,1794,'_s4-list_6_text','field_60bf7fd35a92e'),(22651,1794,'s4-list_7_ttl','Сорбитол'),(22652,1794,'_s4-list_7_ttl','field_60bf7fa95a92c'),(22653,1794,'s4-list_7_formula','C<sup>6</sup>H<sup>14</sup>O<sup>6</sup>'),(22654,1794,'_s4-list_7_formula','field_60bf7fc65a92d'),(22655,1794,'s4-list_7_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(22656,1794,'_s4-list_7_text','field_60bf7fd35a92e'),(22657,1794,'s4-list_8_ttl','Хлор'),(22658,1794,'_s4-list_8_ttl','field_60bf7fa95a92c'),(22659,1794,'s4-list_8_formula','Cl<sup>-</sup>'),(22660,1794,'_s4-list_8_formula','field_60bf7fc65a92d'),(22661,1794,'s4-list_8_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(22662,1794,'_s4-list_8_text','field_60bf7fd35a92e'),(22663,1794,'s4-feature1','Мувозанатлаштирилган таркибга эга<sup>1-3</sup>'),(22664,1794,'_s4-feature1','field_60bf80ca480ea'),(22665,1794,'s4-feature2','Таркибида энг асосий электролитлар мавжуд<sup>4</sup>'),(22666,1794,'_s4-feature2','field_60bf80de480eb'),(22667,1794,'s4-feature3','Консервантлар, бўёқлар ва углеводларсиз<sup>1</sup>'),(22668,1794,'_s4-feature3','field_60bf80e2480ec'),(22669,1794,'s4-feature4','Таъми ёқимли ва ҳатто кўнгил айниганда ҳам осон ичилади<sup>1,3</sup>'),(22670,1794,'_s4-feature4','field_60bf80e5480ed'),(22671,1794,'s2-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(22672,1794,'_s2-list_0_link','field_60ee90d381a4e'),(22673,1794,'s2-list_1_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(22674,1794,'_s2-list_1_link','field_60ee90d381a4e'),(22675,1794,'s2-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(22676,1794,'_s2-list_2_link','field_60ee90d381a4e'),(22677,1794,'s2-list_3_link','/uz/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/қajt-қilish-suvsizlanish-sababi-sifatida/'),(22678,1794,'_s2-list_3_link','field_60ee90d381a4e'),(22679,1794,'s2-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(22680,1794,'_s2-list_4_link','field_60ee90d381a4e'),(22681,1794,'s2-list_5_link','/uz/istemolchi-uchun/reo-sport-bilan-shuғullanganda/yozgi-issiқda-қandaj-қilib-issiқlik-urishi-va-suvsizlanishning-oldini-olish-mumkin/'),(22682,1794,'_s2-list_5_link','field_60ee90d381a4e'),(22683,1794,'s6-list_0_link','/uz/category/istemolchi-uchun/reo-tana-ҳarorati-kўtarilganda/'),(22684,1794,'_s6-list_0_link','field_60ee916b04ace'),(22685,1794,'s6-list_1_link','/uz/category/istemolchi-uchun/reo-ovқatdan-zaҳarlanishlarda/'),(22686,1794,'_s6-list_1_link','field_60ee916b04ace'),(22687,1794,'s6-list_2_link','/uz/category/istemolchi-uchun/reo-ichak-infekcziyalarida/'),(22688,1794,'_s6-list_2_link','field_60ee916b04ace'),(22689,1794,'s6-list_3_link','/uz/category/istemolchi-uchun/reo-ҳomiladorlik-vaқtida/'),(22690,1794,'_s6-list_3_link','field_60ee916b04ace'),(22691,1794,'s6-list_4_link','/uz/category/istemolchi-uchun/reo-sport-bilan-shuғullanganda/'),(22692,1794,'_s6-list_4_link','field_60ee916b04ace'),(22693,1794,'s6-list_5_link','/uz/category/istemolchi-uchun/reo-algokoldan-kejingi-asoratlarda/'),(22694,1794,'_s6-list_5_link','field_60ee916b04ace'),(22695,1794,'slider_0_webplink','/wp-content/themes/reo/images/webp/slide-1.webp'),(22696,1794,'_slider_0_webplink','field_60fa70c989e88'),(22697,1794,'slider_1_webplink','/wp-content/themes/reo/images/webp/slide-2.webp'),(22698,1794,'_slider_1_webplink','field_60fa70c989e88'),(22699,1794,'slider_2_webplink','/wp-content/themes/reo/images/webp/slide-3.webp'),(22700,1794,'_slider_2_webplink','field_60fa70c989e88'),(22701,1794,'slider_3_webplink','/wp-content/themes/reo/images/webp/slide-4.webp'),(22702,1794,'_slider_3_webplink','field_60fa70c989e88'),(22703,1794,'slider_4_webplink','/wp-content/themes/reo/images/webp/slide-5.webp'),(22704,1794,'_slider_4_webplink','field_60fa70c989e88'),(22705,1794,'slider_5_webplink','/wp-content/themes/reo/images/webp/slide-6.webp'),(22706,1794,'_slider_5_webplink','field_60fa70c989e88'),(22707,1794,'slider_6_webplink','/wp-content/themes/reo/images/webp/slide-7.webp'),(22708,1794,'_slider_6_webplink','field_60fa70c989e88'),(22709,1794,'slider_7_webplink','/wp-content/themes/reo/images/webp/slide-8.webp'),(22710,1794,'_slider_7_webplink','field_60fa70c989e88'),(22711,1794,'slider_3_slide','1666'),(22712,1794,'_slider_3_slide','field_60bf7688f46eb'),(22713,1794,'slider_4_slide','1669'),(22714,1794,'_slider_4_slide','field_60bf7688f46eb'),(22715,1799,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(22716,1799,'_s1-text','field_60c069d69838b'),(22717,1799,'s3-list','5'),(22718,1799,'_s3-list','field_60c06d9298394'),(22719,1799,'s3-list2','3'),(22720,1799,'_s3-list2','field_60c06dd498396'),(22721,1799,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(22722,1799,'_s4-ttl','field_60c06ba39838e'),(22723,1799,'s4-list','7'),(22724,1799,'_s4-list','field_60c06bb39838f'),(22725,1799,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(22726,1799,'_s4-slogan','field_60c06d6d98392'),(22727,1799,'s4-list_0_icon','127'),(22728,1799,'_s4-list_0_icon','field_60c06bc298390'),(22729,1799,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(22730,1799,'_s4-list_0_text','field_60c06bce98391'),(22731,1799,'s4-list_1_icon','128'),(22732,1799,'_s4-list_1_icon','field_60c06bc298390'),(22733,1799,'s4-list_1_text','<strong>головокружiння</strong>'),(22734,1799,'_s4-list_1_text','field_60c06bce98391'),(22735,1799,'s4-list_2_icon','68'),(22736,1799,'_s4-list_2_icon','field_60c06bc298390'),(22737,1799,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(22738,1799,'_s4-list_2_text','field_60c06bce98391'),(22739,1799,'s4-list_3_icon','64'),(22740,1799,'_s4-list_3_icon','field_60c06bc298390'),(22741,1799,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(22742,1799,'_s4-list_3_text','field_60c06bce98391'),(22743,1799,'s4-list_4_icon','129'),(22744,1799,'_s4-list_4_icon','field_60c06bc298390'),(22745,1799,'s4-list_4_text','<strong>дiарея</strong>'),(22746,1799,'_s4-list_4_text','field_60c06bce98391'),(22747,1799,'s4-list_5_icon','130'),(22748,1799,'_s4-list_5_icon','field_60c06bc298390'),(22749,1799,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(22750,1799,'_s4-list_5_text','field_60c06bce98391'),(22751,1799,'s4-list_6_icon','131'),(22752,1799,'_s4-list_6_icon','field_60c06bc298390'),(22753,1799,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(22754,1799,'_s4-list_6_text','field_60c06bce98391'),(22755,1799,'s3-list_0_li','має збалансований<br /> склад'),(22756,1799,'_s3-list_0_li','field_60c06db098395'),(22757,1799,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(22758,1799,'_s3-list_1_li','field_60c06db098395'),(22759,1799,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(22760,1799,'_s3-list_2_li','field_60c06db098395'),(22761,1799,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(22762,1799,'_s3-list_3_li','field_60c06db098395'),(22763,1799,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(22764,1799,'_s3-list_4_li','field_60c06db098395'),(22765,1799,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(22766,1799,'_s3-list2_0_li','field_60c06dd498397'),(22767,1799,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(22768,1799,'_s3-list2_1_li','field_60c06dd498397'),(22769,1799,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(22770,1799,'_s3-list2_2_li','field_60c06dd498397'),(22771,1799,'s2-list_0_ttl','Вуглекислота'),(22772,1799,'_s2-list_0_ttl','field_60c0745253144'),(22773,1799,'s2-list_0_formula','Вуглекислота'),(22774,1799,'_s2-list_0_formula','field_60c0747253145'),(22775,1799,'s2-list_0_size','- 0,05-0,3%'),(22776,1799,'_s2-list_0_size','field_60c0749553146'),(22777,1799,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(22778,1799,'_s2-list_0_text','field_60c0749d53147'),(22779,1799,'s2-list','9'),(22780,1799,'_s2-list','field_60c0743a53143'),(22781,1799,'s2-list_1_ttl','Мiнералiзацiя'),(22782,1799,'_s2-list_1_ttl','field_60c0745253144'),(22783,1799,'s2-list_1_formula','Мiнералiзацiя'),(22784,1799,'_s2-list_1_formula','field_60c0747253145'),(22785,1799,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(22786,1799,'_s2-list_1_size','field_60c0749553146'),(22787,1799,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(22788,1799,'_s2-list_1_text','field_60c0749d53147'),(22789,1799,'s2-list_2_ttl','Сорбітол'),(22790,1799,'_s2-list_2_ttl','field_60c0745253144'),(22791,1799,'s2-list_2_formula','Сорбітол'),(22792,1799,'_s2-list_2_formula','field_60c0747253145'),(22793,1799,'s2-list_2_size','до 900 мг/л'),(22794,1799,'_s2-list_2_size','field_60c0749553146'),(22795,1799,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(22796,1799,'_s2-list_2_text','field_60c0749d53147'),(22797,1799,'s2-list_3_ttl','Натрій'),(22798,1799,'_s2-list_3_ttl','field_60c0745253144'),(22799,1799,'s2-list_3_formula','Na<sup>+</sup>'),(22800,1799,'_s2-list_3_formula','field_60c0747253145'),(22801,1799,'s2-list_3_size','- 1300 мг/л'),(22802,1799,'_s2-list_3_size','field_60c0749553146'),(22803,1799,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(22804,1799,'_s2-list_3_text','field_60c0749d53147'),(22805,1799,'s2-list_4_ttl','Магній'),(22806,1799,'_s2-list_4_ttl','field_60c0745253144'),(22807,1799,'s2-list_4_formula','Mg<sup>2+</sup>'),(22808,1799,'_s2-list_4_formula','field_60c0747253145'),(22809,1799,'s2-list_4_size','- 80 мг/л'),(22810,1799,'_s2-list_4_size','field_60c0749553146'),(22811,1799,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(22812,1799,'_s2-list_4_text','field_60c0749d53147'),(22813,1799,'s2-list_5_ttl','Хлор'),(22814,1799,'_s2-list_5_ttl','field_60c0745253144'),(22815,1799,'s2-list_5_formula','Cl<sup>-</sup>'),(22816,1799,'_s2-list_5_formula','field_60c0747253145'),(22817,1799,'s2-list_5_size','- 2000 мг/л'),(22818,1799,'_s2-list_5_size','field_60c0749553146'),(22819,1799,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(22820,1799,'_s2-list_5_text','field_60c0749d53147'),(22821,1799,'s2-list_6_ttl','Калій'),(22822,1799,'_s2-list_6_ttl','field_60c0745253144'),(22823,1799,'s2-list_6_formula','K<sup>+</sup>'),(22824,1799,'_s2-list_6_formula','field_60c0747253145'),(22825,1799,'s2-list_6_size','- 220 мг/л'),(22826,1799,'_s2-list_6_size','field_60c0749553146'),(22827,1799,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(22828,1799,'_s2-list_6_text','field_60c0749d53147'),(22829,1799,'s2-list_7_ttl','Кальцій'),(22830,1799,'_s2-list_7_ttl','field_60c0745253144'),(22831,1799,'s2-list_7_formula','Ca<sup>2+</sup>'),(22832,1799,'_s2-list_7_formula','field_60c0747253145'),(22833,1799,'s2-list_7_size','- 80 мг/л'),(22834,1799,'_s2-list_7_size','field_60c0749553146'),(22835,1799,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(22836,1799,'_s2-list_7_text','field_60c0749d53147'),(22837,1799,'s2-list_8_ttl','Гідрокарбонати'),(22838,1799,'_s2-list_8_ttl','field_60c0745253144'),(22839,1799,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(22840,1799,'_s2-list_8_formula','field_60c0747253145'),(22841,1799,'s2-list_8_size','- 200-400 мг/л'),(22842,1799,'_s2-list_8_size','field_60c0749553146'),(22843,1799,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і макроелементів.'),(22844,1799,'_s2-list_8_text','field_60c0749d53147'),(22845,1800,'s1-text','<strong>ReO</strong> - это вода для специальных медицинских целей, а именно поддержания и восстановления водно-солевого баланса в организме человека. Она содержит в своем составе «главные» для организма человека электролиты в сбалансированном соотношении, а также сорбитол, который является дополнительным источником энергии и усваивается клетками без участия инсулина.'),(22846,1800,'_s1-text','field_60c069d69838b'),(22847,1800,'s3-list','5'),(22848,1800,'_s3-list','field_60c06d9298394'),(22849,1800,'s3-list2','3'),(22850,1800,'_s3-list2','field_60c06dd498396'),(22851,1800,'s4-ttl','Вода ReO помогает уменьшить симптомы дегидратации и интоксикации'),(22852,1800,'_s4-ttl','field_60c06ba39838e'),(22853,1800,'s4-list','7'),(22854,1800,'_s4-list','field_60c06bb39838f'),(22855,1800,'s4-slogan','ReO восстанавливает водно-солевой БАЛАНС И улучшает самочувствие'),(22856,1800,'_s4-slogan','field_60c06d6d98392'),(22857,1800,'s4-list_0_icon','127'),(22858,1800,'_s4-list_0_icon','field_60c06bc298390'),(22859,1800,'s4-list_0_text','<strong>повышенная</strong>\r\nтемпература\r\nтела и/или'),(22860,1800,'_s4-list_0_text','field_60c06bce98391'),(22861,1800,'s4-list_1_icon','128'),(22862,1800,'_s4-list_1_icon','field_60c06bc298390'),(22863,1800,'s4-list_1_text','<strong>головокружение</strong>'),(22864,1800,'_s4-list_1_text','field_60c06bce98391'),(22865,1800,'s4-list_2_icon','68'),(22866,1800,'_s4-list_2_icon','field_60c06bc298390'),(22867,1800,'s4-list_2_text','<strong>тошнота,</strong>\r\nрвота\r\nи/или'),(22868,1800,'_s4-list_2_text','field_60c06bce98391'),(22869,1800,'s4-list_3_icon','64'),(22870,1800,'_s4-list_3_icon','field_60c06bc298390'),(22871,1800,'s4-list_3_text','общая\r\n<strong>слабость</strong>'),(22872,1800,'_s4-list_3_text','field_60c06bce98391'),(22873,1800,'s4-list_4_icon','129'),(22874,1800,'_s4-list_4_icon','field_60c06bc298390'),(22875,1800,'s4-list_4_text','<strong>диарея</strong>'),(22876,1800,'_s4-list_4_text','field_60c06bce98391'),(22877,1800,'s4-list_5_icon','130'),(22878,1800,'_s4-list_5_icon','field_60c06bc298390'),(22879,1800,'s4-list_5_text','сухость во\r\n<strong>рту </strong>'),(22880,1800,'_s4-list_5_text','field_60c06bce98391'),(22881,1800,'s4-list_6_icon','131'),(22882,1800,'_s4-list_6_icon','field_60c06bc298390'),(22883,1800,'s4-list_6_text','<strong>головная</strong>\r\nболь'),(22884,1800,'_s4-list_6_text','field_60c06bce98391'),(22885,1800,'s3-list_0_li','имеет сбалансированный<br /> состав'),(22886,1800,'_s3-list_0_li','field_60c06db098395'),(22887,1800,'s3-list_1_li','содержит дополнительный источник энергии - сорбитол'),(22888,1800,'_s3-list_1_li','field_60c06db098395'),(22889,1800,'s3-list_2_li','обеспечивает быстрое всасывание воды и электролитов'),(22890,1800,'_s3-list_2_li','field_60c06db098395'),(22891,1800,'s3-list_3_li','имеет приятный вкус и ее легко пить даже при ощущении тошноты'),(22892,1800,'_s3-list_3_li','field_60c06db098395'),(22893,1800,'s3-list_4_li','не содержит консервантов, красителей и углеводов'),(22894,1800,'_s3-list_4_li','field_60c06db098395'),(22895,1800,'s3-list2_0_li','Устраняет симптомы<br /> обезвоживания'),(22896,1800,'_s3-list2_0_li','field_60c06dd498397'),(22897,1800,'s3-list2_1_li','Нормализует диурез, снижает интоксикацию'),(22898,1800,'_s3-list2_1_li','field_60c06dd498397'),(22899,1800,'s3-list2_2_li','Помогает поддержать водно-электролитный баланс во время лечения в стационаре и после выписки на дом'),(22900,1800,'_s3-list2_2_li','field_60c06dd498397'),(22901,1800,'s2-list_3_text','Один из важнейших микроэлементов, обеспечивает баланс жидкости в организме. Натрий помогает в регулировании водного баланса, поддержании кислотно-щелочного равновесия и осмотического давления в крови. Во время нехватки натрия человек чувствует головокружение, сонливость, могут возникнуть приступы помутнения сознания, галлюцинации или обморок.'),(22902,1800,'_s2-list_3_text','field_60c0749d53147'),(22903,1800,'s2-list_3_size','- 1300 мг/л'),(22904,1800,'_s2-list_3_size','field_60c0749553146'),(22905,1800,'s2-list_3_formula','Na<sup>+</sup>'),(22906,1800,'_s2-list_3_formula','field_60c0747253145'),(22907,1800,'s2-list_3_ttl','Натрий'),(22908,1800,'_s2-list_3_ttl','field_60c0745253144'),(22909,1800,'s2-list_2_text','Шестиатомный спирт, имеет характерный сладкий вкус. Сорбитол экономит расход витамина В, который сохраняет микрофлору кишечника. Применяют как очистительный препарат при алкогольном отравлении, при изготовлении противокашлевых сиропов и для лечения расстройств желудка.'),(22910,1800,'_s2-list_2_text','field_60c0749d53147'),(22911,1800,'s2-list_2_size','до 90 мг/л'),(22912,1800,'_s2-list_2_size','field_60c0749553146'),(22913,1800,'s2-list_2_formula','Сорбитол'),(22914,1800,'_s2-list_2_formula','field_60c0747253145'),(22915,1800,'s2-list_2_ttl','Сорбитол'),(22916,1800,'_s2-list_2_ttl','field_60c0745253144'),(22917,1800,'s2-list_1_text','Естественное масло для суставов человека. При недостаточном количестве воды в организме возникают мышечные спазмы, поэтому все спортсмены должны употреблять воду до и после тренировки. Польза питьевой воды заключается и в том, что она необходима для нормального пищеварения и играет важную роль в метаболизме организма.'),(22918,1800,'_s2-list_1_text','field_60c0749d53147'),(22919,1800,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(22920,1800,'_s2-list_1_size','field_60c0749553146'),(22921,1800,'s2-list_1_formula','Минерализация'),(22922,1800,'_s2-list_1_formula','field_60c0747253145'),(22923,1800,'s2-list_1_ttl','Минерализация'),(22924,1800,'_s2-list_1_ttl','field_60c0745253144'),(22925,1800,'s2-list_0_ttl','Углекислота'),(22926,1800,'_s2-list_0_ttl','field_60c0745253144'),(22927,1800,'s2-list_0_formula','Углекислота'),(22928,1800,'_s2-list_0_formula','field_60c0747253145'),(22929,1800,'s2-list_0_size','- 0,05-0,3%'),(22930,1800,'_s2-list_0_size','field_60c0749553146'),(22931,1800,'s2-list_0_text','Углекислый газ или оксид углерода является естественным регулятором дыхания и кровообращения и является неотъемлемым компонентом обмена веществ. CO2 - один из конечных продуктов метаболизма. Говоря образно, кислород - это энергия, а углекислый газ - искра, разжигает ее. Влияет на кору головного мозга и стимулирует дыхательный центр.'),(22932,1800,'_s2-list_0_text','field_60c0749d53147'),(22933,1800,'s2-list','9'),(22934,1800,'_s2-list','field_60c0743a53143'),(22935,1800,'s2-list_4_ttl','Магний'),(22936,1800,'_s2-list_4_ttl','field_60c0745253144'),(22937,1800,'s2-list_4_formula','Mg<sup>2+</sup>'),(22938,1800,'_s2-list_4_formula','field_60c0747253145'),(22939,1800,'s2-list_4_size','- 80 мг/л'),(22940,1800,'_s2-list_4_size','field_60c0749553146'),(22941,1800,'s2-list_4_text','Микроэлемент, участвующий в фосфорном и углеводном обмене, способствует образованию коллагена, координирует сердечный ритм, снижает повышенное артериальное давление и регулирует уровень сахара в крови. Потребность в магнии возрастает при физических нагрузках, стрессе, в жару, период беременности и лактации, во время посещения сауны, злоупотребления алкоголем и синдроме хронической усталости.'),(22942,1800,'_s2-list_4_text','field_60c0749d53147'),(22943,1800,'s2-list_5_ttl','Хлор'),(22944,1800,'_s2-list_5_ttl','field_60c0745253144'),(22945,1800,'s2-list_5_formula','Cl<sup>-</sup>'),(22946,1800,'_s2-list_5_formula','field_60c0747253145'),(22947,1800,'s2-list_5_size','- 2000 мг/л'),(22948,1800,'_s2-list_5_size','field_60c0749553146'),(22949,1800,'s2-list_5_text','Макроэлемент, необходимый для регуляции водного баланса. Хлор участвует в обмене веществ в организме, нормализует осмотическое давление. А еще хлор: стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов. Потребность в хлоре возрастает в условиях жаркого климата, при обильном потоотделении, повышенном потреблении воды или сильных физических нагрузках.'),(22950,1800,'_s2-list_5_text','field_60c0749d53147'),(22951,1800,'s2-list_6_ttl','Калий'),(22952,1800,'_s2-list_6_ttl','field_60c0745253144'),(22953,1800,'s2-list_6_formula','K<sup>+</sup>'),(22954,1800,'_s2-list_6_formula','field_60c0747253145'),(22955,1800,'s2-list_6_size','- 220 мг/л'),(22956,1800,'_s2-list_6_size','field_60c0749553146'),(22957,1800,'s2-list_6_text','Минерал, отвечающий за водный баланс в организме. От него зависит работа сердца, его ритм, а также деятельность нервов и мышц. Калий уменьшает отеки и снижает утомляемость. Для того, чтобы необходимое количество калия попадало в организм человека нужно употреблять много зелени, овощей и фруктов, а самое главное выпивать 1,5-2 литра воды каждый день.'),(22958,1800,'_s2-list_6_text','field_60c0749d53147'),(22959,1800,'s2-list_7_ttl','Кальций'),(22960,1800,'_s2-list_7_ttl','field_60c0745253144'),(22961,1800,'s2-list_7_formula','Ca<sup>2+</sup>'),(22962,1800,'_s2-list_7_formula','field_60c0747253145'),(22963,1800,'s2-list_7_size','- 80 мг/л'),(22964,1800,'_s2-list_7_size','field_60c0749553146'),(22965,1800,'s2-list_7_text','Король всех микроэлементов организма. Кальций - основа костей, зубов, ногтей, а также важная составляющая часть кожи, соединительной ткани, мышц, волос. Кальций регулирует ритм сердечных сокращений, снижает частоту пульса, нормализует артериальное давление и препятствует стрессу.'),(22966,1800,'_s2-list_7_text','field_60c0749d53147'),(22967,1800,'s2-list_8_ttl','Гидрокарбонаты'),(22968,1800,'_s2-list_8_ttl','field_60c0745253144'),(22969,1800,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(22970,1800,'_s2-list_8_formula','field_60c0747253145'),(22971,1800,'s2-list_8_size','- 200-400 мг/л'),(22972,1800,'_s2-list_8_size','field_60c0749553146'),(22973,1800,'s2-list_8_text','Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят уровень кислотообразования в желудке, они улучшают усвоение микро- и макроэлементов.'),(22974,1800,'_s2-list_8_text','field_60c0749d53147'),(22975,1801,'s1-text','<strong>ReO</strong> - бу махсус тиббий мақсадлар, хусусан инсон организмида сув-туз мувозанатини сақлаб туриш ва тиклаш учун мўлжалланган сув. У ўз таркибида инсон организми учун “асосий” бўлган электролитларни мувозанатлаштирилган нисбатда сақлайди. Шунингдек унинг таркибида қўшимча энергия манбаи бўлган ва ҳужайралар инсулин иштирокисиз ўзлаштира оладиган сорбитол мавжуд.'),(22976,1801,'_s1-text','field_60c069d69838b'),(22977,1801,'s3-list','5'),(22978,1801,'_s3-list','field_60c06d9298394'),(22979,1801,'s3-list2','3'),(22980,1801,'_s3-list2','field_60c06dd498396'),(22981,1801,'s4-ttl','ReO суви дегидратация ва интоксикация белгиларини камайтиради'),(22982,1801,'_s4-ttl','field_60c06ba39838e'),(22983,1801,'s4-list','7'),(22984,1801,'_s4-list','field_60c06bb39838f'),(22985,1801,'s4-slogan','ReO сув-туз мувозанатини тиклайди ва умумий аҳволни яхшилайди'),(22986,1801,'_s4-slogan','field_60c06d6d98392'),(22987,1801,'s4-list_0_icon','127'),(22988,1801,'_s4-list_0_icon','field_60c06bc298390'),(22989,1801,'s4-list_0_text','<strong>Тана ҳарорати</strong> кўтарилиши ва/ёки'),(22990,1801,'_s4-list_0_text','field_60c06bce98391'),(22991,1801,'s4-list_1_icon','128'),(22992,1801,'_s4-list_1_icon','field_60c06bc298390'),(22993,1801,'s4-list_1_text','<strong>бош айланиши</strong>'),(22994,1801,'_s4-list_1_text','field_60c06bce98391'),(22995,1801,'s4-list_2_icon','68'),(22996,1801,'_s4-list_2_icon','field_60c06bc298390'),(22997,1801,'s4-list_2_text','<strong>кўнгил айниши,</strong>\r\nқайт қилиш\r\nва/ёки'),(22998,1801,'_s4-list_2_text','field_60c06bce98391'),(22999,1801,'s4-list_3_icon','64'),(23000,1801,'_s4-list_3_icon','field_60c06bc298390'),(23001,1801,'s4-list_3_text','умумий\r\n<strong>ҳолсизлик</strong>'),(23002,1801,'_s4-list_3_text','field_60c06bce98391'),(23003,1801,'s4-list_4_icon','129'),(23004,1801,'_s4-list_4_icon','field_60c06bc298390'),(23005,1801,'s4-list_4_text','<strong>ич кетиши</strong>'),(23006,1801,'_s4-list_4_text','field_60c06bce98391'),(23007,1801,'s4-list_5_icon','130'),(23008,1801,'_s4-list_5_icon','field_60c06bc298390'),(23009,1801,'s4-list_5_text','қуриши\r\n<strong>оғиз</strong>'),(23010,1801,'_s4-list_5_text','field_60c06bce98391'),(23011,1801,'s4-list_6_icon','131'),(23012,1801,'_s4-list_6_icon','field_60c06bc298390'),(23013,1801,'s4-list_6_text','<strong>бош</strong>\r\nоғриғи'),(23014,1801,'_s4-list_6_text','field_60c06bce98391'),(23015,1801,'s3-list_0_li','мувозанатлаштирилган таркибга эга'),(23016,1801,'_s3-list_0_li','field_60c06db098395'),(23017,1801,'s3-list_1_li','таркибида қўшимча энергия манбаи – сорбитол бор'),(23018,1801,'_s3-list_1_li','field_60c06db098395'),(23019,1801,'s3-list_2_li','сув ва электролитларни тез сўрилишини таъминлайди'),(23020,1801,'_s3-list_2_li','field_60c06db098395'),(23021,1801,'s3-list_3_li','ёқимли таъмга эга бўлиб, ҳатто кўнгил айниганда ҳам осон ичилади '),(23022,1801,'_s3-list_3_li','field_60c06db098395'),(23023,1801,'s3-list_4_li','консервант, бўёқлар ва углеводларсиз'),(23024,1801,'_s3-list_4_li','field_60c06db098395'),(23025,1801,'s3-list2_0_li','Сувсизланиш белгиларини бартараф этади'),(23026,1801,'_s3-list2_0_li','field_60c06dd498397'),(23027,1801,'s3-list2_1_li','Диурезни нормаллаштиради, интоксикацияни камайтиради'),(23028,1801,'_s3-list2_1_li','field_60c06dd498397'),(23029,1801,'s3-list2_2_li','Стационарда даволаниш вақтида ва уйга чиққандан сўнг сув-электролит мувозанатини тиклашга ёрдам беради'),(23030,1801,'_s3-list2_2_li','field_60c06dd498397'),(23031,1801,'s2-list_3_text','Организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. Натрий сув мувозанатини бошқаришда, кислота-ишқор мувозанати ва қон осмотик босимини ушлаб туришда иштирок этади. Натрий етишмовчилигида инсон бош айланиши, уйқучанликни ҳис қилади. Онгнинг хиралашуви, галлюцинация, ҳушдан кетиш каби ҳолатлар ҳам юзага келиши мумкин.'),(23032,1801,'_s2-list_3_text','field_60c0749d53147'),(23033,1801,'s2-list_3_size','- 1300 мг/л'),(23034,1801,'_s2-list_3_size','field_60c0749553146'),(23035,1801,'s2-list_3_formula','Na<sup>+</sup>'),(23036,1801,'_s2-list_3_formula','field_60c0747253145'),(23037,1801,'s2-list_3_ttl','Натрий'),(23038,1801,'_s2-list_3_ttl','field_60c0745253144'),(23039,1801,'s2-list_2_text','Сорбитол - олти атомли спирт бўлиб, ўзига хос ширин таъмга эга. Сорбитол ичак микрофлорасини тикланишида ёрдам берадиган B витаминининг ортиқча сарфланишини олдини олади.Тозаловчи препарат сифатида алкоголдан заҳарланишларда, шунингдек йўталга қарши ва ошқозон-ичак бузилишларини даволовчи препаратларни тайёрлашда қўланилади.'),(23040,1801,'_s2-list_2_text','field_60c0749d53147'),(23041,1801,'s2-list_2_size','до 90 мг/л'),(23042,1801,'_s2-list_2_size','field_60c0749553146'),(23043,1801,'s2-list_2_formula','Сорбитол'),(23044,1801,'_s2-list_2_formula','field_60c0747253145'),(23045,1801,'s2-list_2_ttl','Сорбитол'),(23046,1801,'_s2-list_2_ttl','field_60c0745253144'),(23047,1801,'s2-list_1_text','Одам бўғимлари учун табиий ёғ. Организмда сув етишмаганда мускуллар тортишиши юзага келади, шунинг учун барча спортчилар машғулотдан олдин ва кейин сув ичишлари зарур. Ичимлик сувининг фойдаси шундан иборатки, у нормал овқат ҳазм қилишда ва организм метаболизмида муҳим рль ўйнайди. '),(23048,1801,'_s2-list_1_text','field_60c0749d53147'),(23049,1801,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(23050,1801,'_s2-list_1_size','field_60c0749553146'),(23051,1801,'s2-list_1_formula','Минерализация'),(23052,1801,'_s2-list_1_formula','field_60c0747253145'),(23053,1801,'s2-list_1_ttl','Минерализация'),(23054,1801,'_s2-list_1_ttl','field_60c0745253144'),(23055,1801,'s2-list_0_ttl','Углекислота'),(23056,1801,'_s2-list_0_ttl','field_60c0745253144'),(23057,1801,'s2-list_0_formula','Углекислота'),(23058,1801,'_s2-list_0_formula','field_60c0747253145'),(23059,1801,'s2-list_0_size','- 0,05-0,3%'),(23060,1801,'_s2-list_0_size','field_60c0749553146'),(23061,1801,'s2-list_0_text','Углекислота – нафас олиш ва қон айланишининг табиий регулятори бўлиб, моддалар алмашинувининг ажралмас қисми саналади. CO2 – метаболизмнинг охирги маҳсулоти, маъжозий маънода айтганда, кислород – бу энергия, углерод диоксиди эса – уни ёқувчи чўғдир. Мия қобиғига таъсир қилиб, нафас марказини рағбатлантиради.'),(23062,1801,'_s2-list_0_text','field_60c0749d53147'),(23063,1801,'s2-list','9'),(23064,1801,'_s2-list','field_60c0743a53143'),(23065,1801,'s2-list_4_ttl','Магний'),(23066,1801,'_s2-list_4_ttl','field_60c0745253144'),(23067,1801,'s2-list_4_formula','Mg<sup>2+</sup>'),(23068,1801,'_s2-list_4_formula','field_60c0747253145'),(23069,1801,'s2-list_4_size','- 80 мг/л'),(23070,1801,'_s2-list_4_size','field_60c0749553146'),(23071,1801,'s2-list_4_text','Фосфор ва углевод алмашинувида иштирок этувчи микроэлемент. Коллаген ҳосил бўлишида иштирок этади, юрак ритмини мувофиқлаштиради, кўтарилган қон босимини меъёрга келтириб, қондаги қанд миқдорини тартибга келтиради. Магнийга бўлган эҳтиёж жисмоний зўриқишларда, стрессда,  иссиқ ҳавода, ҳомиладорликда, эмизикли аёлларда, саунадан кейин, алкоголь ичилгандан сўнг ва сурункали чарчашда ортади.'),(23072,1801,'_s2-list_4_text','field_60c0749d53147'),(23073,1801,'s2-list_5_ttl','Хлор'),(23074,1801,'_s2-list_5_ttl','field_60c0745253144'),(23075,1801,'s2-list_5_formula','Cl<sup>-</sup>'),(23076,1801,'_s2-list_5_formula','field_60c0747253145'),(23077,1801,'s2-list_5_size','- 2000 мг/л'),(23078,1801,'_s2-list_5_size','field_60c0749553146'),(23079,1801,'s2-list_5_text','сув мувозанатини тартибга солишда муҳим макроэлемент. Моддалар алмашинувида иштирок этади, осмотик босимни нормаллаштиради. Шунингдек хлор иштаҳани оширади, жигар фаолиятини яхшилаб, танадан шлак ва токсинларни чиқарилишига ёрдам беради. Хлорга бўлган эҳтиёж иссиқ ҳавода, кўп терлаганда, кўп сув ичилганда ва кучли жисмоний зўриқишларда ортади'),(23080,1801,'_s2-list_5_text','field_60c0749d53147'),(23081,1801,'s2-list_6_ttl','Калий'),(23082,1801,'_s2-list_6_ttl','field_60c0745253144'),(23083,1801,'s2-list_6_formula','K<sup>+</sup>'),(23084,1801,'_s2-list_6_formula','field_60c0747253145'),(23085,1801,'s2-list_6_size','- 220 мг/л'),(23086,1801,'_s2-list_6_size','field_60c0749553146'),(23087,1801,'s2-list_6_text','Организмда сув мувозанати учун жавоб берувчи минерал. Юракнинг иши, унинг ритми, асаб ва мушакларнинг фаолияти у билан чамбарчас боғлиқ. Калий ҳам танадаги шишларни, ҳам чарчоқни камайтиради. Керакли миқдордаги калий организмга тушиши учун кўплаб кўкатлар, мева ва сабзавотлар истеъмол қилиш ва муҳими кунига 1,5-2 литр сув ичиш керак'),(23088,1801,'_s2-list_6_text','field_60c0749d53147'),(23089,1801,'s2-list_7_ttl','Кальций'),(23090,1801,'_s2-list_7_ttl','field_60c0745253144'),(23091,1801,'s2-list_7_formula','Ca<sup>2+</sup>'),(23092,1801,'_s2-list_7_formula','field_60c0747253145'),(23093,1801,'s2-list_7_size','- 80 мг/л'),(23094,1801,'_s2-list_7_size','field_60c0749553146'),(23095,1801,'s2-list_7_text','Организмдаги барча микроэлементларнинг қироли. Кальций нафақат суяклар, тишлар, тирноқлар асоси, балки тери, бириктирувчи тўқима, мушаклар ва сочларнинг ҳам асосий таркибий қисмидир.  Кальций юрак ритмини бошқаришда, юрак уриш сонини камайтиришда, қон босимини нормаллаштиришда иштирок этади ва стресс пайдо бўлишига тўсқинлик қилади'),(23096,1801,'_s2-list_7_text','field_60c0749d53147'),(23097,1801,'s2-list_8_ttl','Гидрокарбонатлар '),(23098,1801,'_s2-list_8_ttl','field_60c0745253144'),(23099,1801,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(23100,1801,'_s2-list_8_formula','field_60c0747253145'),(23101,1801,'s2-list_8_size','- 200-400 мг/л'),(23102,1801,'_s2-list_8_size','field_60c0749553146'),(23103,1801,'s2-list_8_text','Гидрокарбонатлар организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.'),(23104,1801,'_s2-list_8_text','field_60c0749d53147'),(23105,1802,'s1-text','<strong>ReO</strong> - це вода для спеціальних медичних цілей, а саме підтримки та відновлення водно-сольового балансу в організмі людини. Вона містить в своєму складі «найголовніші» для організму людини електроліти в збалансованому співвідношенні, а також сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами без участі інсуліну.'),(23106,1802,'_s1-text','field_60c069d69838b'),(23107,1802,'s3-list','5'),(23108,1802,'_s3-list','field_60c06d9298394'),(23109,1802,'s3-list2','3'),(23110,1802,'_s3-list2','field_60c06dd498396'),(23111,1802,'s4-ttl','Вода РеО допомогає зменшити симптоми дегідратації та інтоксикації'),(23112,1802,'_s4-ttl','field_60c06ba39838e'),(23113,1802,'s4-list','7'),(23114,1802,'_s4-list','field_60c06bb39838f'),(23115,1802,'s4-slogan','РеО відновлює водно-сольовий баланс та покращує самопочуття'),(23116,1802,'_s4-slogan','field_60c06d6d98392'),(23117,1802,'s4-list_0_icon','127'),(23118,1802,'_s4-list_0_icon','field_60c06bc298390'),(23119,1802,'s4-list_0_text','<strong>пiдвищена</strong>\r\nтемпература\r\nтiла та / або'),(23120,1802,'_s4-list_0_text','field_60c06bce98391'),(23121,1802,'s4-list_1_icon','128'),(23122,1802,'_s4-list_1_icon','field_60c06bc298390'),(23123,1802,'s4-list_1_text','<strong>головокружiння</strong>'),(23124,1802,'_s4-list_1_text','field_60c06bce98391'),(23125,1802,'s4-list_2_icon','68'),(23126,1802,'_s4-list_2_icon','field_60c06bc298390'),(23127,1802,'s4-list_2_text','<strong>нудота,</strong>\r\nблювання\r\nта / або'),(23128,1802,'_s4-list_2_text','field_60c06bce98391'),(23129,1802,'s4-list_3_icon','64'),(23130,1802,'_s4-list_3_icon','field_60c06bc298390'),(23131,1802,'s4-list_3_text','загальна\r\n<strong>слабкiсть</strong>'),(23132,1802,'_s4-list_3_text','field_60c06bce98391'),(23133,1802,'s4-list_4_icon','129'),(23134,1802,'_s4-list_4_icon','field_60c06bc298390'),(23135,1802,'s4-list_4_text','<strong>дiарея</strong>'),(23136,1802,'_s4-list_4_text','field_60c06bce98391'),(23137,1802,'s4-list_5_icon','130'),(23138,1802,'_s4-list_5_icon','field_60c06bc298390'),(23139,1802,'s4-list_5_text','сухiсть у <strong>ротi</strong>'),(23140,1802,'_s4-list_5_text','field_60c06bce98391'),(23141,1802,'s4-list_6_icon','131'),(23142,1802,'_s4-list_6_icon','field_60c06bc298390'),(23143,1802,'s4-list_6_text','<strong>головний</strong>\r\nбiль'),(23144,1802,'_s4-list_6_text','field_60c06bce98391'),(23145,1802,'s3-list_0_li','має збалансований<br /> склад'),(23146,1802,'_s3-list_0_li','field_60c06db098395'),(23147,1802,'s3-list_1_li','містить додаткове джерело енергії – сорбітол'),(23148,1802,'_s3-list_1_li','field_60c06db098395'),(23149,1802,'s3-list_2_li','забезпечує швидке всмоктування води та електролітів'),(23150,1802,'_s3-list_2_li','field_60c06db098395'),(23151,1802,'s3-list_3_li','має приємний смак та легко пити навіть при відчутті нудоти'),(23152,1802,'_s3-list_3_li','field_60c06db098395'),(23153,1802,'s3-list_4_li','не містить консервантів, барвників та вуглеводів'),(23154,1802,'_s3-list_4_li','field_60c06db098395'),(23155,1802,'s3-list2_0_li','Усуває симптоми<br /> зневоднення'),(23156,1802,'_s3-list2_0_li','field_60c06dd498397'),(23157,1802,'s3-list2_1_li','Нормалізує діурез, знижує інтоксикацію'),(23158,1802,'_s3-list2_1_li','field_60c06dd498397'),(23159,1802,'s3-list2_2_li','Допомагає підтримати водно-електролітний баланс під час лікування в стаціонарі та після виписки на дому'),(23160,1802,'_s3-list2_2_li','field_60c06dd498397'),(23161,1802,'s2-list_0_ttl','Вуглекислота'),(23162,1802,'_s2-list_0_ttl','field_60c0745253144'),(23163,1802,'s2-list_0_formula','Вуглекислота'),(23164,1802,'_s2-list_0_formula','field_60c0747253145'),(23165,1802,'s2-list_0_size','- 0,05-0,3%'),(23166,1802,'_s2-list_0_size','field_60c0749553146'),(23167,1802,'s2-list_0_text','Вуглекислий газ або оксид вуглецю є природним регулятором дихання і кровообігу та є невід’ємним компонентом обміну речовин. CO2 – один з кінцевих продуктів метаболізму. Тобто, кисень – це енергія, а вуглекислий газ – іскра, розпалює її. Впливає на кору головного мозку і стимулює дихальний центр.'),(23168,1802,'_s2-list_0_text','field_60c0749d53147'),(23169,1802,'s2-list','9'),(23170,1802,'_s2-list','field_60c0743a53143'),(23171,1802,'s2-list_1_ttl','Мiнералiзацiя'),(23172,1802,'_s2-list_1_ttl','field_60c0745253144'),(23173,1802,'s2-list_1_formula','Мiнералiзацiя'),(23174,1802,'_s2-list_1_formula','field_60c0747253145'),(23175,1802,'s2-list_1_size','<br /> 2500-3000 (мг/дм<sup>3</sup>'),(23176,1802,'_s2-list_1_size','field_60c0749553146'),(23177,1802,'s2-list_1_text','Природнє мастило для суглобів людини. При недостатній кількості води в організмі виникають м\'язові спазми, тому всі спортсмени повинні вживати воду до та після тренування. Користь питної води полягає і в тому, що вона необхідна для нормального травлення та грає важливу роль в метаболізмі організму.'),(23178,1802,'_s2-list_1_text','field_60c0749d53147'),(23179,1802,'s2-list_2_ttl','Сорбітол'),(23180,1802,'_s2-list_2_ttl','field_60c0745253144'),(23181,1802,'s2-list_2_formula','Сорбітол'),(23182,1802,'_s2-list_2_formula','field_60c0747253145'),(23183,1802,'s2-list_2_size','до 90 мг/л'),(23184,1802,'_s2-list_2_size','field_60c0749553146'),(23185,1802,'s2-list_2_text','Шестиатомный спирт, що має характерний солодкий смак. Сорбітол економить розтрату вітамінy В, що береже мікрофлору кишечника. Застосовують як очисний препарат при алкогольному отруєнні, під час виготовлення протикашльових сиропів та для лікування розладів шлунка.'),(23186,1802,'_s2-list_2_text','field_60c0749d53147'),(23187,1802,'s2-list_3_ttl','Натрій'),(23188,1802,'_s2-list_3_ttl','field_60c0745253144'),(23189,1802,'s2-list_3_formula','Na<sup>+</sup>'),(23190,1802,'_s2-list_3_formula','field_60c0747253145'),(23191,1802,'s2-list_3_size','- 1300 мг/л'),(23192,1802,'_s2-list_3_size','field_60c0749553146'),(23193,1802,'s2-list_3_text','Один з найважливіших мікроелементів, що забезпечує баланс рідини в організмі. Натрій допомагає в регулюванні водного балансу, підтриманні кислотно-лужної рівноваги та осмотичного тиску в крові. Під час нестачі натрію людина відчуває запаморочення, сонливість, можуть виникнути напади помутніння свідомості, галюцинації або непритомність.'),(23194,1802,'_s2-list_3_text','field_60c0749d53147'),(23195,1802,'s2-list_4_ttl','Магній'),(23196,1802,'_s2-list_4_ttl','field_60c0745253144'),(23197,1802,'s2-list_4_formula','Mg<sup>2+</sup>'),(23198,1802,'_s2-list_4_formula','field_60c0747253145'),(23199,1802,'s2-list_4_size','- 80 мг/л'),(23200,1802,'_s2-list_4_size','field_60c0749553146'),(23201,1802,'s2-list_4_text','Мікроелемент, що бере участь у фосфорному і вуглеводному обміні, сприяє утворенню колагену, координує серцевий ритм, знижує підвищений артеріальний тиск та регулює рівень цукру в крові. Потреба в магнії зростає при фізичних навантаженнях, стресі, в спеку, період вагітності і лактації, під час відвідування сауни, зловживання алкоголем і синдромі хронічної втоми.'),(23202,1802,'_s2-list_4_text','field_60c0749d53147'),(23203,1802,'s2-list_5_ttl','Хлор'),(23204,1802,'_s2-list_5_ttl','field_60c0745253144'),(23205,1802,'s2-list_5_formula','Cl<sup>-</sup>'),(23206,1802,'_s2-list_5_formula','field_60c0747253145'),(23207,1802,'s2-list_5_size','- 2000 мг/л'),(23208,1802,'_s2-list_5_size','field_60c0749553146'),(23209,1802,'s2-list_5_text','Макроелемент необхідний для регуляції водного балансу. Хлор бере участь в обміні речовин в організмі, нормалізує осмотичний тиск. А ще хлор: стимулює апетит, покращує функцію печінки та сприяє виведенню з організму шлаків і токсинів. Потреба в хлорі зростає в умовах жаркого клімату, при рясному потовиділенні, підвищеному споживанні води або сильних фізичних навантаженнях.'),(23210,1802,'_s2-list_5_text','field_60c0749d53147'),(23211,1802,'s2-list_6_ttl','Калій'),(23212,1802,'_s2-list_6_ttl','field_60c0745253144'),(23213,1802,'s2-list_6_formula','K<sup>+</sup>'),(23214,1802,'_s2-list_6_formula','field_60c0747253145'),(23215,1802,'s2-list_6_size','- 220 мг/л'),(23216,1802,'_s2-list_6_size','field_60c0749553146'),(23217,1802,'s2-list_6_text','Мінеральний елемент, що відповідає за водний баланс в організмі. Від нього залежить робота серця, його ритм, а також діяльність нервів і м’язів. Калій зменшує набряки та знижує стомлюваність, постачаючи мозок киснем. Для того щоб необхідна кількість калію потрапляла в організм людини потрібно вживати багато зелені, овочів та фруктів, а саме головне випивати 1,5-2 літра води кожного дня.'),(23218,1802,'_s2-list_6_text','field_60c0749d53147'),(23219,1802,'s2-list_7_ttl','Кальцій'),(23220,1802,'_s2-list_7_ttl','field_60c0745253144'),(23221,1802,'s2-list_7_formula','Ca<sup>2+</sup>'),(23222,1802,'_s2-list_7_formula','field_60c0747253145'),(23223,1802,'s2-list_7_size','- 80 мг/л'),(23224,1802,'_s2-list_7_size','field_60c0749553146'),(23225,1802,'s2-list_7_text','Король усіх мікроелементів організму. Кальцій – основа кісток, зубів, нігтів, а також важлива складова частина шкіри, сполучної ткани, м`язів, волосся. Кальцій регулює ритм серцевих скорочень, знижує частоту пульсу, нормалізує артеріальний тиск та протидіє стресу.'),(23226,1802,'_s2-list_7_text','field_60c0749d53147'),(23227,1802,'s2-list_8_ttl','Гідрокарбонати'),(23228,1802,'_s2-list_8_ttl','field_60c0745253144'),(23229,1802,'s2-list_8_formula','HCO<sub>3</sub><sup>-</sup>'),(23230,1802,'_s2-list_8_formula','field_60c0747253145'),(23231,1802,'s2-list_8_size','- 200-400 мг/л'),(23232,1802,'_s2-list_8_size','field_60c0749553146'),(23233,1802,'s2-list_8_text','Гідрокарбонати очищають організм від токсинів, регулюють водний баланс, вуглеводний і білковий обмін, сприяють травленню. Гідрокарбонати гальмують рівень кислотоутворення у шлунку, вони поліпшують засвоєння мікро- і 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Ми зобов’язуємося захищати приватність осіб, які відвідують наш Веб-сайт і використовують наші онлайн-інструменти. У даній Політиці конфіденційності (далі – <strong>Політика</strong>) ми хочемо розповісти Вам про порядок збору, обробки та використання персональних даних.\r\n\r\nБудь ласка, зверніть увагу, що Ви приймаєте цю Політику конфіденційності в разі перегляду Веб-сайту або його використання іншим чином, незалежно від того, чи попросять Вас дати додатковий дозвіл під час використання Веб-сайту. Ознайомлення з цією політикою конфіденційності є виключно Вашою відповідальністю.\r\n<ol>\r\n 	<li><strong> Інформація, яку ми збираємо</strong></li>\r\n</ol>\r\n1.1. Під час використання Веб-сайту, Ви можете прийняти рішення про надання нам певної інформації про Вас, заповнюючи онлайн-форми, реєструючись на нашому Веб-сайті, роблячи замовлення, звертаючись до нас та ін. Видами персональної інформації, яку Ви можете нам надати, можуть бути, без обмеження, контактна інформація (адреса, електронна пошта, номер телефону), ім’я користувача і особисті вподобання, інтереси та використання різних продуктів і послуг, зміст комунікації з нами. Для доступу на Веб-сайт Ви не зобов’язані надавати перелічені вище персональні дані, проте в такому випадку деякі функції можуть бути Вам недоступні.\r\n\r\n1.2. Відразу після того, як Ви зайшли на сайт, ми можемо автоматично отримати деяку інформацію, яка може бути використана для Вашої ідентифікації, наприклад, номер домену, IP-адреса Вашого комп’ютера, вид використовуваного Вами браузера, операційної системи і платформи, технічна інформація, інформація про географічне місцезнаходження під час відвідування Веб-сайту (тривалість перебування, популярні продукти, час відгуку сторінки, шляхи навігації, а також інформація про час, частоту і спосіб використання послуги Вами та ін.). Ми можемо використовувати таку інформацію окремо або в сукупності, для технічного управління нашим Веб-сайтом, аналітичної системи відстеження, досліджень і розробок. Мета такої обробки – моніторинг та поліпшення нашого Веб-сайту та послуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обробка персональних даних</strong></li>\r\n</ol>\r\nМи захищаємо Ваші дані, обмежуючи доступ до Ваших даних тільки особами, які повинні мати до них доступ для здійснення або спрощення операцій між Вами і нами, або особами, які з інших причин повинні виконувати дії, описані в даному розділі.\r\n\r\n2.1. Ми можемо обробляти Вашу інформацію, яка вказана у Вашому профілі на нашому Веб-сайті. Дані профілю можуть містити Ваше ім’я, адресу, номер телефону, адресу електронної пошти, фото профілю, стать, дату народження, сімейний статус, інтереси та хобі, дані про освіту і місце роботи. Ми свідомо не збираємо інформацію про осіб молодше 18 років. Дані профілю можуть бути оброблені для надання Вам можливості використання та моніторингу нашого Веб-сайту та послуг, створення Вашого особистого профілю і управління ним, роботи з Веб-сайтом, надання наших послуг, забезпечення безпеки нашого Веб-сайту та послуг, резервного зберігання даних в наших базах і спілкування з Вами. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.2. Ми можемо обробляти інформацію, яку Ви публікуєте на нашому Веб-сайті або через наші послуги. Дані публікації можуть бути оброблені з метою дозволу публікацій або управління нашим Веб-сайтом і послугами. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.3. Ми можемо обробляти інформацію з Вашого запиту про товари і/або послуги. Дані запиту можуть бути оброблені з метою пропозиції, маркетингу та продажу відповідних товарів і/або послуг Вам та для обробки Ваших окремих запитів. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.4. Ми можемо обробляти інформацію, пов’язану із взаємовідносинами з клієнтами, зокрема контактну інформацію клієнта. Дані про взаємини клієнта можуть включати ім’я, місце роботи, назву посади або ролі, контактну інформацію, інформацію, що була отримана в комунікації між нами. Дані про взаємини клієнта можуть оброблятися з метою управління нашими взаєминами із клієнтами, комунікації з клієнтами, ведення записів про таку комунікацію, допомоги при виборі товарів і надання Вам рекомендацій, рекламування наших товарів і послуг клієнтам. Метою такої обробки є належне управління взаєминами з клієнтом.\r\n\r\n2.5. Ми можемо обробляти надану Вами інформацію з метою підписання Вас на наші електронні розсилки та/або інформаційні листи. Дані про повідомлення можуть оброблятися з метою відправки Вам відповідних повідомлень та/або інформаційних листів, інформації про нашу продукцію, послуги і рекламних матеріалів. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.6. На додаток до цілей, для яких ми можемо обробляти Ваші персональні дані, викладених у цьому розділі, ми також можемо обробляти Ваші персональні дані, якщо така обробка необхідна для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<ol start=\"3\">\r\n 	<li><strong> Надання </strong><strong>Ваших </strong><strong>персональних даних іншим особам</strong></li>\r\n</ol>\r\n3.1. Ми не передаємо в оренду, не продаємо або іншим чином не розголошуємо персональну інформацію, яку ми збираємо, за винятком описаних нижче випадків. Ми можемо поділитися Вашими персональними даними для здійснення дій, описаних у даному розділі.\r\n\r\n3.2. Ми можемо розголосити Ваші персональні дані будь-якому учаснику нашої групи компаній (тобто дочірнім підприємствам, кінцевій холдинговій компанії та всім її дочірнім підприємствам), якщо це обґрунтовано необхідно для цілей та за правових підстав, передбачених цією політикою.\r\n\r\n3.3. Ми можемо розголосити Ваші персональні дані нашим постачальникам послуг, що надають послуги від нашого імені, по нашим розпорядженням, страховикам або професійним консультантам, якщо це обґрунтовано необхідно для отримання відповідної страховки, управління ризиками, отримання професійної консультації і надання послуг.\r\n\r\nМи можемо поділитися Вашими персональними даними з нашими постачальниками послуг, які беруть участь в наших бізнес-процесах.\r\n\r\n<strong>Приклад використання персональних даних нашими постачальниками послуг:</strong>\r\n<ul>\r\n 	<li>ми передаємо Вашу персональну інформацію постачальникам послуг, що допомагають нам у діяльності, пов’язаної з маркетингом та аналізом даних, щоб повідомляти Вас і надавати рекомендації про нашу продукцію, в тому числі про розпродажі, спеціальні пропозиції, нові характеристики Веб-сайту, направляти Вам повідомлення рекламного характеру.</li>\r\n</ul>\r\nНашими постачальниками маркетингових послуг і даних є \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" та інші. Політика конфіденційності наших постачальників послуг доступна на їхніх Веб-сайтах. Ми не аналізуємо діяльність таких постачальників послуг, страховиків і професійних консультантів перед використанням або розголошенням персональної інформації, крім випадків, коли це необхідно для надання послуг від нашого імені або виконання вимог закону, однак у будь-якому разі ми не несемо жодної відповідальності за дії (діяльність)/бездіяльність таких постачальників послуг.\r\n\r\n3.4. На додаток окремим випадкам розголошення, викладеним в цьому розділі, ми також можемо розголошувати Ваші персональні дані, якщо таке розголошення інформації необхідне для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб. Ми також можемо розголошувати ваші персональні дані, якщо таке розголошення необхідне для встановлення, реалізації або захисту законних вимог у судовому провадженні або в адміністративному порядку, або в порядку досудового вирішення спору.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача </strong><strong>Ваших </strong><strong>персональних даних за кордон</strong></li>\r\n</ol>\r\n4.1. У даному розділі ми надаємо інформацію про випадки, в яких персональні дані можуть передаватися за межі України.\r\n\r\n4.2. Ми можемо передавати Ваші персональні дані нашим контрагентам за межами України (іноземним суб’єктам відносин, пов’язаних із персональними даними) для надання послуг від нашого імені та/або виконання вимог законодавства. Передача іноземним суб’єктам відносин, пов’язаних із персональними даними, буде захищена належними засобами захисту та здійснюватиметься лише за умови забезпечення відповідною державою належного захисту персональних даних у випадках, встановлених законодавством України або міжнародними договорами України.\r\n\r\n4.3. Хостинг нашого Веб-сайту знаходиться в центрах даних м. Київ, Україна (хостинговий сервіс: HOSTiQ). У разі передачі даних на хостинг іноземним суб’єктам відносин, пов’язаних із персональними даними, такі дані будуть захищені належними засобами захисту, та лише за умови забезпечення відповідною державою належного захисту персональних даних у випадках, встановлених законодавством України або міжнародними договорами України.\r\n\r\n4.4. Якщо Ви заходите на даний Веб-сайт в країні, відмінній від країни перебування нашого сервера, комунікація між нами може передбачати передачу інформації за межі міжнародних державних кордонів. Відвідуючи наш Веб-сайт або іншим чином вступаючи з нами в електронну комунікацію, Ви погоджуєтеся на таку передачу. Навіть якщо у Вашій юрисдикції відсутні такі ж законодавчі норми про конфіденційність, як в юрисдикції місцезнаходження сервера, ми будемо вважати Вашу інформацію такою, що підлягає захисту, цією політикою конфіденційності.\r\n<ol start=\"5\">\r\n 	<li><strong> Повідомлення і розсилки</strong></li>\r\n</ol>\r\nЗаповнивши реєстраційну форму на сайті та проставивши під час складання реєстраційної форми графічного символа у полі, де пропонується надати згоду на розсилку інформаційних та маркетингових повідомлень, які містять інформацію щодо товарів та/або послуг, рекламні та комерційні пропозиції щодо таких товарів та/або послуг, з посиланнями на умови такої згоди (далі – Повідомлення), ви надали згоду на використання ваших контактних даних (адреса електронної пошти, номер телефону, інші мережеві ідентифікатори абонента) для надіслання Вам Повідомлень (підписуєтесь на розсилку) від нас, а також наших партнерів, зокрема ДУ «Інститут патології крові та трансфузійної медицини НАМН України», ПП «Інфузія» (далі – Згода).\r\n\r\nУ разі внесення подальших змін до Політики, ми повідомимо Вас про такі зміни листом на електронну пошту, адреса якої зазначена Вами при реєстрації.\r\n\r\nІнформаційні та рекламні розсилки здійснюються на підставі Вашої згоди (підписки на розсилки), оформленої Вами через Сайт, шляхом реєстрації на онлайн-захід, або при замовленні товарів та/або послуг через Сайт, заповнення окремої форми підписки на розсилки, чи форми зворотного зв’язку.\r\n\r\nМи можемо направляти Вам інформаційні та рекламні розсилки, які містять інформацію щодо товарів та/або послуг, маркетингові, рекламні та комерційні пропозиції щодо таких товарів та/або послуг.\r\n\r\nМи здійснюємо інформаційні, рекламні, маркетингові розсилки у вигляді електронних листів, повідомлень у Viber, SMS-повідомлень.\r\n\r\n<strong>Ви можете у будь-який час безкоштовно, у простій та зрозумілій формі відмовитися від отримання інформаційних та рекламних Повідомлень (відписатися від розсилок), та відкликати свою Згоду на отримання Повідомлень (розсилку).</strong>\r\n\r\nПорядок відписки від розсилки:\r\n<ul>\r\n 	<li><strong>Електронні листи. </strong>Для відмови від отримання Повідомлень(відписки від розсилки), що надсилаються на адресу вашої електронної пошти, перейдіть за гіперпосиланням «відписатись від розсилки», яке знаходиться в кінці кожного електронного листа.</li>\r\n 	<li><strong>Viber</strong><strong>-розсилки</strong>. Для відмови від отримання Повідомлень(відписки від розсилки), що надсилаються через застосунок Viber на Вашому смартфоні, Вам необхідно у самому застосунку Viber обрати контакт, з якого Ви отримуєте Повідомлення від нас, натиснути «Детально», та зняти галочку «Отримувати повідомлення».</li>\r\n 	<li><strong>SMS</strong><strong>-розсилка</strong>. Щоб відписатися від розсилки SMS-повідомлень, напишіть, будь ласка, у довільній формі звернення щодо відписки від SMS-розсилки на поштову скриньку <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. У своєму листі обов’язково зазначте Ваш контактний номер телефону, який Ви хочете відписати від розсилки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong>Збереження та видалення персональних даних</strong></li>\r\n</ol>\r\n6.1. У даному розділі описана політика і процедура зберігання даних, що забезпечує дотримання нами юридичних зобов’язань щодо збереження і видалення персональних даних.\r\n\r\n6.2. Ми можемо зберігати Вашу персональну інформацію лише протягом строку, протягом якого у нас є законний інтерес для цього. Після того, як необхідність у відповідних даних відпала, ми видаляємо інформацію, яка може будь-яким чином ідентифікувати Вашу особу, однак можемо зберігати анонімізовані (знеособлені) дані, наприклад, для аналітичних чи дослідницьких цілей, зокрема, нами може здійснюватися передача такої інформації тертім особам, однак лише за умови видалення будь-яких персональних даних про Вас.\r\n\r\n6.3. Ваші персональні дані зберігаються протягом мінімального періоду – 1 робочий день після надання Вашої згоди з даною Політикою конфіденційності, а також протягом максимального періоду – 3 робочих дня після повідомлення про скасування підписки або запиту про видалення даних.\r\n\r\n6.4. Незважаючи на викладені вище положення даного розділу 6, ми зберігаємо Ваші персональні дані, якщо таке збереження інформації необхідне для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів, або життєво важливих інтересів інших фізичних осіб.\r\n<ol start=\"7\">\r\n 	<li><strong> Зміни та доповнення</strong></li>\r\n</ol>\r\n7.1. Ми можемо періодично оновлювати дану Політику, публікуючи нову версію на нашому Веб-сайті.\r\n\r\n7.2. Ми можемо в будь-який момент змінити або доповнити дану Політику на наш розсуд. Такі зміни вступають в силу відразу ж після опублікування повідомлення про зміну або доповнення на даному сайті. Ми також можемо повідомляти Вас про зміну Політики через електронну пошту або інші засоби електронної комунікації. Продовжуючи використовувати Веб-сайт, Ви підтверджуєте згоду з умовами Політики з відповідними змінами та доповненнями.\r\n<ol start=\"8\">\r\n 	<li><strong>Ваші права </strong><strong>та </strong><strong>обов’язки</strong></li>\r\n</ol>\r\n8.1. У даному розділі ми дамо коротку довідку про Ваші права за законодавством про захист даних. Деякі права є комплексними і не всі подробиці включені в нашу довідку. Таким чином, Вам слід ознайомитися з відповідними законами і настановами регуляторних органів, щоб отримати повне роз’яснення таких прав.\r\n\r\n8.2. Ви маєте право на виправлення будь-яких неправильних персональних даних про Вас і, з урахуванням цілей обробки, на доповнення неповних персональних даних про Вас.\r\n\r\n8.3. У деяких випадках Ви маєте право видалити Ваші персональні дані без зайвого зволікання. До таких випадків відносяться:\r\n<ul>\r\n 	<li>персональні дані, які вже не потрібні для тих цілей, для яких вони збиралися або оброблялися іншим чином;</li>\r\n 	<li>скасування Вами згоди на обробку даних, обробка яких вимагає Вашої згоди;</li>\r\n 	<li>якщо Ви проти обробки даних відповідно до норм законодавства про захист даних;</li>\r\n 	<li>незаконна обробка персональних даних.</li>\r\n</ul>\r\nПри цьому існують винятки з права на видалення даних. Загальне виключення передбачає необхідність обробки для реалізації свободи висловлювання та права на інформацію; дотримання передбаченого законом зобов’язання; пред’явлення, реалізації або захисту законних претензій.\r\n\r\n8.4. У деяких випадках Ви маєте право обмежити обробку Ваших персональних даних. До таких випадків відносяться:\r\n<ul>\r\n 	<li>заперечення Вами точності персональних даних;</li>\r\n 	<li>обробка була здійснена незаконним шляхом, однак Ви проти видалення даних;</li>\r\n 	<li>нам вже не потрібні персональні дані для цілей, в яких вони оброблялися, але Вам знадобилися персональні дані для пред’явлення, реалізації або захисту законних претензій;</li>\r\n 	<li>Ви проти обробки, до перевірки такого протесту.</li>\r\n</ul>\r\nЯкщо обробка була обмежена на цій підставі, ми можемо продовжувати зберігати Ваші персональні дані. При цьому ми однаково будемо здійснювати її обробку іншим шляхом:\r\n<ul>\r\n 	<li>за Вашою згодою, для пред’явлення, реалізації або захисту законних претензій;</li>\r\n 	<li>для захисту прав інших фізичних або юридичних осіб;</li>\r\n 	<li>з інших причин, пов’язаних з важливими суспільними інтересами.</li>\r\n</ul>\r\n8.5. Щоб допомогти нам захистити Вашу приватність:\r\n<ul>\r\n 	<li>завершіть сеанс на Веб-сайті після завершення роботи з ним;</li>\r\n 	<li>надайте нам правдиву, точну і повну інформацію;</li>\r\n 	<li>не використовуйте Веб-сайт, якщо Ви молодше 18 років;</li>\r\n 	<li>не надавайте нам інформацію про будь-кого іншого, якщо у вас немає на це дозволу.</li>\r\n</ul>\r\n8.6. Якщо Ви хочете дізнатися більше про те, яку саме інформацію про Вас ми зберігаємо, включаючи зміни або запити на видалення, Ви маєте право подати Запит суб’єкта персональних даних. Ви можете подати запит на електронну адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просимо звернути Вашу увагу на те, що ми повинні будемо виключити деяку інформацію як частину Вашого запиту, наприклад, для захисту приватності інших осіб, або якщо у нас є законні чи інші причини виключати таку інформацію.\r\n\r\n8.7. Будь ласка, зверніть увагу, що видалення Вашої персональної інформації обмежить нашу можливість зв’язатися з Вами для надання пропозицій, що, в свою чергу, обмежить Вашу можливість скористатися такими пропозиціями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файли </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – це файли, що містять ідентифікатор (набір букв і цифр), відправлений інтернет-сервером інтернет-браузеру, і який зберігається в браузері. Потім ідентифікатор прямує назад на сервер кожен раз, коли браузер запитує сторінку на сервері.\r\n\r\n9.2. Cookie – файли можуть бути \"постійними\" або \"сесійними\". Постійні cookie зберігаються в браузері та діють до дати закінчення терміну дії, якщо не будуть видалені до настання такої дати; сесійні cookie припиняють дію після завершення сесії користувачем, після закриття браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, які ми використовуємо</strong></li>\r\n</ol>\r\n10.1. Ми використовуємо cookie в наступних цілях:\r\n<ul>\r\n 	<li>аутентифікація – ми використовуємо cookie для Вашої ідентифікації під час відвідування Вами Веб-сайту та навігації по ньому;</li>\r\n 	<li>статус – ми використовуємо cookie, щоб допомогти визначити, чи ввійшли Ви на наш Веб-сайт під своїм логіном;</li>\r\n 	<li>персоналізація – ми використовуємо cookie, щоб зберігати інформацію про Ваші уподобання і персоналізувати Веб-сайт під ваші потреби;</li>\r\n 	<li>безпека – ми використовуємо cookie як елемент захисту облікового запису користувача, в тому числі для запобігання несанкціонованого використання даних входу і захисту нашого Веб-сайту, та послуг в цілому;</li>\r\n 	<li>реклама – ми використовуємо cookie, щоб показувати рекламу, яка може бути Вам цікава;</li>\r\n 	<li>аналіз – ми використовуємо cookie, щоб проаналізувати ефективність нашого Веб-сайту та послуг;</li>\r\n 	<li>згода – ми використовуємо cookie, щоб зберігати Ваші уподобання щодо використання cookie для більш великих цілей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, використовувані нашими постачальниками послуг</strong></li>\r\n</ol>\r\n11.1. Наші постачальники послуг використовують cookie і вони можуть зберігатися на вашому комп’ютері під час відвідування Веб-сайту.\r\n\r\n11.2. Для аналізу використання нашого Веб-сайту ми використовуємо Google Analytics. Google Analytics збирає інформацію про використання нашого Веб-сайту за допомогою cookie. Зібрана інформація, що стосується нашого Веб-сайту, використовується для створення звітів про використання нашого Вебсайту. Політика конфіденційності Google доступна за <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>цим </strong><strong>посиланням</strong></a>.\r\n\r\n11.3. Сookies від Analytics допомагає нам зрозуміти скільки відвідувачів заходить на наш Веб-сайт, скільки разів вони його відвідали і скільки разів передивлялися певні сторінки на нашому сайті. Незважаючи на те, що cookiе аналітики дозволяють нам збирати певну інформацію про Вашу веб історію або про те, скільки разів Ви заходили на сайт, ми не можемо використовувати це щоб дізнатися Ваші дані, наприклад, ім’я чи адресу.\r\n<ol start=\"12\">\r\n 	<li><strong>Управління файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Якщо Ви не хочете приймати cookies від нашого Веб-сайту, Ви можете змінити налаштування Вашого браузера і cookie більше не будуть прийматися. Якщо Ви приймете таке рішення, будь ласка, зверніть увагу, що Веб-сайт не зможе функціонувати як раніше.\r\n\r\n12.2. Усі популярні браузери (Google Chrome, Safari,Microsoft Edge, Mozilla Firefox, Samsung Internet, Opera) дозволяють змінювати налаштування cookie таким чином, щоб не включати їх ні на яких відвідуваних Вами сайтах. Ви можете знайти інформацію про відключення cookie в основних браузерах в розділі \"Як управляти файлами cookie\", зокрема на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайті</strong><strong>Офісу Уповноваженого з питань інформації Великої Британії</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Як з нами </strong><strong>зв’язатися</strong></li>\r\n</ol>\r\nЗ питань обробки персональних даних, будь ласка, звертайтеся:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u></a><u><a href=\"mailto:uf@uf.ua\">ua</a>\r\n</u>Будемо раді Вас вітати! Ми дуже цінуємо Вашу думку, коментарі або пропозиції – вони допомагають нам покращувати якість нашої роботи.\r\n<strong>Ця Політик</strong><strong>а</strong><strong> в редакції станом на </strong><strong>12</strong><strong>.</strong><strong>0</strong><strong>9</strong><strong>.</strong><strong>2022</strong><strong>.</strong>','Політика конфіденційності','','publish','closed','closed','','terms-of-use','','','2022-09-15 17:38:32','2022-09-15 14:38:32','',0,'https://reo.ua/?page_id=290',12,'page','',0),(5,1,'2021-06-08 15:17:17','2021-06-08 12:17:17','<div class=\"title\"><h3>Напишите нам</h3></div>\r\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Имя*\"]</div>\r\n<div class=\"form-group\">[email* email class:form-control placeholder \"Контактный e-mail*\"]</div>\r\n<div class=\"form-group\">[tel* tel class:form-control placeholder \"Контактный телефон*\"]</div>\r\n<div class=\"form-group\">[textarea mailtext class:form-control placeholder \"Сообщение\"]</div>\r\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я соглашаюсь с <a href=\"/ru/terms-of-use/\" target=\"_blank\" rel=\"noopener\">Политикой конфиденциальности</a>.</div>\r\n<div class=\"form-group align-right\">[submit class:butn \"Отправить\"]</div>\r\n<div class=\"form-group requaired\"><p>* Поля, отмеченные звездочкой, обязательны для заполнения.</p></div>\n1\nОбратная связь\nsend@reo.ua\nn.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\n<p><strong>Имя:</strong> [nname]</p>\r\n<p><strong>Email:</strong> [email]</p>\r\n<p><strong>Телефон:</strong> [tel]</p>\r\n<p><strong>Сообщение:</strong> [mailtext]</p>\n\n\n1\n1\n\n[_site_title] \"[your-subject]\"\n[_site_title] <wordpress@reo.tonic-adv.com>\n[your-email]\nСообщение:\r\n[your-message]\r\n\r\n-- \r\nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\nReply-To: [_site_admin_email]\n\n\n\nСпасибо за Ваше сообщение. Оно успешно отправлено.\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nОдно или несколько полей содержат ошибочные данные. Пожалуйста, проверьте их и попробуйте ещё раз.\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nВы должны принять условия и положения перед отправкой вашего сообщения.\nПоле обязательно для заполнения.\nПоле слишком длинное.\nПоле слишком короткое.\nПри загрузке файла произошла неизвестная ошибка.\nВам не разрешено загружать файлы этого типа.\nФайл слишком большой.\nПри загрузке файла произошла ошибка.\nФормат даты некорректен.\nВведённая дата слишком далеко в прошлом.\nВведённая дата слишком далеко в будущем.\nФормат числа некорректен.\nЧисло меньше минимально допустимого.\nЧисло больше максимально допустимого.\nНеверный ответ на проверочный вопрос.\nНеверно введён электронный адрес.\nВведён некорректный URL адрес.\nВведён некорректный телефонный номер.','Обратная связь (ру)','','publish','closed','closed','','kontaktnaya-forma-1','','','2022-06-29 15:14:19','2022-06-29 12:14:19','',0,'https://reo.ua/?post_type=wpcf7_contact_form&#038;p=5',0,'wpcf7_contact_form','',0),(8,1,'2021-06-08 15:21:10','2021-06-08 12:21:10','','Головна','','publish','closed','closed','','home','','','2021-09-30 20:24:57','2021-09-30 17:24:57','',0,'https://reo.ua/?page_id=8',1,'page','',0),(111,1,'2021-06-09 10:11:49','2021-06-09 07:11:49','a:7:{s:8:\"location\";a:1:{i:0;a:1:{i:0;a:3:{s:5:\"param\";s:13:\"page_template\";s:8:\"operator\";s:2:\"==\";s:5:\"value\";s:14:\"page-about.php\";}}}s:8:\"position\";s:6:\"normal\";s:5:\"style\";s:7:\"default\";s:15:\"label_placement\";s:3:\"top\";s:21:\"instruction_placement\";s:5:\"label\";s:14:\"hide_on_screen\";a:1:{i:0;s:11:\"the_content\";}s:11:\"description\";s:0:\"\";}','Про воду','pro-vodu','publish','closed','closed','','group_60c069a27c606','','','2021-06-09 11:10:42','2021-06-09 08:10:42','',0,'https://reo.ua/?post_type=acf-field-group&#038;p=111',0,'acf-field-group','',0),(9,1,'2021-06-08 15:21:10','2021-06-08 12:21:10','','Головна','','inherit','closed','closed','','8-revision-v1','','','2021-06-08 15:21:10','2021-06-08 12:21:10','',8,'https://reo.ua/?p=9',0,'revision','',0),(11,1,'2021-06-08 15:22:03','2021-06-08 12:22:03','','Про воду ReO','','publish','closed','closed','','about','','','2021-12-21 13:33:01','2021-12-21 10:33:01','',0,'https://reo.ua/?page_id=11',17,'page','',0),(12,1,'2021-06-08 15:22:03','2021-06-08 12:22:03','','Про воду ReO','','inherit','closed','closed','','11-revision-v1','','','2021-06-08 15:22:03','2021-06-08 12:22:03','',11,'https://reo.ua/?p=12',0,'revision','',0),(1149,1,'2021-07-14 11:03:22','2021-07-14 08:03:22',' ','','','publish','closed','closed','','1149','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',0,'https://reo.ua/?p=1149',17,'nav_menu_item','',0),(14,1,'2021-07-14 14:00:11','2021-06-08 12:23:24',' ','','','publish','closed','closed','','14','','','2021-07-14 14:00:11','2021-07-14 11:00:11','',0,'https://reo.ua/?p=14',1,'nav_menu_item','',0),(15,1,'2021-07-14 14:00:11','2021-06-08 12:23:24','','Як пити воду РеО','','publish','closed','closed','','yak-piti-vodu-reo','','','2021-07-14 14:00:11','2021-07-14 11:00:11','',0,'https://reo.ua/?p=15',2,'nav_menu_item','',0),(753,1,'2021-07-02 14:23:25','2021-07-02 11:23:25','Воду для медичних цілей РЕО можна придбати в аптеках та магазинах вашого міста:','Де придбати','','inherit','closed','closed','','747-revision-v1','','','2021-07-02 14:23:25','2021-07-02 11:23:25','',747,'https://reo.ua/?p=753',0,'revision','',0),(18,1,'2021-07-14 14:00:12','2021-06-08 12:23:24','','Часті питання','','publish','closed','closed','','chasti-pitannya','','','2021-07-14 14:00:12','2021-07-14 11:00:12','',0,'https://reo.ua/?p=18',8,'nav_menu_item','',0),(40,1,'2021-06-08 16:56:42','2021-06-08 13:56:42','a:7:{s:8:\"location\";a:1:{i:0;a:1:{i:0;a:3:{s:5:\"param\";s:13:\"page_template\";s:8:\"operator\";s:2:\"==\";s:5:\"value\";s:9:\"index.php\";}}}s:8:\"position\";s:6:\"normal\";s:5:\"style\";s:7:\"default\";s:15:\"label_placement\";s:3:\"top\";s:21:\"instruction_placement\";s:5:\"label\";s:14:\"hide_on_screen\";a:1:{i:0;s:11:\"the_content\";}s:11:\"description\";s:0:\"\";}','Главная','glavnaya','publish','closed','closed','','group_60bf766886634','','','2021-07-27 10:27:15','2021-07-27 07:27:15','',0,'https://reo.ua/?post_type=acf-field-group&#038;p=40',0,'acf-field-group','',0),(436,1,'2021-07-14 11:03:22','2021-06-25 07:50:58',' ','','','publish','closed','closed','','436','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=436',5,'nav_menu_item','',0),(395,1,'2021-06-24 14:35:52','2021-06-24 11:35:52',' ','','','publish','closed','closed','','395','','','2021-06-24 14:35:52','2021-06-24 11:35:52','',0,'https://reo.ua/bez-kategori%d1%97/395/',2,'nav_menu_item','',0),(396,1,'2021-06-24 14:46:03','2021-06-24 11:46:03','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і частим диханням може призвести до зневоднення. Симптомами зневоднення у дорослих виступають - відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення. У дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання; у немовлят – сухий підгузок протягом 3 годин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png\"><img class=\"aligncenter size-large wp-image-1114\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1-1024x663.png\" alt=\"\" width=\"1024\" height=\"663\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищеної температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','publish','open','open','','chomu-potribno-bagato-piti-pri-pidvishhenij-temperaturi','','','2021-07-14 10:18:29','2021-07-14 07:18:29','',0,'https://reo.ua/?p=396',41,'post','',0),(383,1,'2021-06-24 14:15:24','2021-06-24 11:15:24',' ','','','publish','closed','closed','','383','','','2021-06-24 14:15:24','2021-06-24 11:15:24','',0,'https://reo.ua/bez-kategori%d1%97/383/',3,'nav_menu_item','',0),(384,1,'2021-06-24 14:27:25','2021-06-24 11:27:25','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи різке порушення мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму, щоб позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються: солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости.\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати вживання  їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це може спричинити поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','publish','open','open','','znevodnennya-pri-harchovih-otruennyah','','','2021-07-13 16:43:09','2021-07-13 13:43:09','',0,'https://reo.ua/?p=384',44,'post','',0),(440,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','440','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=440',13,'nav_menu_item','',0),(410,1,'2021-06-25 10:18:06','2021-06-25 07:18:06',' ','','','publish','closed','closed','','410','','','2021-06-25 10:18:06','2021-06-25 07:18:06','',0,'https://reo.ua/bez-kategori%d1%97/410/',6,'nav_menu_item','',0),(411,1,'2021-06-25 10:22:53','2021-06-25 07:22:53','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при інтенсивному диханні ротом. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце. Втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО - це маломінералізованна вода, що містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','publish','open','open','','skilki-potribno-piti-pid-chas-trenuvan','','','2021-07-14 02:32:40','2021-07-13 23:32:40','',0,'https://reo.ua/?p=411',38,'post','',0),(438,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','438','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',0,'https://reo.ua/?p=438',8,'nav_menu_item','',0),(439,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','439','','','2021-07-14 11:03:22','2021-07-14 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11:11:54','2021-06-15 08:11:54','','Производитель','','inherit','closed','closed','','178-autosave-v1','','','2021-06-15 11:11:54','2021-06-15 08:11:54','',178,'https://reo.ua/?p=274',0,'revision','',0),(275,1,'2021-06-15 11:11:59','2021-06-15 08:11:59','','Производитель','','inherit','closed','closed','','178-revision-v1','','','2021-06-15 11:11:59','2021-06-15 08:11:59','',178,'https://reo.ua/?p=275',0,'revision','',0),(291,1,'2021-06-15 11:49:30','2021-06-15 08:49:30','Ласкаво просимо на reo.ua.\r\nДаний сайт є інтелектуальною власністю ТОВ \"Юрія-Фарм\". ТОВ \"Юрія-фарм\" - компанія, зареєстрована в Києві, Україна, з головним офісом в Києві, Україна, реєстраційний номер компанії: 30109129 (далі - ми, наш, нас), який керує даним Веб-сайтом (далі - \"Веб-сайт\").\r\n\r\nНам дуже важливо захистити ваші персональні дані. Ми зобов\'язуємося захищати приватність осіб, які відвідують наш Веб-сайт і використовують наші онлайн-інструменти. У даній Політиці конфіденційності ми хочемо розповісти вам про порядок збору, обробки та використання персональних даних.\r\n\r\nБудь ласка, зверніть увагу, що ви приймаєте цю Політику конфіденційності в разі перегляду Веб-сайту або його використання іншим чином, незалежно від того, чи попросять вас дати додатковий дозвіл під час використання Веб-сайту. Ознайомлення з цією політикою конфіденційності є виключно вашою відповідальністю.\r\n<h2>1. Інформація, яку ми збираємо</h2>\r\n1.1. Під час використання Веб-сайту, ви можете прийняти рішення про надання нам певної інформації про вас, заповнюючи онлайн-форми, реєструючись на нашому Веб-сайті, роблячи замовлення, звертаючись до нас та ін. Видами персональної інформації, яку ви можете нам надати, можуть бути, без обмеження, контактна інформація (адреса, електронна пошта, номер телефону, факсу), ім\'я користувача і особисті вподобання, інтереси та використання різних продуктів і послуг, зміст комунікації з нами. Для доступу на Веб-сайт ви не зобов\'язані надавати перелічені нижче персональні дані, проте в такому випадку деякі функції можуть бути вам недоступні.\r\n\r\n1.2. Відразу після того, як ви зайшли на сайт, ми можемо автоматично отримати деяку інформацію, яка може бути використана для вашої ідентифікації, наприклад, номер домену, IP-адреса вашого комп\'ютера, вид використовуваного вами браузера, операційної системи та платформи, технічна інформація, інформація про географічне місцезнаходження під час відвідування Веб-сайту (тривалість перебування, популярні продукти, час відгуку сторінки, шляхи навігації, а також інформація про час, частоту та спосіб використання послуги вами та ін.). Ми можемо використовувати таку інформацію окремо або в сукупності, для технічного управління нашим Веб-сайтом, аналітичної системи відстеження, досліджень і розробок. Правова підстава такої обробки - наші законні інтереси для моніторингу та поліпшення нашого Веб-сайту та послуг.\r\n<h2>2. Обробка персональних даних</h2>\r\nМи захищаємо ваші дані, обмежуючи доступ до ваших даних тільки особами, які повинні мати до них доступ для здійснення або спрощення операцій між вами і нами, або особами, які з інших причин повинні виконувати дії, описані в даному розділі.\r\n\r\n2.1. Ми можемо обробляти вашу інформацію, яка вказана у вашому профілі на нашому Веб-сайті. Дані профілю можуть містити ваше ім\'я, адресу, номер телефону, електронної адреси, фото профілю, стать, дату народження, сімейний статус, інтереси та хобі, дані про освіту й місце роботи. Ми свідомо не збираємо інформацію про осіб молодше 18 років. Дані профілю можуть бути оброблені для надання вам можливості використання та моніторингу нашого Веб-сайту та послуг, створення вашого особистого профілю й управління ним, роботи з Веб-сайтом, надання наших послуг, забезпечення безпеки нашого Веб-сайту та послуг, резервного зберігання даних в наших базах і спілкування з вами. Правова підстава такої обробки - наші законні інтереси для належного управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.2. Ми можемо обробляти інформацію, яку ви публікуєте на нашому Веб-сайті або через наші послуги. Дані публікації можуть бути оброблені з метою дозволу публікацій або управління нашим Веб-сайтом і послугами. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.3. Ми можемо обробляти інформацію з вашого запиту про товари і/або послуги. Дані запиту можуть бути оброблені з цілю пропозиції, маркетингу та продажу відповідних товарів і/або послуг вам та для обробки ваших окремих запитів. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.4. Ми можемо обробляти інформацію, пов\'язану із взаємовідносинами з клієнтами, в тому числі контактну інформацію клієнта. Дані про взаємини клієнта можуть включати ім\'я, роботодавця, назва посади або ролі, контактну інформацію, інформацію, отриману в комунікації між нами. Дані про взаємини клієнта можуть оброблятися з метою управління нашими взаєминами з клієнтами, комунікації з клієнтами, ведення записів про таку комунікацію, допомоги при виборі товарів і надання вам рекомендацій, рекламування наших товарів і послуг клієнтам. Правовою підставою такої обробки є належне управління взаєминами з клієнтом.\r\n\r\n2.5. Ми можемо обробляти надану вами інформацію з метою підписання вас на наші електронні розсилки та/або інформаційні листи. Дані про повідомлення можуть оброблятися з метою відправки вам відповідних повідомлень та/або інформаційних листів, інформації про нашу продукцію, послуги і рекламних матеріалів. Після того, як ви підпишетеся на розсилку новин на нашому Веб-сайті, ми направимо вам повідомлення на вказану електронну адресу для підтвердження. Якщо ви не підтвердите підписку, вона буде автоматично видалена. Ви можете в будь-який момент відкликати свою згоду на отримання нашої розсилки. Щоб відписатися від розсилки, перейдіть за посиланням, яке надається у всіх інформаційних розсилках, напишіть нам листа електронною поштою за адресою, вказаною в розділі 12 \"Як з нами зв\'язатися\" або зателефонуйте +38 (044) 246-83-83. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.6. На додаток до цілей, для яких ми можемо обробляти ваші персональні дані, викладеним в цьому розділі, ми також можемо обробляти ваші персональні дані, якщо така обробка необхідна для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>3. Надання ваших персональних даних іншим особам</h2>\r\nМи не передаємо в оренду, не продаємо або іншим чином не розголошуємо персональну інформацію, яку ми збираємо, за винятком описаних нижче випадків. Ми можемо поділитися вашими персональними даними для здійснення дій, описаних в даному розділі.\r\n\r\n3.1. Ми можемо розголосити ваші персональні дані будь-якому учаснику нашої групи компаній (тобто дочірнім підприємствам, кінцевій холдинговій компанії та всім її дочірнім підприємствам), якщо це обґрунтовано необхідно для цілей та правових підстав, передбачених цією політикою.\r\n\r\n3.2. Ми можемо розголосити ваші персональні дані нашим постачальникам послуг, що надають послуги від нашого імені, по нашим розпорядженням, страховикам або професійним консультантам, якщо це обґрунтовано необхідно для отримання відповідної страховки, управління ризиками, отримання професійної консультації та надання послуг.\r\n\r\nМи можемо поділитися вашими персональними даними з нашими постачальниками послуг, які беруть участь в наших бізнес-процесах.\r\n\r\n<u>Приклад використання персональних даних нашими постачальниками послуг:</u>\r\n<ul>\r\n 	<li>ми передаємо вашу персональну інформацію постачальникам послуг, що допомагають нам в діяльності, яка пов\'язана з маркетингом та аналізом даних, щоб повідомляти вас і надавати рекомендації про нашу продукцію, в тому числі про розпродажі, спеціальні пропозиції, нові характеристики Веб-сайту, направляти вам повідомлення рекламного характеру. Нашими постачальниками маркетингових послуг і даних є \"Google Analytics\", \"Contact Form 7\", \"AddThis\". Політика конфіденційності наших постачальників послуг доступна на їх відповідних Веб-сайтах.</li>\r\n</ul>\r\nМи не аналізуємо таких постачальників послуг, страховиків і професійних консультантів перед використанням або розголошенням персональної інформації, крім випадків, коли це необхідно для надання послуг від нашого імені або виконання вимог закону.\r\n\r\n3.3. На додаток окремим випадкам розголошення, викладеним у цьому розділі, ми також можемо розголошувати ваші персональні дані, якщо таке розголошення інформації необхідне для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб. Ми також можемо розголошувати ваші персональні дані, якщо таке розголошення необхідне для встановлення, реалізації або захисту законних вимог в судовому провадженні або в адміністративному порядку, або в порядку досудового вирішення спору.\r\n<h2>4. Передача ваших персональних даних за кордон</h2>\r\nВ даному розділі ми надаємо інформацію про випадки, в яких персональні дані можуть передаватися в країни за межі Європейської економічної зони (ЄЕЗ).\r\n\r\n4.1. Ми ділимося вашими персональними даними з нашими контрагентами за межами Європейської економічної зони (ЄЕЗ) для надання послуг від нашого імені і/або виконання вимог законодавства. Передача в такі країни буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.2. Хостинг нашого Веб-сайту знаходиться в центрах даних м. Київ, Україна (хостинговий сервіс: Mirohost.net). Передача на хостинги буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.3. Якщо ви заходите на даний Веб-сайт в країні, відмінній від країни перебування нашого сервера, комунікація між нами може передбачати передачу інформації за межі міжнародних державних кордонів. Відвідуючи наш Веб-сайт або іншим чином вступаючи з нами в електронну комунікацію, ви погоджуєтеся на таку передачу. Навіть якщо у вашій юрисдикції відсутні такі ж законодавчі норми про конфіденційність, як в юрисдикції місцезнаходження сервера, ми будемо вважати вашу інформацію підлягаючою захисту, передбаченим цією політикою конфіденційності.\r\n<h2>5. Збереження та видалення персональних даних</h2>\r\nВ даному розділі описана політика та процедура зберігання даних, що забезпечує дотримання нами юридичних зобов\'язань щодо збереження і видалення персональних даних.\r\n\r\n5.1. Ми можемо зберігати вашу персональну інформацію тільки протягом терміну, під час якого у нас є законний інтерес для цього. Таким чином, ми більше не вимагаємо цю інформацію у форматі, за яким можна ідентифікувати вашу особу, наприклад, якщо ми зберігаємо інформацію для аналітичних і дослідницьких цілей або з метою передачі інформації, ми видаляємо всі персональні дані про вас.\r\n\r\n5.2. Ваші персональні дані зберігаються протягом мінімального періоду - 1 робочий день після прийняття даної Політики конфіденційності, а також протягом максимального періоду 3 робочих дня після повідомлення про скасування підписки або запиту про видалення даних.\r\n\r\n5.3. Незважаючи на викладені вище положення даного розділу 5, ми зберігаємо ваші персональні дані, якщо таке збереження інформації необхідно для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>6. Зміни та доповнення</h2>\r\n6.1. Ми можемо періодично оновлювати дану політику, публікуючи нову версію на нашому Веб-сайті.\r\n\r\n6.2. Ми можемо в будь-який момент змінити або доповнити дану Політику конфіденційності на наш розсуд. Такі зміни вступають в силу відразу ж після опублікування повідомлення про зміну або доповнення на даному сайті. Ми також можемо повідомляти вас про зміни конфіденційності особистих даних за допомогою інших засобів, зокрема по електронній пошті. Продовжуючи використовувати Веб-сайт, ви підтверджуєте згоду з умовами Політики конфіденційності з відповідними змінами та доповненнями.\r\n<h2>7. Ваші права і обов\'язки</h2>\r\nВ даному розділі ми дамо коротку довідку про ваші права за законодавством про захист даних. Деякі права є комплексними і не всі подробиці включені в нашу довідку. Таким чином, вам слід ознайомитися з відповідними законами і постановами регуляторних органів, щоб отримати повне роз\'яснення таких прав.\r\n\r\n7.1. Ви маєте право на виправлення будь-яких неправильних персональних даних про вас і, з урахуванням цілей обробки, на доповнення неповних персональних даних про вас.\r\n\r\n7.2. У деяких випадках ви маєте право видалити ваші персональні дані без зайвого зволікання. До таких випадків відносяться: персональні дані, які вже не потрібні для тих цілей, для яких вони збиралися або оброблялися іншим чином; скасування вами згоди на обробку даних, що вимагає згоди; якщо ви проти обробки даних відповідно до визначених нормами законодавства про захист даних; обробка безпосередньо для маркетингових цілей; незаконна обробка персональних даних. При цьому існують винятки з права на видалення даних. Загальне виключення передбачає необхідність обробки для реалізації свободи висловлювання та права на інформацію; дотримання передбаченого законом зобов\'язання; пред\'явлення, реалізації або захисту законних претензій.\r\n\r\n7.3. У деяких випадках ви маєте право обмежити обробку ваших персональних даних. До таких випадків відносяться: заперечення вами точності персональних даних; обробка була здійснена незаконним шляхом, однак ви проти видалення даних; нам вже не потрібні персональні дані для цілей, в яких вони оброблялися, але вам знадобилися персональні дані для пред\'явлення, реалізації або захисту законних претензій; ви проти обробки, до перевірки такого протесту. Якщо обробка була обмежена на цій підставі, ми можемо продовжувати зберігати ваші персональні дані. При цьому ми все одно будемо здійснювати її обробку іншим шляхом: за вашою згодою, для пред\'явлення, реалізації або захисту законних претензій; для захисту прав інших фізичних або юридичних осіб; з інших причин, пов\'язаних з важливими суспільними інтересами.\r\n\r\n7.4. Щоб допомогти нам захистити вашу приватність: завершіть сеанс на Веб-сайті після завершення роботи з ним; надайте нам правдиву, точну і повну інформацію; не використовуйте Веб-сайт, якщо ви молодше 18 років; не надайте нам інформацію про будь-кого іншому, якщо у вас немає на це дозволу.\r\n\r\n7.5. Якщо ви хочете дізнатися більше про те, яку саме інформацію про вас ми зберігаємо, включаючи зміни або запити на видалення, ви маєте право подати Запит суб\'єкта персональних даних. Ви можете подати запит на електронну адресу info@uf.ua. Просимо звернути Вашу увагу на те, що ми повинні будемо виключити деяку інформацію як частину вашого запиту, наприклад, для захисту приватності інших осіб або якщо у нас є законні чи інші причини виключати таку інформацію.\r\n\r\n7.6. Будь ласка, зверніть увагу, що видалення вашої персональної інформації обмежить нашу можливість зв\'язатися з вами для надання пропозицій, що, в свою чергу, обмежить вашу можливість скористатися такими пропозиціями.\r\n<h2>8. Файли Cookie</h2>\r\n8.1. Сookie - це файли, що містять ідентифікатор (набір букв і цифр), відправлений інтернет-сервером інтернет-браузеру і який зберігається в браузері. Потім ідентифікатор прямує назад на сервер кожен раз, коли браузер запитує сторінку на сервері.\r\n\r\n8.2. Cookie-файли можуть бути \"постійними\" або \"сесійними\". Постійні cookie зберігаються в браузері та діють до дати закінчення терміну дії, якщо не будуть видалені до настання такої дати; сесійні cookie припиняють дію після завершення сесії користувачем, після закриття браузера.\r\n<h2>9. Сookie, які ми використовуємо</h2>\r\n9.1. Ми використовуємо cookie в наступних цілях: аутентифікація - ми використовуємо cookie для вашої ідентифікації під час відвідування вами Веб-сайту та навігації по ньому; статус - ми використовуємо cookie, щоб допомогти визначити, чи ввійшли ви на наш Веб-сайт під своїм логіном; персоналізація - ми використовуємо cookie, щоб зберігати інформацію про ваші уподобання і персоналізувати Веб-сайт під ваші потреби; безпека - ми використовуємо cookie як елемент захисту облікового запису користувача, в тому числі для запобігання несанкціонованого використання даних входу і захисту нашого Веб-сайту та послуг в цілому; реклама - ми використовуємо cookie, щоб показувати рекламу, яка може бути вам цікава; аналіз - ми використовуємо cookie, щоб проаналізувати ефективність нашого Веб-сайту та послуг; згода - ми використовуємо cookie, щоб зберігати ваші уподобання щодо використання cookie для більш великих цілей.\r\n<h2>10. Сookie, використовувані нашими постачальниками послуг</h2>\r\n10.1. Наші постачальники послуг використовують cookie і вони можуть зберігатися на вашому комп\'ютері під час відвідування Веб-сайту.\r\n\r\n10.2. Для аналізу використання нашого Веб-сайту ми використовуємо Google Analytics. Google Analytics збирає інформацію про використання нашого Веб-сайту за допомогою cookie. Зібрана інформація, що стосується нашого Веб-сайту використовується для створення звітів про використання нашого Веб-сайту. Політика конфіденційності Google доступна за посиланням: https://www.google.com/policies/privacy.\r\n\r\n10.3. Сookies від Analytics допомагає нам зрозуміти скільки відвідувачів заходить на наш Веб-сайт, скільки разів вони його відвідали і скільки разів передивлялися певні сторінки на нашому сайті. Незважаючи на те, що cookiе аналітики дозволяють нам збирати певну інформацію про Вашу веб історію або про те, скільки разів ви заходили на сайт, ми не можемо використовувати це щоб дізнатися ваші дані, наприклад, ім\'я чи адресу.\r\n<h2>11. Управління файлами Cookie</h2>\r\n11.1. Якщо ви не хочете приймати cookies від нашого Веб-сайту, ви можете змінити налаштування вашого браузера і cookie більше не будуть прийматися. Якщо ви приймете таке рішення, будь ласка, зверніть увагу, що Веб-сайт не зможе функціонувати як раніше.\r\n\r\n11.2. Всі популярні браузери (Chrome, Internet Explorer, Firefox, Opera та Safari) дозволяють змінювати налаштування cookie таким чином, щоб не включати їх ні на яких відвідуваних вами сайтах. Ви можете знайти інформацію про відключення cookie в основних браузерах в розділі \"Як знайти інформацію про контролюючі файли cookie\" на веб-сайті Інформаційних комісій https://ico.org.uk/for-the-public/online/cookies.\r\n<h2>12. Як з нами зв\'язатися</h2>\r\nЗ питань обробки персональних даних, будь ласка, звертайтеся:\r\n\r\nТел./Факс: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:info@uf.ua\">info@uf.ua</a>\r\n\r\nБудемо раді вам! Ми дуже цінуємо вашу думку, коментарі або пропозиції - вони допомагають нам покращувати якість нашої роботи.\r\n\r\nДякуємо, що вибрали reo.ua\r\n<p style=\"text-align: right;\">Дата вступу в силу: 24 травня 2018 року.</p>','','','inherit','closed','closed','','290-revision-v1','','','2021-06-15 11:49:30','2021-06-15 08:49:30','',290,'https://reo.ua/?p=291',0,'revision','',0),(292,1,'2021-06-15 11:50:25','2021-06-15 08:50:25','Ласкаво просимо на reo.ua.\r\nДаний сайт є інтелектуальною власністю ТОВ \"Юрія-Фарм\". ТОВ \"Юрія-фарм\" - компанія, зареєстрована в Києві, Україна, з головним офісом в Києві, Україна, реєстраційний номер компанії: 30109129 (далі - ми, наш, нас), який керує даним Веб-сайтом (далі - \"Веб-сайт\").\r\n\r\nНам дуже важливо захистити ваші персональні дані. Ми зобов\'язуємося захищати приватність осіб, які відвідують наш Веб-сайт і використовують наші онлайн-інструменти. У даній Політиці конфіденційності ми хочемо розповісти вам про порядок збору, обробки та використання персональних даних.\r\n\r\nБудь ласка, зверніть увагу, що ви приймаєте цю Політику конфіденційності в разі перегляду Веб-сайту або його використання іншим чином, незалежно від того, чи попросять вас дати додатковий дозвіл під час використання Веб-сайту. Ознайомлення з цією політикою конфіденційності є виключно вашою відповідальністю.\r\n<h2>1. Інформація, яку ми збираємо</h2>\r\n1.1. Під час використання Веб-сайту, ви можете прийняти рішення про надання нам певної інформації про вас, заповнюючи онлайн-форми, реєструючись на нашому Веб-сайті, роблячи замовлення, звертаючись до нас та ін. Видами персональної інформації, яку ви можете нам надати, можуть бути, без обмеження, контактна інформація (адреса, електронна пошта, номер телефону, факсу), ім\'я користувача і особисті вподобання, інтереси та використання різних продуктів і послуг, зміст комунікації з нами. Для доступу на Веб-сайт ви не зобов\'язані надавати перелічені нижче персональні дані, проте в такому випадку деякі функції можуть бути вам недоступні.\r\n\r\n1.2. Відразу після того, як ви зайшли на сайт, ми можемо автоматично отримати деяку інформацію, яка може бути використана для вашої ідентифікації, наприклад, номер домену, IP-адреса вашого комп\'ютера, вид використовуваного вами браузера, операційної системи та платформи, технічна інформація, інформація про географічне місцезнаходження під час відвідування Веб-сайту (тривалість перебування, популярні продукти, час відгуку сторінки, шляхи навігації, а також інформація про час, частоту та спосіб використання послуги вами та ін.). Ми можемо використовувати таку інформацію окремо або в сукупності, для технічного управління нашим Веб-сайтом, аналітичної системи відстеження, досліджень і розробок. Правова підстава такої обробки - наші законні інтереси для моніторингу та поліпшення нашого Веб-сайту та послуг.\r\n<h2>2. Обробка персональних даних</h2>\r\nМи захищаємо ваші дані, обмежуючи доступ до ваших даних тільки особами, які повинні мати до них доступ для здійснення або спрощення операцій між вами і нами, або особами, які з інших причин повинні виконувати дії, описані в даному розділі.\r\n\r\n2.1. Ми можемо обробляти вашу інформацію, яка вказана у вашому профілі на нашому Веб-сайті. Дані профілю можуть містити ваше ім\'я, адресу, номер телефону, електронної адреси, фото профілю, стать, дату народження, сімейний статус, інтереси та хобі, дані про освіту й місце роботи. Ми свідомо не збираємо інформацію про осіб молодше 18 років. Дані профілю можуть бути оброблені для надання вам можливості використання та моніторингу нашого Веб-сайту та послуг, створення вашого особистого профілю й управління ним, роботи з Веб-сайтом, надання наших послуг, забезпечення безпеки нашого Веб-сайту та послуг, резервного зберігання даних в наших базах і спілкування з вами. Правова підстава такої обробки - наші законні інтереси для належного управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.2. Ми можемо обробляти інформацію, яку ви публікуєте на нашому Веб-сайті або через наші послуги. Дані публікації можуть бути оброблені з метою дозволу публікацій або управління нашим Веб-сайтом і послугами. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.3. Ми можемо обробляти інформацію з вашого запиту про товари і/або послуги. Дані запиту можуть бути оброблені з цілю пропозиції, маркетингу та продажу відповідних товарів і/або послуг вам та для обробки ваших окремих запитів. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.4. Ми можемо обробляти інформацію, пов\'язану із взаємовідносинами з клієнтами, в тому числі контактну інформацію клієнта. Дані про взаємини клієнта можуть включати ім\'я, роботодавця, назва посади або ролі, контактну інформацію, інформацію, отриману в комунікації між нами. Дані про взаємини клієнта можуть оброблятися з метою управління нашими взаєминами з клієнтами, комунікації з клієнтами, ведення записів про таку комунікацію, допомоги при виборі товарів і надання вам рекомендацій, рекламування наших товарів і послуг клієнтам. Правовою підставою такої обробки є належне управління взаєминами з клієнтом.\r\n\r\n2.5. Ми можемо обробляти надану вами інформацію з метою підписання вас на наші електронні розсилки та/або інформаційні листи. Дані про повідомлення можуть оброблятися з метою відправки вам відповідних повідомлень та/або інформаційних листів, інформації про нашу продукцію, послуги і рекламних матеріалів. Після того, як ви підпишетеся на розсилку новин на нашому Веб-сайті, ми направимо вам повідомлення на вказану електронну адресу для підтвердження. Якщо ви не підтвердите підписку, вона буде автоматично видалена. Ви можете в будь-який момент відкликати свою згоду на отримання нашої розсилки. Щоб відписатися від розсилки, перейдіть за посиланням, яке надається у всіх інформаційних розсилках, напишіть нам листа електронною поштою за адресою, вказаною в розділі 12 \"Як з нами зв\'язатися\" або зателефонуйте +38 (044) 246-83-83. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.6. На додаток до цілей, для яких ми можемо обробляти ваші персональні дані, викладеним в цьому розділі, ми також можемо обробляти ваші персональні дані, якщо така обробка необхідна для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>3. Надання ваших персональних даних іншим особам</h2>\r\nМи не передаємо в оренду, не продаємо або іншим чином не розголошуємо персональну інформацію, яку ми збираємо, за винятком описаних нижче випадків. Ми можемо поділитися вашими персональними даними для здійснення дій, описаних в даному розділі.\r\n\r\n3.1. Ми можемо розголосити ваші персональні дані будь-якому учаснику нашої групи компаній (тобто дочірнім підприємствам, кінцевій холдинговій компанії та всім її дочірнім підприємствам), якщо це обґрунтовано необхідно для цілей та правових підстав, передбачених цією політикою.\r\n\r\n3.2. Ми можемо розголосити ваші персональні дані нашим постачальникам послуг, що надають послуги від нашого імені, по нашим розпорядженням, страховикам або професійним консультантам, якщо це обґрунтовано необхідно для отримання відповідної страховки, управління ризиками, отримання професійної консультації та надання послуг.\r\n\r\nМи можемо поділитися вашими персональними даними з нашими постачальниками послуг, які беруть участь в наших бізнес-процесах.\r\n\r\n<u>Приклад використання персональних даних нашими постачальниками послуг:</u>\r\n<ul>\r\n 	<li>ми передаємо вашу персональну інформацію постачальникам послуг, що допомагають нам в діяльності, яка пов\'язана з маркетингом та аналізом даних, щоб повідомляти вас і надавати рекомендації про нашу продукцію, в тому числі про розпродажі, спеціальні пропозиції, нові характеристики Веб-сайту, направляти вам повідомлення рекламного характеру. Нашими постачальниками маркетингових послуг і даних є \"Google Analytics\", \"Contact Form 7\", \"AddThis\". Політика конфіденційності наших постачальників послуг доступна на їх відповідних Веб-сайтах.</li>\r\n</ul>\r\nМи не аналізуємо таких постачальників послуг, страховиків і професійних консультантів перед використанням або розголошенням персональної інформації, крім випадків, коли це необхідно для надання послуг від нашого імені або виконання вимог закону.\r\n\r\n3.3. На додаток окремим випадкам розголошення, викладеним у цьому розділі, ми також можемо розголошувати ваші персональні дані, якщо таке розголошення інформації необхідне для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб. Ми також можемо розголошувати ваші персональні дані, якщо таке розголошення необхідне для встановлення, реалізації або захисту законних вимог в судовому провадженні або в адміністративному порядку, або в порядку досудового вирішення спору.\r\n<h2>4. Передача ваших персональних даних за кордон</h2>\r\nВ даному розділі ми надаємо інформацію про випадки, в яких персональні дані можуть передаватися в країни за межі Європейської економічної зони (ЄЕЗ).\r\n\r\n4.1. Ми ділимося вашими персональними даними з нашими контрагентами за межами Європейської економічної зони (ЄЕЗ) для надання послуг від нашого імені і/або виконання вимог законодавства. Передача в такі країни буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.2. Хостинг нашого Веб-сайту знаходиться в центрах даних м. Київ, Україна (хостинговий сервіс: Mirohost.net). Передача на хостинги буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.3. Якщо ви заходите на даний Веб-сайт в країні, відмінній від країни перебування нашого сервера, комунікація між нами може передбачати передачу інформації за межі міжнародних державних кордонів. Відвідуючи наш Веб-сайт або іншим чином вступаючи з нами в електронну комунікацію, ви погоджуєтеся на таку передачу. Навіть якщо у вашій юрисдикції відсутні такі ж законодавчі норми про конфіденційність, як в юрисдикції місцезнаходження сервера, ми будемо вважати вашу інформацію підлягаючою захисту, передбаченим цією політикою конфіденційності.\r\n<h2>5. Збереження та видалення персональних даних</h2>\r\nВ даному розділі описана політика та процедура зберігання даних, що забезпечує дотримання нами юридичних зобов\'язань щодо збереження і видалення персональних даних.\r\n\r\n5.1. Ми можемо зберігати вашу персональну інформацію тільки протягом терміну, під час якого у нас є законний інтерес для цього. Таким чином, ми більше не вимагаємо цю інформацію у форматі, за яким можна ідентифікувати вашу особу, наприклад, якщо ми зберігаємо інформацію для аналітичних і дослідницьких цілей або з метою передачі інформації, ми видаляємо всі персональні дані про вас.\r\n\r\n5.2. Ваші персональні дані зберігаються протягом мінімального періоду - 1 робочий день після прийняття даної Політики конфіденційності, а також протягом максимального періоду 3 робочих дня після повідомлення про скасування підписки або запиту про видалення даних.\r\n\r\n5.3. Незважаючи на викладені вище положення даного розділу 5, ми зберігаємо ваші персональні дані, якщо таке збереження інформації необхідно для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>6. Зміни та доповнення</h2>\r\n6.1. Ми можемо періодично оновлювати дану політику, публікуючи нову версію на нашому Веб-сайті.\r\n\r\n6.2. Ми можемо в будь-який момент змінити або доповнити дану Політику конфіденційності на наш розсуд. Такі зміни вступають в силу відразу ж після опублікування повідомлення про зміну або доповнення на даному сайті. Ми також можемо повідомляти вас про зміни конфіденційності особистих даних за допомогою інших засобів, зокрема по електронній пошті. Продовжуючи використовувати Веб-сайт, ви підтверджуєте згоду з умовами Політики конфіденційності з відповідними змінами та доповненнями.\r\n<h2>7. Ваші права і обов\'язки</h2>\r\nВ даному розділі ми дамо коротку довідку про ваші права за законодавством про захист даних. Деякі права є комплексними і не всі подробиці включені в нашу довідку. Таким чином, вам слід ознайомитися з відповідними законами і постановами регуляторних органів, щоб отримати повне роз\'яснення таких прав.\r\n\r\n7.1. Ви маєте право на виправлення будь-яких неправильних персональних даних про вас і, з урахуванням цілей обробки, на доповнення неповних персональних даних про вас.\r\n\r\n7.2. У деяких випадках ви маєте право видалити ваші персональні дані без зайвого зволікання. До таких випадків відносяться: персональні дані, які вже не потрібні для тих цілей, для яких вони збиралися або оброблялися іншим чином; скасування вами згоди на обробку даних, що вимагає згоди; якщо ви проти обробки даних відповідно до визначених нормами законодавства про захист даних; обробка безпосередньо для маркетингових цілей; незаконна обробка персональних даних. При цьому існують винятки з права на видалення даних. Загальне виключення передбачає необхідність обробки для реалізації свободи висловлювання та права на інформацію; дотримання передбаченого законом зобов\'язання; пред\'явлення, реалізації або захисту законних претензій.\r\n\r\n7.3. У деяких випадках ви маєте право обмежити обробку ваших персональних даних. До таких випадків відносяться: заперечення вами точності персональних даних; обробка була здійснена незаконним шляхом, однак ви проти видалення даних; нам вже не потрібні персональні дані для цілей, в яких вони оброблялися, але вам знадобилися персональні дані для пред\'явлення, реалізації або захисту законних претензій; ви проти обробки, до перевірки такого протесту. Якщо обробка була обмежена на цій підставі, ми можемо продовжувати зберігати ваші персональні дані. При цьому ми все одно будемо здійснювати її обробку іншим шляхом: за вашою згодою, для пред\'явлення, реалізації або захисту законних претензій; для захисту прав інших фізичних або юридичних осіб; з інших причин, пов\'язаних з важливими суспільними інтересами.\r\n\r\n7.4. Щоб допомогти нам захистити вашу приватність: завершіть сеанс на Веб-сайті після завершення роботи з ним; надайте нам правдиву, точну і повну інформацію; не використовуйте Веб-сайт, якщо ви молодше 18 років; не надайте нам інформацію про будь-кого іншому, якщо у вас немає на це дозволу.\r\n\r\n7.5. Якщо ви хочете дізнатися більше про те, яку саме інформацію про вас ми зберігаємо, включаючи зміни або запити на видалення, ви маєте право подати Запит суб\'єкта персональних даних. Ви можете подати запит на електронну адресу info@uf.ua. Просимо звернути Вашу увагу на те, що ми повинні будемо виключити деяку інформацію як частину вашого запиту, наприклад, для захисту приватності інших осіб або якщо у нас є законні чи інші причини виключати таку інформацію.\r\n\r\n7.6. Будь ласка, зверніть увагу, що видалення вашої персональної інформації обмежить нашу можливість зв\'язатися з вами для надання пропозицій, що, в свою чергу, обмежить вашу можливість скористатися такими пропозиціями.\r\n<h2>8. Файли Cookie</h2>\r\n8.1. Сookie - це файли, що містять ідентифікатор (набір букв і цифр), відправлений інтернет-сервером інтернет-браузеру і який зберігається в браузері. Потім ідентифікатор прямує назад на сервер кожен раз, коли браузер запитує сторінку на сервері.\r\n\r\n8.2. Cookie-файли можуть бути \"постійними\" або \"сесійними\". Постійні cookie зберігаються в браузері та діють до дати закінчення терміну дії, якщо не будуть видалені до настання такої дати; сесійні cookie припиняють дію після завершення сесії користувачем, після закриття браузера.\r\n<h2>9. Сookie, які ми використовуємо</h2>\r\n9.1. Ми використовуємо cookie в наступних цілях: аутентифікація - ми використовуємо cookie для вашої ідентифікації під час відвідування вами Веб-сайту та навігації по ньому; статус - ми використовуємо cookie, щоб допомогти визначити, чи ввійшли ви на наш Веб-сайт під своїм логіном; персоналізація - ми використовуємо cookie, щоб зберігати інформацію про ваші уподобання і персоналізувати Веб-сайт під ваші потреби; безпека - ми використовуємо cookie як елемент захисту облікового запису користувача, в тому числі для запобігання несанкціонованого використання даних входу і захисту нашого Веб-сайту та послуг в цілому; реклама - ми використовуємо cookie, щоб показувати рекламу, яка може бути вам цікава; аналіз - ми використовуємо cookie, щоб проаналізувати ефективність нашого Веб-сайту та послуг; згода - ми використовуємо cookie, щоб зберігати ваші уподобання щодо використання cookie для більш великих цілей.\r\n<h2>10. Сookie, використовувані нашими постачальниками послуг</h2>\r\n10.1. Наші постачальники послуг використовують cookie і вони можуть зберігатися на вашому комп\'ютері під час відвідування Веб-сайту.\r\n\r\n10.2. Для аналізу використання нашого Веб-сайту ми використовуємо Google Analytics. Google Analytics збирає інформацію про використання нашого Веб-сайту за допомогою cookie. Зібрана інформація, що стосується нашого Веб-сайту використовується для створення звітів про використання нашого Веб-сайту. Політика конфіденційності Google доступна за посиланням: https://www.google.com/policies/privacy.\r\n\r\n10.3. Сookies від Analytics допомагає нам зрозуміти скільки відвідувачів заходить на наш Веб-сайт, скільки разів вони його відвідали і скільки разів передивлялися певні сторінки на нашому сайті. Незважаючи на те, що cookiе аналітики дозволяють нам збирати певну інформацію про Вашу веб історію або про те, скільки разів ви заходили на сайт, ми не можемо використовувати це щоб дізнатися ваші дані, наприклад, ім\'я чи адресу.\r\n<h2>11. Управління файлами Cookie</h2>\r\n11.1. Якщо ви не хочете приймати cookies від нашого Веб-сайту, ви можете змінити налаштування вашого браузера і cookie більше не будуть прийматися. Якщо ви приймете таке рішення, будь ласка, зверніть увагу, що Веб-сайт не зможе функціонувати як раніше.\r\n\r\n11.2. Всі популярні браузери (Chrome, Internet Explorer, Firefox, Opera та Safari) дозволяють змінювати налаштування cookie таким чином, щоб не включати їх ні на яких відвідуваних вами сайтах. Ви можете знайти інформацію про відключення cookie в основних браузерах в розділі \"Як знайти інформацію про контролюючі файли cookie\" на веб-сайті Інформаційних комісій https://ico.org.uk/for-the-public/online/cookies.\r\n<h2>12. Як з нами зв\'язатися</h2>\r\nЗ питань обробки персональних даних, будь ласка, звертайтеся:\r\n\r\nТел./Факс: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:info@uf.ua\">info@uf.ua</a>\r\n\r\nБудемо раді вам! Ми дуже цінуємо вашу думку, коментарі або пропозиції - вони допомагають нам покращувати якість нашої роботи.\r\n\r\nДякуємо, що вибрали reo.ua\r\n<p style=\"text-align: right;\">Дата вступу в силу: 24 травня 2018 року.</p>','Політика конфіденційності','','inherit','closed','closed','','290-revision-v1','','','2021-06-15 11:50:25','2021-06-15 08:50:25','',290,'https://reo.ua/?p=292',0,'revision','',0),(293,1,'2021-06-15 11:49:30','2021-06-15 08:49:30','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – <strong>Политика</strong>) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Политика конфиденциальности','','publish','closed','closed','','terms-of-use','','','2022-09-15 18:16:55','2022-09-15 15:16:55','',0,'https://reo.ua/terms-of-use/',12,'page','',0),(294,1,'2022-09-15 17:46:05','2022-09-15 14:46:05','','Политика конфиденциальности','','inherit','closed','closed','','293-autosave-v1','','','2022-09-15 17:46:05','2022-09-15 14:46:05','',293,'https://reo.ua/?p=294',0,'revision','',0),(1857,1,'2022-09-15 17:46:47','2022-09-15 14:46:47','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – Политика) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Политика конфиденциальности','','inherit','closed','closed','','293-revision-v1','','','2022-09-15 17:46:47','2022-09-15 14:46:47','',293,'https://reo.ua/?p=1857',0,'revision','',0),(295,1,'2021-06-15 11:55:49','2021-06-15 08:55:49','Добро пожаловать на reo.ua.\r\nДанный сайт является собственностью ООО \"Юрия-фарм\". ООО \"Юрия-фарм\" - компания, зарегистрированная в Киеве, Украина, с головным офисом в Киеве, Украина, регистрационный номер компании: 30109129 (далее - мы, наш, нас), который управляет данным Веб-сайтом (далее - \"Веб-сайт).\r\n\r\nНам очень важно защитить ваши персональные данные. Мы обязуемся защищать приватность лиц, посещающих наш Веб-сайт и использующих наши онлайн-инструменты. В данной Политике конфиденциальности мы хотим рассказать вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что вы принимаете данную Политику конфиденциальности в случае просмотра Веб-сайта или его использования иным образом, независимо от того, попросят ли вас дать дополнительное разрешение во время использования Веб-сайта. Ознакомление с данной Политикой конфиденциальности является исключительно вашей ответственностью.\r\n<h2>1. Информация, которую мы собираем</h2>\r\n1.1. Во время использования Веб-сайта, вы можете принять решение о предоставлении нам определенной информации о вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и пр. Видами персональной информации, которую вы можете нам предоставить, могут быть, без ограничения, контактная информация (адрес, электронная почта, номер телефона, факса), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт вы не обязаны предоставлять перечисленные ниже персональные данные, однако в таком случае некоторые функции могут быть вам недоступны.\r\n\r\n1.2. Сразу после того, как вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для вашей идентификации, например, номер домена, IP адрес вашего компьютера, вид используемого вами браузера, операционной системы и платформы, техническая информация, информация о географическом местонахождении во время посещения Вебсайта (длительность нахождения, просматриваемые продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги вами и пр.). Мы можем использовать такую информацию по отдельности или в совокупности, для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Правовое основание такой обработки - наши законные интересы для мониторинга и улучшения нашего Веб-сайта и услуг.\r\n<h2>2. Обработка персональной информации</h2>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать вашу информацию, которая указана в вашем профиле на нашем Веб-сайте. Данные профиля могут содержать ваше имя, адрес, номер телефона, электронного адреса, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах моложе 18 лет. Данные профиля могут быть обработаны для предоставления вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания вашего личного профиля и управления ним, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общения с вами. Правовое основание такой обработки - наши законные интересы для надлежащего управления нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, которую вы публикуете на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию из вашего запроса о товарах и/или услугах. Данные запроса могут быть обработаны с целю предложения, маркетинга и продажи соответствующих товаров и/или услуг вам и для обработки ваших отдельных запросов. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, в том числе контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, работодателя, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления наших взаимоотношений с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления вам рекомендаций, рекламирования наших товаров и услуг клиентам. Правовым основанием такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставляемую вами информацию с целью подписания вас на наши электронные рассылки и/или информационные письма. Данные об уведомлениях могут обрабатываться с целью отправки вам соответствующих уведомлений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалов. После того, как вы подпишетесь на новостную рассылку на нашем Веб-сайте, мы направим вам сообщение по указанному электронному адресу для подтверждения. Если вы не подведите подписку, она будет автоматически удалена. Вы можете в любой момент отозвать свое согласие на получение нашей новостной рассылки. Чтобы отписаться от рассылки, перейдите по ссылке, предоставленной во всех информационных рассылках, напишите нам электронное письмо по адресу, указанному в разделе 12 \"Как с нами связаться\" или позвоните по телефону +38 (044) 246-83-83. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать ваши персональные данные, изложенным в этом разделе, мы также можем обрабатывать ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц.\r\n<h2>3. Предоставление ваших персональных данных другим лицам</h2>\r\nМы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для совершения действий, описанных в данном разделе.\r\n\r\n3.1. Мы можем разгласить ваши персональные данные любому участнику нашей группы компаний (то есть дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных данной политикой.\r\n\r\n3.2. Мы можем разгласить ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<u>Пример использования персональных данных нашими поставщиками услуг:</u>\r\n<ul>\r\n 	<li>мы передаем вашу персональную информацию поставщикам услуг, помогающим нам в деятельности, связанной с маркетингом и анализом данных, чтобы уведомлять вас и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять вам уведомления рекламного характера. Нашими поставщиками маркетинговых услуг и данных являются “Google Analytics”, “Contact Form 7”, “AddThis”. Политика конфиденциальности наших поставщиков услуг доступна на их соответствующих Веб-сайтах.\r\nМы не анализируем таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона.</li>\r\n</ul>\r\n3.3. В дополнение отдельным случаям разглашения, изложенным в этом разделе, мы также можем разглашать ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном производстве или в административном порядке, либо в порядке досудебного решения спора.\r\n<h2>4. Передача ваших персональных данных за границу</h2>\r\nВ данном разделе мы предоставляем информацию о случаях, в которых персональные данные могут передаваться в страны за пределы Европейской экономической зоны (ЕЭЗ).\r\n\r\n4.1. Мы делимся вашими персональными данными с нашими контрагентами за пределами Европейской экономической зоны (ЕЭЗ) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача в такие страны будет защищена надлежащими средствами защиты, а именно стандартными пунктами о защите данных, принятыми или утвержденными Европейской Комиссией.\r\n\r\n4.2. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: Mirohost.net). Передача на хостинги будет защищена надлежащими средствами защиты, а именно стандартными пунктами о защите данных, принятыми или утвержденными Европейской Комиссией.\r\n\r\n4.3. Если вы заходите на данный Веб-сайт в стране, отличной от страны нахождения нашего сервера, коммуникация между нами может привести к передаче информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, вы соглашаетесь на такую передачу. Даже если в вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать вашу информацию подлежащей защите, предусмотренной данной Политикой конфиденциальности.\r\n<h2>5. Сохранение и удаление персональных данных</h2>\r\nВ данном разделе описана политика и процедура сохранения данных, обеспечивающая соблюдение нами юридических обязательств относительно сохранения и удаления персональных данных.\r\n\r\n5.1. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. Таким образом, мы больше не требуем информацию в формате, по которому можно идентифицировать вашу личность, например, если мы храним информацию для аналитических и исследовательских целей или с целью передачи информации, мы удаляем все персональные данные о вас.\r\n\r\n5.2. Ваши персональные данные хранятся в течение минимального периода - 1 рабочий день после принятия данной Политики конфиденциальности, а также в течение максимального периода 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n5.3. Несмотря на изложенные выше положения данного раздела 6, мы сохраняем ваши персональные данные, если такое сохранение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц.\r\n<h2>6. Изменения и дополнения</h2>\r\n6.1. Мы можем периодически обновлять данную политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n6.2. Мы можем в любой момент изменить или дополнить данную Политику конфиденциальности на наше усмотрение. Такие изменения вступают в силу сразу же после опубликования уведомления об изменении или дополнении на данном сайте. Мы также можем уведомлять вас об изменениях конфиденциальности личных данных при помощи других средств, в частности по электронной почте. Продолжая использовать Веб-сайт, вы подтверждаете согласие с условиями Политики конфиденциальности с соответствующими изменениями и дополнениями.\r\n<h2>7. Ваши права и обязанности</h2>\r\nВ данном разделе мы дадим краткую справку о ваших правах по законодательству о защите данных. Некоторые права являются комплексными и не все подробности включены в нашу справку. Таким образом, вам следует ознакомиться с соответствующими законами и руководствами регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n7.1. Вы имеете право на исправление любых неправильных персональных данных о вас и, с учетом целей обработки, на дополнение неполных персональных данных о вас.\r\n\r\n7.2. В некоторых случаях вы имеете право удалить ваши персональные данные без излишней задержки. К таким случаям относятся: персональные данные, которые уже не нужны для тех целей, для которых они собирались или обрабатывались иным образом; отмена вами согласия на обработку данных, требующую согласия; если вы против обработки данных в соответствии с определенными нормами законодательства о защите данных; обработка непосредственно для маркетинговых целей; незаконная обработка персональных данных. При этом существуют исключения из права на удаление данных. Общее исключение предусматривает необходимость обработки для реализации свободы высказывания и права на информацию; соблюдение предусмотренного законом обязательства; предъявления, реализации или защиты законных претензий.\r\n\r\n7.3. В некоторых случаях вы имеете право ограничить обработку ваших персональных данных. К таким случаям относятся: отрицание вами точности персональных данных; обработка была осуществлена незаконным путем, однако вы против удаления данных; нам уже не нужны персональные данные для целей, в которых они обрабатывались, но вам понадобились персональные данные для предъявления, реализации или защиты законных претензий; вы против обработки, до проверки такого протеста. Если обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем осуществлять ее обработку иным путем: по вашему согласию, для предъявления, реализации или защиты законных претензий; для защиты прав других физических или юридических лиц; по другим причинам, связанным с важными общественными интересами.\r\n\r\n7.4. Чтобы помочь нам защитить вашу приватность: завершите сеанс на Веб-сайте после завершения работы с ним; предоставьте нам правдивую, точную и полную информацию; не используйте Веб-сайт, если вы моложе 18 лет; не предоставляйте нам информацию о ком-либо другом, если у вас нет на это разрешения.\r\n\r\n7.5. Если вы хотите узнать больше о том, какую именно информацию о вас мы храним, включая изменения или запросы на удаление, вы имеете право подать Запрос субъекта персональных данных. Вы можете подать запрос по электронной почте <a href=\"mailto:info@uf.ua\">info@uf.ua</a>. Просим обратить Ваше внимание на то, что мы должны будем исключить некоторую информацию как часть вашего запроса, например, для защиты приватности других лиц или если у нас есть законные или иные причины исключать такую информацию.\r\n\r\n7.6. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<h2>8. Файлы Cookie</h2>\r\n8.1. Сookie - это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузеру и который хранится в браузере. Затем идентификатор направляется обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n8.2. Файлы сookie могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем, после закрытия браузера.\r\n<h2>9. Сookie, которые мы используем</h2>\r\n9.1. Мы используем cookie в следующих целях: аутентификация - мы используем cookie для вашей идентификации во время посещения вами Веб-сайта и навигации по нему; статус - мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином; персонализация - мы используем cookie, чтобы хранить информацию о ваших предпочтениях и персонализировать Веб-сайт под ваши нужды; безопасность - мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом; реклама - мы используем cookie, чтобы показывать рекламу, которая может быть вам интересна; анализ - мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг; согласие - мы используем cookie, чтобы хранить ваши предпочтения относительно использования cookie для более обширных целей.\r\n<h2>10. Сookie, используемые нашими поставщиками услуг</h2>\r\n10.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере во время посещения Веб-сайта.\r\n\r\n10.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта при помощи cookie. Собираемая информация, касающаяся нашего Веб-сайта используется для создания отчетов об использовании нашего Веб-сайта. Политика конфиденциальности Google доступна по ссылке: <a href=\"https://www.google.com/policies/privacy\" target=\"_blank\" rel=\"nofollow noopener\">https://www.google.com/policies/privacy</a>.\r\n\r\n10.3. Сookies от Analytics помогает нам понять сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривали определенные страницы на нашем сайте. Несмотря на то, что cookiе аналитики позволяют нам собирать определенную информацию о посещенных вами страницах или о том, сколько раз вы заходили на сайт, мы не можем использовать это чтобы узнать ваши данные, например, имя или адрес.\r\n<h2>11. Управление файлами Cookie</h2>\r\n11.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n11.2. Все популярные браузеры (Chrome, Internet Explorer, Firefox, Opera и Safari) позволяют менять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как найти информацию о контролирующих файлах cookie\" на веб-сайте Информационных комиссий <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"nofollow noopener\">https://ico.org.uk/for-the-public/online/cookies</a>.\r\n<h2>12. Как с нами связаться</h2>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\n\r\nТел./факс: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:info@uf.ua\">info@uf.ua</a>\r\n\r\nБудем рады вас приветствовать! Мы очень ценим ваши отзывы, комментарии или предложения - они помогают нам улучшать качество нашей работы.\r\n\r\nСпасибо что выбрали reo.ua\r\n<p style=\"text-align: right;\">Дата вступления в силу: 24 мая 2018 года.</p>','Политика конфиденциальности','','inherit','closed','closed','','293-revision-v1','','','2021-06-15 11:55:49','2021-06-15 08:55:49','',293,'https://reo.ua/?p=295',0,'revision','',0),(1855,1,'2022-09-15 17:37:46','2022-09-15 14:37:46','','Махфийлик сиёсати','','inherit','closed','closed','','1385-autosave-v1','','','2022-09-15 17:37:46','2022-09-15 14:37:46','',1385,'https://reo.ua/?p=1855',0,'revision','',0),(1856,1,'2022-09-15 17:38:32','2022-09-15 14:38:32','Нам дуже важливо захистити Ваші персональні дані. Ми зобов’язуємося захищати приватність осіб, які відвідують наш Веб-сайт і використовують наші онлайн-інструменти. У даній Політиці конфіденційності (далі – <strong>Політика</strong>) ми хочемо розповісти Вам про порядок збору, обробки та використання персональних даних.\r\n\r\nБудь ласка, зверніть увагу, що Ви приймаєте цю Політику конфіденційності в разі перегляду Веб-сайту або його використання іншим чином, незалежно від того, чи попросять Вас дати додатковий дозвіл під час використання Веб-сайту. Ознайомлення з цією політикою конфіденційності є виключно Вашою відповідальністю.\r\n<ol>\r\n 	<li><strong> Інформація, яку ми збираємо</strong></li>\r\n</ol>\r\n1.1. Під час використання Веб-сайту, Ви можете прийняти рішення про надання нам певної інформації про Вас, заповнюючи онлайн-форми, реєструючись на нашому Веб-сайті, роблячи замовлення, звертаючись до нас та ін. Видами персональної інформації, яку Ви можете нам надати, можуть бути, без обмеження, контактна інформація (адреса, електронна пошта, номер телефону), ім’я користувача і особисті вподобання, інтереси та використання різних продуктів і послуг, зміст комунікації з нами. Для доступу на Веб-сайт Ви не зобов’язані надавати перелічені вище персональні дані, проте в такому випадку деякі функції можуть бути Вам недоступні.\r\n\r\n1.2. Відразу після того, як Ви зайшли на сайт, ми можемо автоматично отримати деяку інформацію, яка може бути використана для Вашої ідентифікації, наприклад, номер домену, IP-адреса Вашого комп’ютера, вид використовуваного Вами браузера, операційної системи і платформи, технічна інформація, інформація про географічне місцезнаходження під час відвідування Веб-сайту (тривалість перебування, популярні продукти, час відгуку сторінки, шляхи навігації, а також інформація про час, частоту і спосіб використання послуги Вами та ін.). Ми можемо використовувати таку інформацію окремо або в сукупності, для технічного управління нашим Веб-сайтом, аналітичної системи відстеження, досліджень і розробок. Мета такої обробки – моніторинг та поліпшення нашого Веб-сайту та послуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обробка персональних даних</strong></li>\r\n</ol>\r\nМи захищаємо Ваші дані, обмежуючи доступ до Ваших даних тільки особами, які повинні мати до них доступ для здійснення або спрощення операцій між Вами і нами, або особами, які з інших причин повинні виконувати дії, описані в даному розділі.\r\n\r\n2.1. Ми можемо обробляти Вашу інформацію, яка вказана у Вашому профілі на нашому Веб-сайті. Дані профілю можуть містити Ваше ім’я, адресу, номер телефону, адресу електронної пошти, фото профілю, стать, дату народження, сімейний статус, інтереси та хобі, дані про освіту і місце роботи. Ми свідомо не збираємо інформацію про осіб молодше 18 років. Дані профілю можуть бути оброблені для надання Вам можливості використання та моніторингу нашого Веб-сайту та послуг, створення Вашого особистого профілю і управління ним, роботи з Веб-сайтом, надання наших послуг, забезпечення безпеки нашого Веб-сайту та послуг, резервного зберігання даних в наших базах і спілкування з Вами. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.2. Ми можемо обробляти інформацію, яку Ви публікуєте на нашому Веб-сайті або через наші послуги. Дані публікації можуть бути оброблені з метою дозволу публікацій або управління нашим Веб-сайтом і послугами. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.3. Ми можемо обробляти інформацію з Вашого запиту про товари і/або послуги. Дані запиту можуть бути оброблені з метою пропозиції, маркетингу та продажу відповідних товарів і/або послуг Вам та для обробки Ваших окремих запитів. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.4. Ми можемо обробляти інформацію, пов’язану із взаємовідносинами з клієнтами, зокрема контактну інформацію клієнта. Дані про взаємини клієнта можуть включати ім’я, місце роботи, назву посади або ролі, контактну інформацію, інформацію, що була отримана в комунікації між нами. Дані про взаємини клієнта можуть оброблятися з метою управління нашими взаєминами із клієнтами, комунікації з клієнтами, ведення записів про таку комунікацію, допомоги при виборі товарів і надання Вам рекомендацій, рекламування наших товарів і послуг клієнтам. Метою такої обробки є належне управління взаєминами з клієнтом.\r\n\r\n2.5. Ми можемо обробляти надану Вами інформацію з метою підписання Вас на наші електронні розсилки та/або інформаційні листи. Дані про повідомлення можуть оброблятися з метою відправки Вам відповідних повідомлень та/або інформаційних листів, інформації про нашу продукцію, послуги і рекламних матеріалів. Мета такої обробки – належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.6. На додаток до цілей, для яких ми можемо обробляти Ваші персональні дані, викладених у цьому розділі, ми також можемо обробляти Ваші персональні дані, якщо така обробка необхідна для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<ol start=\"3\">\r\n 	<li><strong> Надання </strong><strong>Ваших </strong><strong>персональних даних іншим особам</strong></li>\r\n</ol>\r\n3.1. Ми не передаємо в оренду, не продаємо або іншим чином не розголошуємо персональну інформацію, яку ми збираємо, за винятком описаних нижче випадків. Ми можемо поділитися Вашими персональними даними для здійснення дій, описаних у даному розділі.\r\n\r\n3.2. Ми можемо розголосити Ваші персональні дані будь-якому учаснику нашої групи компаній (тобто дочірнім підприємствам, кінцевій холдинговій компанії та всім її дочірнім підприємствам), якщо це обґрунтовано необхідно для цілей та за правових підстав, передбачених цією політикою.\r\n\r\n3.3. Ми можемо розголосити Ваші персональні дані нашим постачальникам послуг, що надають послуги від нашого імені, по нашим розпорядженням, страховикам або професійним консультантам, якщо це обґрунтовано необхідно для отримання відповідної страховки, управління ризиками, отримання професійної консультації і надання послуг.\r\n\r\nМи можемо поділитися Вашими персональними даними з нашими постачальниками послуг, які беруть участь в наших бізнес-процесах.\r\n\r\n<strong>Приклад використання персональних даних нашими постачальниками послуг:</strong>\r\n<ul>\r\n 	<li>ми передаємо Вашу персональну інформацію постачальникам послуг, що допомагають нам у діяльності, пов’язаної з маркетингом та аналізом даних, щоб повідомляти Вас і надавати рекомендації про нашу продукцію, в тому числі про розпродажі, спеціальні пропозиції, нові характеристики Веб-сайту, направляти Вам повідомлення рекламного характеру.</li>\r\n</ul>\r\nНашими постачальниками маркетингових послуг і даних є \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" та інші. Політика конфіденційності наших постачальників послуг доступна на їхніх Веб-сайтах. Ми не аналізуємо діяльність таких постачальників послуг, страховиків і професійних консультантів перед використанням або розголошенням персональної інформації, крім випадків, коли це необхідно для надання послуг від нашого імені або виконання вимог закону, однак у будь-якому разі ми не несемо жодної відповідальності за дії (діяльність)/бездіяльність таких постачальників послуг.\r\n\r\n3.4. На додаток окремим випадкам розголошення, викладеним в цьому розділі, ми також можемо розголошувати Ваші персональні дані, якщо таке розголошення інформації необхідне для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб. Ми також можемо розголошувати ваші персональні дані, якщо таке розголошення необхідне для встановлення, реалізації або захисту законних вимог у судовому провадженні або в адміністративному порядку, або в порядку досудового вирішення спору.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача </strong><strong>Ваших </strong><strong>персональних даних за кордон</strong></li>\r\n</ol>\r\n4.1. У даному розділі ми надаємо інформацію про випадки, в яких персональні дані можуть передаватися за межі України.\r\n\r\n4.2. Ми можемо передавати Ваші персональні дані нашим контрагентам за межами України (іноземним суб’єктам відносин, пов’язаних із персональними даними) для надання послуг від нашого імені та/або виконання вимог законодавства. Передача іноземним суб’єктам відносин, пов’язаних із персональними даними, буде захищена належними засобами захисту та здійснюватиметься лише за умови забезпечення відповідною державою належного захисту персональних даних у випадках, встановлених законодавством України або міжнародними договорами України.\r\n\r\n4.3. Хостинг нашого Веб-сайту знаходиться в центрах даних м. Київ, Україна (хостинговий сервіс: HOSTiQ). У разі передачі даних на хостинг іноземним суб’єктам відносин, пов’язаних із персональними даними, такі дані будуть захищені належними засобами захисту, та лише за умови забезпечення відповідною державою належного захисту персональних даних у випадках, встановлених законодавством України або міжнародними договорами України.\r\n\r\n4.4. Якщо Ви заходите на даний Веб-сайт в країні, відмінній від країни перебування нашого сервера, комунікація між нами може передбачати передачу інформації за межі міжнародних державних кордонів. Відвідуючи наш Веб-сайт або іншим чином вступаючи з нами в електронну комунікацію, Ви погоджуєтеся на таку передачу. Навіть якщо у Вашій юрисдикції відсутні такі ж законодавчі норми про конфіденційність, як в юрисдикції місцезнаходження сервера, ми будемо вважати Вашу інформацію такою, що підлягає захисту, цією політикою конфіденційності.\r\n<ol start=\"5\">\r\n 	<li><strong> Повідомлення і розсилки</strong></li>\r\n</ol>\r\nЗаповнивши реєстраційну форму на сайті та проставивши під час складання реєстраційної форми графічного символа у полі, де пропонується надати згоду на розсилку інформаційних та маркетингових повідомлень, які містять інформацію щодо товарів та/або послуг, рекламні та комерційні пропозиції щодо таких товарів та/або послуг, з посиланнями на умови такої згоди (далі – Повідомлення), ви надали згоду на використання ваших контактних даних (адреса електронної пошти, номер телефону, інші мережеві ідентифікатори абонента) для надіслання Вам Повідомлень (підписуєтесь на розсилку) від нас, а також наших партнерів, зокрема ДУ «Інститут патології крові та трансфузійної медицини НАМН України», ПП «Інфузія» (далі – Згода).\r\n\r\nУ разі внесення подальших змін до Політики, ми повідомимо Вас про такі зміни листом на електронну пошту, адреса якої зазначена Вами при реєстрації.\r\n\r\nІнформаційні та рекламні розсилки здійснюються на підставі Вашої згоди (підписки на розсилки), оформленої Вами через Сайт, шляхом реєстрації на онлайн-захід, або при замовленні товарів та/або послуг через Сайт, заповнення окремої форми підписки на розсилки, чи форми зворотного зв’язку.\r\n\r\nМи можемо направляти Вам інформаційні та рекламні розсилки, які містять інформацію щодо товарів та/або послуг, маркетингові, рекламні та комерційні пропозиції щодо таких товарів та/або послуг.\r\n\r\nМи здійснюємо інформаційні, рекламні, маркетингові розсилки у вигляді електронних листів, повідомлень у Viber, SMS-повідомлень.\r\n\r\n<strong>Ви можете у будь-який час безкоштовно, у простій та зрозумілій формі відмовитися від отримання інформаційних та рекламних Повідомлень (відписатися від розсилок), та відкликати свою Згоду на отримання Повідомлень (розсилку).</strong>\r\n\r\nПорядок відписки від розсилки:\r\n<ul>\r\n 	<li><strong>Електронні листи. </strong>Для відмови від отримання Повідомлень(відписки від розсилки), що надсилаються на адресу вашої електронної пошти, перейдіть за гіперпосиланням «відписатись від розсилки», яке знаходиться в кінці кожного електронного листа.</li>\r\n 	<li><strong>Viber</strong><strong>-розсилки</strong>. Для відмови від отримання Повідомлень(відписки від розсилки), що надсилаються через застосунок Viber на Вашому смартфоні, Вам необхідно у самому застосунку Viber обрати контакт, з якого Ви отримуєте Повідомлення від нас, натиснути «Детально», та зняти галочку «Отримувати повідомлення».</li>\r\n 	<li><strong>SMS</strong><strong>-розсилка</strong>. Щоб відписатися від розсилки SMS-повідомлень, напишіть, будь ласка, у довільній формі звернення щодо відписки від SMS-розсилки на поштову скриньку <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. У своєму листі обов’язково зазначте Ваш контактний номер телефону, який Ви хочете відписати від розсилки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong>Збереження та видалення персональних даних</strong></li>\r\n</ol>\r\n6.1. У даному розділі описана політика і процедура зберігання даних, що забезпечує дотримання нами юридичних зобов’язань щодо збереження і видалення персональних даних.\r\n\r\n6.2. Ми можемо зберігати Вашу персональну інформацію лише протягом строку, протягом якого у нас є законний інтерес для цього. Після того, як необхідність у відповідних даних відпала, ми видаляємо інформацію, яка може будь-яким чином ідентифікувати Вашу особу, однак можемо зберігати анонімізовані (знеособлені) дані, наприклад, для аналітичних чи дослідницьких цілей, зокрема, нами може здійснюватися передача такої інформації тертім особам, однак лише за умови видалення будь-яких персональних даних про Вас.\r\n\r\n6.3. Ваші персональні дані зберігаються протягом мінімального періоду – 1 робочий день після надання Вашої згоди з даною Політикою конфіденційності, а також протягом максимального періоду – 3 робочих дня після повідомлення про скасування підписки або запиту про видалення даних.\r\n\r\n6.4. Незважаючи на викладені вище положення даного розділу 6, ми зберігаємо Ваші персональні дані, якщо таке збереження інформації необхідне для виконання юридичних зобов’язань, відповідно до яких ми зобов’язані це зробити для захисту Ваших життєво важливих інтересів, або життєво важливих інтересів інших фізичних осіб.\r\n<ol start=\"7\">\r\n 	<li><strong> Зміни та доповнення</strong></li>\r\n</ol>\r\n7.1. Ми можемо періодично оновлювати дану Політику, публікуючи нову версію на нашому Веб-сайті.\r\n\r\n7.2. Ми можемо в будь-який момент змінити або доповнити дану Політику на наш розсуд. Такі зміни вступають в силу відразу ж після опублікування повідомлення про зміну або доповнення на даному сайті. Ми також можемо повідомляти Вас про зміну Політики через електронну пошту або інші засоби електронної комунікації. Продовжуючи використовувати Веб-сайт, Ви підтверджуєте згоду з умовами Політики з відповідними змінами та доповненнями.\r\n<ol start=\"8\">\r\n 	<li><strong>Ваші права </strong><strong>та </strong><strong>обов’язки</strong></li>\r\n</ol>\r\n8.1. У даному розділі ми дамо коротку довідку про Ваші права за законодавством про захист даних. Деякі права є комплексними і не всі подробиці включені в нашу довідку. Таким чином, Вам слід ознайомитися з відповідними законами і настановами регуляторних органів, щоб отримати повне роз’яснення таких прав.\r\n\r\n8.2. Ви маєте право на виправлення будь-яких неправильних персональних даних про Вас і, з урахуванням цілей обробки, на доповнення неповних персональних даних про Вас.\r\n\r\n8.3. У деяких випадках Ви маєте право видалити Ваші персональні дані без зайвого зволікання. До таких випадків відносяться:\r\n<ul>\r\n 	<li>персональні дані, які вже не потрібні для тих цілей, для яких вони збиралися або оброблялися іншим чином;</li>\r\n 	<li>скасування Вами згоди на обробку даних, обробка яких вимагає Вашої згоди;</li>\r\n 	<li>якщо Ви проти обробки даних відповідно до норм законодавства про захист даних;</li>\r\n 	<li>незаконна обробка персональних даних.</li>\r\n</ul>\r\nПри цьому існують винятки з права на видалення даних. Загальне виключення передбачає необхідність обробки для реалізації свободи висловлювання та права на інформацію; дотримання передбаченого законом зобов’язання; пред’явлення, реалізації або захисту законних претензій.\r\n\r\n8.4. У деяких випадках Ви маєте право обмежити обробку Ваших персональних даних. До таких випадків відносяться:\r\n<ul>\r\n 	<li>заперечення Вами точності персональних даних;</li>\r\n 	<li>обробка була здійснена незаконним шляхом, однак Ви проти видалення даних;</li>\r\n 	<li>нам вже не потрібні персональні дані для цілей, в яких вони оброблялися, але Вам знадобилися персональні дані для пред’явлення, реалізації або захисту законних претензій;</li>\r\n 	<li>Ви проти обробки, до перевірки такого протесту.</li>\r\n</ul>\r\nЯкщо обробка була обмежена на цій підставі, ми можемо продовжувати зберігати Ваші персональні дані. При цьому ми однаково будемо здійснювати її обробку іншим шляхом:\r\n<ul>\r\n 	<li>за Вашою згодою, для пред’явлення, реалізації або захисту законних претензій;</li>\r\n 	<li>для захисту прав інших фізичних або юридичних осіб;</li>\r\n 	<li>з інших причин, пов’язаних з важливими суспільними інтересами.</li>\r\n</ul>\r\n8.5. Щоб допомогти нам захистити Вашу приватність:\r\n<ul>\r\n 	<li>завершіть сеанс на Веб-сайті після завершення роботи з ним;</li>\r\n 	<li>надайте нам правдиву, точну і повну інформацію;</li>\r\n 	<li>не використовуйте Веб-сайт, якщо Ви молодше 18 років;</li>\r\n 	<li>не надавайте нам інформацію про будь-кого іншого, якщо у вас немає на це дозволу.</li>\r\n</ul>\r\n8.6. Якщо Ви хочете дізнатися більше про те, яку саме інформацію про Вас ми зберігаємо, включаючи зміни або запити на видалення, Ви маєте право подати Запит суб’єкта персональних даних. Ви можете подати запит на електронну адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просимо звернути Вашу увагу на те, що ми повинні будемо виключити деяку інформацію як частину Вашого запиту, наприклад, для захисту приватності інших осіб, або якщо у нас є законні чи інші причини виключати таку інформацію.\r\n\r\n8.7. Будь ласка, зверніть увагу, що видалення Вашої персональної інформації обмежить нашу можливість зв’язатися з Вами для надання пропозицій, що, в свою чергу, обмежить Вашу можливість скористатися такими пропозиціями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файли </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – це файли, що містять ідентифікатор (набір букв і цифр), відправлений інтернет-сервером інтернет-браузеру, і який зберігається в браузері. Потім ідентифікатор прямує назад на сервер кожен раз, коли браузер запитує сторінку на сервері.\r\n\r\n9.2. Cookie – файли можуть бути \"постійними\" або \"сесійними\". Постійні cookie зберігаються в браузері та діють до дати закінчення терміну дії, якщо не будуть видалені до настання такої дати; сесійні cookie припиняють дію після завершення сесії користувачем, після закриття браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, які ми використовуємо</strong></li>\r\n</ol>\r\n10.1. Ми використовуємо cookie в наступних цілях:\r\n<ul>\r\n 	<li>аутентифікація – ми використовуємо cookie для Вашої ідентифікації під час відвідування Вами Веб-сайту та навігації по ньому;</li>\r\n 	<li>статус – ми використовуємо cookie, щоб допомогти визначити, чи ввійшли Ви на наш Веб-сайт під своїм логіном;</li>\r\n 	<li>персоналізація – ми використовуємо cookie, щоб зберігати інформацію про Ваші уподобання і персоналізувати Веб-сайт під ваші потреби;</li>\r\n 	<li>безпека – ми використовуємо cookie як елемент захисту облікового запису користувача, в тому числі для запобігання несанкціонованого використання даних входу і захисту нашого Веб-сайту, та послуг в цілому;</li>\r\n 	<li>реклама – ми використовуємо cookie, щоб показувати рекламу, яка може бути Вам цікава;</li>\r\n 	<li>аналіз – ми використовуємо cookie, щоб проаналізувати ефективність нашого Веб-сайту та послуг;</li>\r\n 	<li>згода – ми використовуємо cookie, щоб зберігати Ваші уподобання щодо використання cookie для більш великих цілей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, використовувані нашими постачальниками послуг</strong></li>\r\n</ol>\r\n11.1. Наші постачальники послуг використовують cookie і вони можуть зберігатися на вашому комп’ютері під час відвідування Веб-сайту.\r\n\r\n11.2. Для аналізу використання нашого Веб-сайту ми використовуємо Google Analytics. Google Analytics збирає інформацію про використання нашого Веб-сайту за допомогою cookie. Зібрана інформація, що стосується нашого Веб-сайту, використовується для створення звітів про використання нашого Вебсайту. Політика конфіденційності Google доступна за <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>цим </strong><strong>посиланням</strong></a>.\r\n\r\n11.3. Сookies від Analytics допомагає нам зрозуміти скільки відвідувачів заходить на наш Веб-сайт, скільки разів вони його відвідали і скільки разів передивлялися певні сторінки на нашому сайті. Незважаючи на те, що cookiе аналітики дозволяють нам збирати певну інформацію про Вашу веб історію або про те, скільки разів Ви заходили на сайт, ми не можемо використовувати це щоб дізнатися Ваші дані, наприклад, ім’я чи адресу.\r\n<ol start=\"12\">\r\n 	<li><strong>Управління файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Якщо Ви не хочете приймати cookies від нашого Веб-сайту, Ви можете змінити налаштування Вашого браузера і cookie більше не будуть прийматися. Якщо Ви приймете таке рішення, будь ласка, зверніть увагу, що Веб-сайт не зможе функціонувати як раніше.\r\n\r\n12.2. Усі популярні браузери (Google Chrome, Safari,Microsoft Edge, Mozilla Firefox, Samsung Internet, Opera) дозволяють змінювати налаштування cookie таким чином, щоб не включати їх ні на яких відвідуваних Вами сайтах. Ви можете знайти інформацію про відключення cookie в основних браузерах в розділі \"Як управляти файлами cookie\", зокрема на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайті</strong><strong>Офісу Уповноваженого з питань інформації Великої Британії</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Як з нами </strong><strong>зв’язатися</strong></li>\r\n</ol>\r\nЗ питань обробки персональних даних, будь ласка, звертайтеся:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u></a><u><a href=\"mailto:uf@uf.ua\">ua</a>\r\n</u>Будемо раді Вас вітати! Ми дуже цінуємо Вашу думку, коментарі або пропозиції – вони допомагають нам покращувати якість нашої роботи.\r\n<strong>Ця Політик</strong><strong>а</strong><strong> в редакції станом на </strong><strong>12</strong><strong>.</strong><strong>0</strong><strong>9</strong><strong>.</strong><strong>2022</strong><strong>.</strong>','Політика конфіденційності','','inherit','closed','closed','','290-revision-v1','','','2022-09-15 17:38:32','2022-09-15 14:38:32','',290,'https://reo.ua/?p=1856',0,'revision','',0),(748,1,'2021-07-02 14:18:49','2021-07-02 11:18:49','','Де придбати','','inherit','closed','closed','','747-revision-v1','','','2021-07-02 14:18:49','2021-07-02 11:18:49','',747,'https://reo.ua/?p=748',0,'revision','',0),(297,1,'2021-06-15 11:57:22','2021-06-15 08:57:22','Ласкаво просимо на reo.ua.\r\nДаний сайт є інтелектуальною власністю ТОВ \"Юрія-Фарм\". ТОВ \"Юрія-фарм\" - компанія, зареєстрована в Києві, Україна, з головним офісом в Києві, Україна, реєстраційний номер компанії: 30109129 (далі - ми, наш, нас), який керує даним Веб-сайтом (далі - \"Веб-сайт\").\r\n\r\nНам дуже важливо захистити ваші персональні дані. Ми зобов\'язуємося захищати приватність осіб, які відвідують наш Веб-сайт і використовують наші онлайн-інструменти. У даній Політиці конфіденційності ми хочемо розповісти вам про порядок збору, обробки та використання персональних даних.\r\n\r\nБудь ласка, зверніть увагу, що ви приймаєте цю Політику конфіденційності в разі перегляду Веб-сайту або його використання іншим чином, незалежно від того, чи попросять вас дати додатковий дозвіл під час використання Веб-сайту. Ознайомлення з цією політикою конфіденційності є виключно вашою відповідальністю.\r\n<h2>1. Інформація, яку ми збираємо</h2>\r\n1.1. Під час використання Веб-сайту, ви можете прийняти рішення про надання нам певної інформації про вас, заповнюючи онлайн-форми, реєструючись на нашому Веб-сайті, роблячи замовлення, звертаючись до нас та ін. Видами персональної інформації, яку ви можете нам надати, можуть бути, без обмеження, контактна інформація (адреса, електронна пошта, номер телефону, факсу), ім\'я користувача і особисті вподобання, інтереси та використання різних продуктів і послуг, зміст комунікації з нами. Для доступу на Веб-сайт ви не зобов\'язані надавати перелічені нижче персональні дані, проте в такому випадку деякі функції можуть бути вам недоступні.\r\n\r\n1.2. Відразу після того, як ви зайшли на сайт, ми можемо автоматично отримати деяку інформацію, яка може бути використана для вашої ідентифікації, наприклад, номер домену, IP-адреса вашого комп\'ютера, вид використовуваного вами браузера, операційної системи та платформи, технічна інформація, інформація про географічне місцезнаходження під час відвідування Веб-сайту (тривалість перебування, популярні продукти, час відгуку сторінки, шляхи навігації, а також інформація про час, частоту та спосіб використання послуги вами та ін.). Ми можемо використовувати таку інформацію окремо або в сукупності, для технічного управління нашим Веб-сайтом, аналітичної системи відстеження, досліджень і розробок. Правова підстава такої обробки - наші законні інтереси для моніторингу та поліпшення нашого Веб-сайту та послуг.\r\n<h2>2. Обробка персональних даних</h2>\r\nМи захищаємо ваші дані, обмежуючи доступ до ваших даних тільки особами, які повинні мати до них доступ для здійснення або спрощення операцій між вами і нами, або особами, які з інших причин повинні виконувати дії, описані в даному розділі.\r\n\r\n2.1. Ми можемо обробляти вашу інформацію, яка вказана у вашому профілі на нашому Веб-сайті. Дані профілю можуть містити ваше ім\'я, адресу, номер телефону, електронної адреси, фото профілю, стать, дату народження, сімейний статус, інтереси та хобі, дані про освіту й місце роботи. Ми свідомо не збираємо інформацію про осіб молодше 18 років. Дані профілю можуть бути оброблені для надання вам можливості використання та моніторингу нашого Веб-сайту та послуг, створення вашого особистого профілю й управління ним, роботи з Веб-сайтом, надання наших послуг, забезпечення безпеки нашого Веб-сайту та послуг, резервного зберігання даних в наших базах і спілкування з вами. Правова підстава такої обробки - наші законні інтереси для належного управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.2. Ми можемо обробляти інформацію, яку ви публікуєте на нашому Веб-сайті або через наші послуги. Дані публікації можуть бути оброблені з метою дозволу публікацій або управління нашим Веб-сайтом і послугами. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.3. Ми можемо обробляти інформацію з вашого запиту про товари і/або послуги. Дані запиту можуть бути оброблені з цілю пропозиції, маркетингу та продажу відповідних товарів і/або послуг вам та для обробки ваших окремих запитів. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.4. Ми можемо обробляти інформацію, пов\'язану із взаємовідносинами з клієнтами, в тому числі контактну інформацію клієнта. Дані про взаємини клієнта можуть включати ім\'я, роботодавця, назва посади або ролі, контактну інформацію, інформацію, отриману в комунікації між нами. Дані про взаємини клієнта можуть оброблятися з метою управління нашими взаєминами з клієнтами, комунікації з клієнтами, ведення записів про таку комунікацію, допомоги при виборі товарів і надання вам рекомендацій, рекламування наших товарів і послуг клієнтам. Правовою підставою такої обробки є належне управління взаєминами з клієнтом.\r\n\r\n2.5. Ми можемо обробляти надану вами інформацію з метою підписання вас на наші електронні розсилки та/або інформаційні листи. Дані про повідомлення можуть оброблятися з метою відправки вам відповідних повідомлень та/або інформаційних листів, інформації про нашу продукцію, послуги і рекламних матеріалів. Після того, як ви підпишетеся на розсилку новин на нашому Веб-сайті, ми направимо вам повідомлення на вказану електронну адресу для підтвердження. Якщо ви не підтвердите підписку, вона буде автоматично видалена. Ви можете в будь-який момент відкликати свою згоду на отримання нашої розсилки. Щоб відписатися від розсилки, перейдіть за посиланням, яке надається у всіх інформаційних розсилках, напишіть нам листа електронною поштою за адресою, вказаною в розділі 12 \"Як з нами зв\'язатися\" або зателефонуйте +38 (044) 246-83-83. Правова підстава такої обробки - належне управління нашим Веб-сайтом і бізнесом.\r\n\r\n2.6. На додаток до цілей, для яких ми можемо обробляти ваші персональні дані, викладеним в цьому розділі, ми також можемо обробляти ваші персональні дані, якщо така обробка необхідна для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>3. Надання ваших персональних даних іншим особам</h2>\r\nМи не передаємо в оренду, не продаємо або іншим чином не розголошуємо персональну інформацію, яку ми збираємо, за винятком описаних нижче випадків. Ми можемо поділитися вашими персональними даними для здійснення дій, описаних в даному розділі.\r\n\r\n3.1. Ми можемо розголосити ваші персональні дані будь-якому учаснику нашої групи компаній (тобто дочірнім підприємствам, кінцевій холдинговій компанії та всім її дочірнім підприємствам), якщо це обґрунтовано необхідно для цілей та правових підстав, передбачених цією політикою.\r\n\r\n3.2. Ми можемо розголосити ваші персональні дані нашим постачальникам послуг, що надають послуги від нашого імені, по нашим розпорядженням, страховикам або професійним консультантам, якщо це обґрунтовано необхідно для отримання відповідної страховки, управління ризиками, отримання професійної консультації та надання послуг.\r\n\r\nМи можемо поділитися вашими персональними даними з нашими постачальниками послуг, які беруть участь в наших бізнес-процесах.\r\n\r\n<u>Приклад використання персональних даних нашими постачальниками послуг:</u>\r\n<ul>\r\n 	<li>ми передаємо вашу персональну інформацію постачальникам послуг, що допомагають нам в діяльності, яка пов\'язана з маркетингом та аналізом даних, щоб повідомляти вас і надавати рекомендації про нашу продукцію, в тому числі про розпродажі, спеціальні пропозиції, нові характеристики Веб-сайту, направляти вам повідомлення рекламного характеру. Нашими постачальниками маркетингових послуг і даних є \"Google Analytics\", \"Contact Form 7\", \"AddThis\". Політика конфіденційності наших постачальників послуг доступна на їх відповідних Веб-сайтах.</li>\r\n</ul>\r\nМи не аналізуємо таких постачальників послуг, страховиків і професійних консультантів перед використанням або розголошенням персональної інформації, крім випадків, коли це необхідно для надання послуг від нашого імені або виконання вимог закону.\r\n\r\n3.3. На додаток окремим випадкам розголошення, викладеним у цьому розділі, ми також можемо розголошувати ваші персональні дані, якщо таке розголошення інформації необхідне для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб. Ми також можемо розголошувати ваші персональні дані, якщо таке розголошення необхідне для встановлення, реалізації або захисту законних вимог в судовому провадженні або в адміністративному порядку, або в порядку досудового вирішення спору.\r\n<h2>4. Передача ваших персональних даних за кордон</h2>\r\nВ даному розділі ми надаємо інформацію про випадки, в яких персональні дані можуть передаватися в країни за межі Європейської економічної зони (ЄЕЗ).\r\n\r\n4.1. Ми ділимося вашими персональними даними з нашими контрагентами за межами Європейської економічної зони (ЄЕЗ) для надання послуг від нашого імені і/або виконання вимог законодавства. Передача в такі країни буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.2. Хостинг нашого Веб-сайту знаходиться в центрах даних м. Київ, Україна (хостинговий сервіс: Mirohost.net). Передача на хостинги буде захищена належними засобами захисту, а саме стандартними пунктами про захист даних, прийнятих або затверджених Європейською Комісією.\r\n\r\n4.3. Якщо ви заходите на даний Веб-сайт в країні, відмінній від країни перебування нашого сервера, комунікація між нами може передбачати передачу інформації за межі міжнародних державних кордонів. Відвідуючи наш Веб-сайт або іншим чином вступаючи з нами в електронну комунікацію, ви погоджуєтеся на таку передачу. Навіть якщо у вашій юрисдикції відсутні такі ж законодавчі норми про конфіденційність, як в юрисдикції місцезнаходження сервера, ми будемо вважати вашу інформацію підлягаючою захисту, передбаченим цією політикою конфіденційності.\r\n<h2>5. Збереження та видалення персональних даних</h2>\r\nВ даному розділі описана політика та процедура зберігання даних, що забезпечує дотримання нами юридичних зобов\'язань щодо збереження і видалення персональних даних.\r\n\r\n5.1. Ми можемо зберігати вашу персональну інформацію тільки протягом терміну, під час якого у нас є законний інтерес для цього. Таким чином, ми більше не вимагаємо цю інформацію у форматі, за яким можна ідентифікувати вашу особу, наприклад, якщо ми зберігаємо інформацію для аналітичних і дослідницьких цілей або з метою передачі інформації, ми видаляємо всі персональні дані про вас.\r\n\r\n5.2. Ваші персональні дані зберігаються протягом мінімального періоду - 1 робочий день після прийняття даної Політики конфіденційності, а також протягом максимального періоду 3 робочих дня після повідомлення про скасування підписки або запиту про видалення даних.\r\n\r\n5.3. Незважаючи на викладені вище положення даного розділу 5, ми зберігаємо ваші персональні дані, якщо таке збереження інформації необхідно для виконання юридичних зобов\'язань, відповідно до яких ми зобов\'язані це зробити для захисту ваших життєво важливих інтересів або життєво важливих інтересів інших фізичних осіб.\r\n<h2>6. Зміни та доповнення</h2>\r\n6.1. Ми можемо періодично оновлювати дану політику, публікуючи нову версію на нашому Веб-сайті.\r\n\r\n6.2. Ми можемо в будь-який момент змінити або доповнити дану Політику конфіденційності на наш розсуд. Такі зміни вступають в силу відразу ж після опублікування повідомлення про зміну або доповнення на даному сайті. Ми також можемо повідомляти вас про зміни конфіденційності особистих даних за допомогою інших засобів, зокрема по електронній пошті. Продовжуючи використовувати Веб-сайт, ви підтверджуєте згоду з умовами Політики конфіденційності з відповідними змінами та доповненнями.\r\n<h2>7. Ваші права і обов\'язки</h2>\r\nВ даному розділі ми дамо коротку довідку про ваші права за законодавством про захист даних. Деякі права є комплексними і не всі подробиці включені в нашу довідку. Таким чином, вам слід ознайомитися з відповідними законами і постановами регуляторних органів, щоб отримати повне роз\'яснення таких прав.\r\n\r\n7.1. Ви маєте право на виправлення будь-яких неправильних персональних даних про вас і, з урахуванням цілей обробки, на доповнення неповних персональних даних про вас.\r\n\r\n7.2. У деяких випадках ви маєте право видалити ваші персональні дані без зайвого зволікання. До таких випадків відносяться: персональні дані, які вже не потрібні для тих цілей, для яких вони збиралися або оброблялися іншим чином; скасування вами згоди на обробку даних, що вимагає згоди; якщо ви проти обробки даних відповідно до визначених нормами законодавства про захист даних; обробка безпосередньо для маркетингових цілей; незаконна обробка персональних даних. При цьому існують винятки з права на видалення даних. Загальне виключення передбачає необхідність обробки для реалізації свободи висловлювання та права на інформацію; дотримання передбаченого законом зобов\'язання; пред\'явлення, реалізації або захисту законних претензій.\r\n\r\n7.3. У деяких випадках ви маєте право обмежити обробку ваших персональних даних. До таких випадків відносяться: заперечення вами точності персональних даних; обробка була здійснена незаконним шляхом, однак ви проти видалення даних; нам вже не потрібні персональні дані для цілей, в яких вони оброблялися, але вам знадобилися персональні дані для пред\'явлення, реалізації або захисту законних претензій; ви проти обробки, до перевірки такого протесту. Якщо обробка була обмежена на цій підставі, ми можемо продовжувати зберігати ваші персональні дані. При цьому ми все одно будемо здійснювати її обробку іншим шляхом: за вашою згодою, для пред\'явлення, реалізації або захисту законних претензій; для захисту прав інших фізичних або юридичних осіб; з інших причин, пов\'язаних з важливими суспільними інтересами.\r\n\r\n7.4. Щоб допомогти нам захистити вашу приватність: завершіть сеанс на Веб-сайті після завершення роботи з ним; надайте нам правдиву, точну і повну інформацію; не використовуйте Веб-сайт, якщо ви молодше 18 років; не надайте нам інформацію про будь-кого іншому, якщо у вас немає на це дозволу.\r\n\r\n7.5. Якщо ви хочете дізнатися більше про те, яку саме інформацію про вас ми зберігаємо, включаючи зміни або запити на видалення, ви маєте право подати Запит суб\'єкта персональних даних. Ви можете подати запит на електронну адресу <a href=\"mailto:info@uf.ua\">info@uf.ua</a>. Просимо звернути Вашу увагу на те, що ми повинні будемо виключити деяку інформацію як частину вашого запиту, наприклад, для захисту приватності інших осіб або якщо у нас є законні чи інші причини виключати таку інформацію.\r\n\r\n7.6. Будь ласка, зверніть увагу, що видалення вашої персональної інформації обмежить нашу можливість зв\'язатися з вами для надання пропозицій, що, в свою чергу, обмежить вашу можливість скористатися такими пропозиціями.\r\n<h2>8. Файли Cookie</h2>\r\n8.1. Сookie - це файли, що містять ідентифікатор (набір букв і цифр), відправлений інтернет-сервером інтернет-браузеру і який зберігається в браузері. Потім ідентифікатор прямує назад на сервер кожен раз, коли браузер запитує сторінку на сервері.\r\n\r\n8.2. Cookie-файли можуть бути \"постійними\" або \"сесійними\". Постійні cookie зберігаються в браузері та діють до дати закінчення терміну дії, якщо не будуть видалені до настання такої дати; сесійні cookie припиняють дію після завершення сесії користувачем, після закриття браузера.\r\n<h2>9. Сookie, які ми використовуємо</h2>\r\n9.1. Ми використовуємо cookie в наступних цілях: аутентифікація - ми використовуємо cookie для вашої ідентифікації під час відвідування вами Веб-сайту та навігації по ньому; статус - ми використовуємо cookie, щоб допомогти визначити, чи ввійшли ви на наш Веб-сайт під своїм логіном; персоналізація - ми використовуємо cookie, щоб зберігати інформацію про ваші уподобання і персоналізувати Веб-сайт під ваші потреби; безпека - ми використовуємо cookie як елемент захисту облікового запису користувача, в тому числі для запобігання несанкціонованого використання даних входу і захисту нашого Веб-сайту та послуг в цілому; реклама - ми використовуємо cookie, щоб показувати рекламу, яка може бути вам цікава; аналіз - ми використовуємо cookie, щоб проаналізувати ефективність нашого Веб-сайту та послуг; згода - ми використовуємо cookie, щоб зберігати ваші уподобання щодо використання cookie для більш великих цілей.\r\n<h2>10. Сookie, використовувані нашими постачальниками послуг</h2>\r\n10.1. Наші постачальники послуг використовують cookie і вони можуть зберігатися на вашому комп\'ютері під час відвідування Веб-сайту.\r\n\r\n10.2. Для аналізу використання нашого Веб-сайту ми використовуємо Google Analytics. Google Analytics збирає інформацію про використання нашого Веб-сайту за допомогою cookie. Зібрана інформація, що стосується нашого Веб-сайту використовується для створення звітів про використання нашого Веб-сайту. Політика конфіденційності Google доступна за посиланням: <a href=\"https://www.google.com/policies/privacy\" target=\"_blank\" rel=\"nofollow noopener\">https://www.google.com/policies/privacy</a>.\r\n\r\n10.3. Сookies від Analytics допомагає нам зрозуміти скільки відвідувачів заходить на наш Веб-сайт, скільки разів вони його відвідали і скільки разів передивлялися певні сторінки на нашому сайті. Незважаючи на те, що cookiе аналітики дозволяють нам збирати певну інформацію про Вашу веб історію або про те, скільки разів ви заходили на сайт, ми не можемо використовувати це щоб дізнатися ваші дані, наприклад, ім\'я чи адресу.\r\n<h2>11. Управління файлами Cookie</h2>\r\n11.1. Якщо ви не хочете приймати cookies від нашого Веб-сайту, ви можете змінити налаштування вашого браузера і cookie більше не будуть прийматися. Якщо ви приймете таке рішення, будь ласка, зверніть увагу, що Веб-сайт не зможе функціонувати як раніше.\r\n\r\n11.2. Всі популярні браузери (Chrome, Internet Explorer, Firefox, Opera та Safari) дозволяють змінювати налаштування cookie таким чином, щоб не включати їх ні на яких відвідуваних вами сайтах. Ви можете знайти інформацію про відключення cookie в основних браузерах в розділі \"Як знайти інформацію про контролюючі файли cookie\" на веб-сайті Інформаційних комісій <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"nofollow noopener\">https://ico.org.uk/for-the-public/online/cookies</a>.\r\n<h2>12. Як з нами зв\'язатися</h2>\r\nЗ питань обробки персональних даних, будь ласка, звертайтеся:\r\n\r\nТел./Факс: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:info@uf.ua\">info@uf.ua</a>\r\n\r\nБудемо раді вам! Ми дуже цінуємо вашу думку, коментарі або пропозиції - вони допомагають нам покращувати якість нашої роботи.\r\n\r\nДякуємо, що вибрали reo.ua\r\n<p style=\"text-align: right;\">Дата вступу в силу: 24 травня 2018 року.</p>','Політика конфіденційності','','inherit','closed','closed','','290-revision-v1','','','2021-06-15 11:57:22','2021-06-15 08:57:22','',290,'https://reo.ua/?p=297',0,'revision','',0),(1280,1,'2021-07-27 10:24:49','2021-07-27 07:24:49','','silpo','','inherit','open','closed','','silpo-3','','','2021-07-27 10:24:49','2021-07-27 07:24:49','',747,'https://reo.ua/wp-content/uploads/2021/07/silpo.webp',0,'attachment','image/webp',0),(1281,1,'2021-07-27 10:24:50','2021-07-27 07:24:50','','socar','','inherit','open','closed','','socar','','','2021-07-27 10:24:50','2021-07-27 07:24:50','',776,'https://reo.ua/wp-content/uploads/2021/07/socar.webp',0,'attachment','image/webp',0),(747,1,'2021-07-02 14:18:49','2021-07-02 11:18:49','<p style=\"text-align: center;\">Воду для медичних цілей РеО (ReO) можна придбати в аптеках та магазинах вашого міста:</p>','Де придбати','','publish','closed','closed','','de-pridbati','','','2022-09-28 11:51:34','2022-09-28 08:51:34','',0,'https://reo.ua/?page_id=747',6,'page','',0),(301,1,'2021-06-15 13:42:56','2021-06-15 10:42:56','<h2>ГОЛОВНИЙ ОФІС МІЖНАРОДНОЇ СПЕЦІАЛІЗОВАНОЇ ФАРМАЦЕВТИЧНОЇ КОРПОРАЦІЇ «ЮРІЯ-ФАРМ»</h2>','Контакти','','publish','closed','closed','','contacts','','','2021-06-17 13:20:03','2021-06-17 10:20:03','',0,'https://reo.ua/?page_id=301',9,'page','',0),(302,1,'2021-06-15 13:42:56','2021-06-15 10:42:56','','Контакты','','inherit','closed','closed','','301-revision-v1','','','2021-06-15 13:42:56','2021-06-15 10:42:56','',301,'https://reo.ua/?p=302',0,'revision','',0),(303,1,'2021-06-15 13:43:21','2021-06-15 10:43:21','','Контакти','','inherit','closed','closed','','301-revision-v1','','','2021-06-15 13:43:21','2021-06-15 10:43:21','',301,'https://reo.ua/?p=303',0,'revision','',0),(304,1,'2021-06-15 13:44:52','2021-06-15 10:44:52','<h2>ГОЛОВНИЙ ОФІС МІЖНАРОДНОЇ СПЕЦІАЛІЗОВАНОЇ ФАРМАЦЕВТИЧНОЇ КОРПОРАЦІЇ «ЮРІЯ-ФАРМ»</h2>\r\n<strong>Адреса:</strong> 03038, Україна, м. Київ, вул. М. Амосова, 10\r\n<strong>Тел./факс:</strong> +38 (044) 246-83-83, 275-01-08\r\n<strong>E-mail:</strong> <a href=\"mailto:uf@uf.ua\">uf@uf.ua</a>\r\n<strong>Сайт:</strong> <a href=\"http://www.uf.ua/\">www.uf.ua</a>','Контакти','','inherit','closed','closed','','301-revision-v1','','','2021-06-15 13:44:52','2021-06-15 10:44:52','',301,'https://reo.ua/?p=304',0,'revision','',0),(305,1,'2021-07-14 14:00:12','2021-06-15 10:45:05',' ','','','publish','closed','closed','','305','','','2021-07-14 14:00:12','2021-07-14 11:00:12','',0,'https://reo.ua/?p=305',9,'nav_menu_item','',0),(1130,1,'2021-07-14 10:16:44','2021-07-14 07:16:44','','Оральная регидратация у взрослых','','inherit','open','closed','','oralnaya-regidratacziya-u-vzroslyh','','','2021-07-14 10:16:44','2021-07-14 07:16:44','',571,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-vzroslyh.pdf',0,'attachment','application/pdf',0),(306,1,'2021-06-15 14:30:33','2021-06-15 11:30:33','<h2>ГОЛОВНИЙ ОФІС МІЖНАРОДНОЇ СПЕЦІАЛІЗОВАНОЇ ФАРМАЦЕВТИЧНОЇ КОРПОРАЦІЇ «ЮРІЯ-ФАРМ»</h2>\r\n\r\n<hr />\r\n\r\n<strong>Адреса:</strong> 03038, Україна, м. Київ, вул. М. Амосова, 10\r\n<strong>Тел./факс:</strong> +38 (044) 246-83-83, 275-01-08\r\n<strong>E-mail:</strong> <a href=\"mailto:uf@uf.ua\">uf@uf.ua</a>\r\n<strong>Сайт:</strong> <a href=\"http://www.uf.ua/\">www.uf.ua</a>','Контакти','','inherit','closed','closed','','301-revision-v1','','','2021-06-15 14:30:33','2021-06-15 11:30:33','',301,'https://reo.ua/?p=306',0,'revision','',0),(307,1,'2021-06-15 14:32:32','2021-06-15 11:32:32','<div class=\"title\"><h3>Напишіть нам</h3></div>\r\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Iм\'я*\"]</div>\r\n<div class=\"form-group\">[email* email class:form-control placeholder \"Контактний e-mail*\"]</div>\r\n<div class=\"form-group\">[tel* tel class:form-control placeholder \"Контактний телефон*\"]</div>\r\n<div class=\"form-group\">[textarea mailtext class:form-control placeholder \"Повідомлення\"]</div>\r\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я погоджуюсь з <a href=\"/terms-of-use/\" target=\"_blank\" rel=\"noopener\">Політикою конфіденційності</a>.</div>\r\n<div class=\"form-group align-right\">[submit class:butn \"Надіслати\"]</div>\r\n<div class=\"form-group requaired\"><p>* Поля, позначені зірочкою, обов\'язкові для заповнення.</p></div>\n1\nОбратная связь\nsend@reo.ua\nn.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\n<p><strong>Имя:</strong> [nname]</p>\r\n<p><strong>Email:</strong> [email]</p>\r\n<p><strong>Телефон:</strong> [tel]</p>\r\n<p><strong>Сообщение:</strong> [mailtext]</p>\n\n\n1\n1\n\n[_site_title] \"[your-subject]\"\n[_site_title] <wordpress@reo.tonic-adv.com>\n[your-email]\nСообщение:\r\n[your-message]\r\n\r\n-- \r\nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\nReply-To: [_site_admin_email]\n\n\n\nДякую за ваше повідомлення. Воно було відправлено.\nСталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\nОдне або декілька полів містять помилкові дані. Будь ласка перевірте їх і спробуйте ще раз.\nСталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\nВи повинні прийняти умови та положення перед тим, як відправляти Ваше повідомлення.\nПоле обов\'язково.\nПоле задовге.\nПоле занадто короткий.\nПід час завантаження файлу сталася невідома помилка.\nВи не дозволено завантажувати файли цього типу.\nФайл занадто великий.\nПід час завантаження файлу сталася помилка.\nФормат дати некоректний.\nВведённая дата слишком далеко в прошлом.\nВведена дата надто далеко в минулому.\nФормат числа некоректний.\nЧисло менше мінімально допустимого.\nЧисло більше максимально допустимого.\nНеправильна відповідь на перевірки питання.\nНевірно введений електронну адресу.\nВведено некоректний URL адресу.\nВведено некоректний телефонний номер.','Обратная связь (укр)','','publish','closed','closed','','obratnaya-svyaz_copy','','','2022-06-29 15:14:22','2022-06-29 12:14:22','',0,'https://reo.ua/?post_type=wpcf7_contact_form&#038;p=307',0,'wpcf7_contact_form','',0),(308,1,'2021-06-15 13:42:56','2021-06-15 10:42:56','<h2>Главный офис международной специализированной фармацевтической корпорации «ЮРіЯ-ФАРМ»</h2>','Контакты','','publish','closed','closed','','contacts','','','2021-06-17 13:20:42','2021-06-17 10:20:42','',0,'https://reo.ua/contacts/',8,'page','',0),(364,1,'2021-06-17 13:20:03','2021-06-17 10:20:03','<h2>ГОЛОВНИЙ ОФІС МІЖНАРОДНОЇ СПЕЦІАЛІЗОВАНОЇ ФАРМАЦЕВТИЧНОЇ КОРПОРАЦІЇ «ЮРІЯ-ФАРМ»</h2>','Контакти','','inherit','closed','closed','','301-revision-v1','','','2021-06-17 13:20:03','2021-06-17 10:20:03','',301,'https://reo.ua/?p=364',0,'revision','',0),(309,1,'2021-06-15 14:35:30','2021-06-15 11:35:30','<h2>Главный офис международной специализированной фармацевтической корпорации «ЮРіЯ-ФАРМ»</h2>\r\n\r\n<hr />\r\n\r\n<strong>Адреса:</strong> 03038, Украина, г. Киев, ул. Н. Амосова, 10\r\n<strong>Тел./факс:</strong> +38 (044) 246-83-83, 275-01-08\r\n<strong>E-mail:</strong> <a href=\"mailto:uf@uf.ua\">uf@uf.ua</a>\r\n<strong>Сайт:</strong> <a href=\"http://www.uf.ua\">www.uf.ua</a>','Контакти','','inherit','closed','closed','','308-revision-v1','','','2021-06-15 14:35:30','2021-06-15 11:35:30','',308,'https://reo.ua/?p=309',0,'revision','',0),(310,1,'2021-06-15 14:35:36','2021-06-15 11:35:36','<h2>Главный офис международной специализированной фармацевтической корпорации «ЮРіЯ-ФАРМ»</h2>\r\n\r\n<hr />\r\n\r\n<strong>Адреса:</strong> 03038, Украина, г. Киев, ул. Н. Амосова, 10\r\n<strong>Тел./факс:</strong> +38 (044) 246-83-83, 275-01-08\r\n<strong>E-mail:</strong> <a href=\"mailto:uf@uf.ua\">uf@uf.ua</a>\r\n<strong>Сайт:</strong> <a href=\"http://www.uf.ua\">www.uf.ua</a>','Контакты','','inherit','closed','closed','','308-revision-v1','','','2021-06-15 14:35:36','2021-06-15 11:35:36','',308,'https://reo.ua/?p=310',0,'revision','',0),(311,1,'2021-07-14 14:01:40','2021-06-15 11:36:03',' ','','','publish','closed','closed','','311','','','2021-07-14 14:01:40','2021-07-14 11:01:40','',0,'https://reo.ua/2021/06/15/311/',9,'nav_menu_item','',0),(313,1,'2021-06-16 10:57:37','2021-06-16 07:57:37','<div class=\"row align-center order-header\">\r\n<div class=\"col-md-4 col-sm-4 col-xs-4\">\r\n<p>Цена <span>(за единицу)</span></p>\r\n</div>\r\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Количество</p></div>\r\n<div class=\"col-md-4 col-sm-4 col-xs-4\"><p>Сумма</p></div>\r\n</div>\r\n<div class=\"row body-order text-center\">\r\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"price\" data-price=\"47\"></p></div>\r\n<div class=\"col-md-4 col-sm-4 col-xs-4 flex-center\">\r\n<div class=\"number-input\">\r\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepDown()\" id=\"minus\" class=\"minus\"></button>\r\n[number products class:quantity class:form_ajax_js id:quantity min:1 \"1\"]\r\n<button type=\"button\" onclick=\"this.parentNode.querySelector(\'input[type=number]\').stepUp()\" id=\"plus\" class=\"plus\"></button>\r\n<input type=\"hidden\" id=\"hidden_sum_js\" name=\"appbundle_order[sum]\" class=\"form_ajax_js\" value=\"90\">\r\n</div>\r\n</div>\r\n<div class=\"col-md-4 col-sm-4 col-xs-4 price-text\"><p class=\"price text-center\" id=\"total-price\"></p></div>\r\n<div class=\"col-md-12\"><p class=\"align-center\">В одной упаковке 12 бутылок</p>\r\n</div>\r\n</div>\r\n<div class=\"row\">\r\n<div class=\"col-md-6\" style=\"z-index: 999;\">\r\n<div class=\"form-group\">[tel* tel class:form-control class:phone-select placeholder \"Контактный телефон*\"]</div>\r\n</div>\r\n<div class=\"col-md-6\">\r\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Имя*\"]</div>\r\n</div>\r\n<div class=\"col-md-6\" style=\"z-index: 999;\">\r\n<div class=\"form-group\">[email* email class:form-control placeholder \"Email*\"]</div>\r\n</div>\r\n<div class=\"col-md-6\">\r\n<div class=\"form-group\">[text* adress class:form-control placeholder \"Адреса доставки*\"]</div>\r\n</div>\r\n</div>\r\n<div class=\"form-group agree\">[checkbox* agree \"\"] Я соглашаюсь с <a href=\"/ru/terms-of-use/\" target=\"_blank\" rel=\"noopener\">Политикой конфиденциальности</a>.</div>\r\n<div class=\"form-group align-right\">[submit class:butn class:order-butn \"Оформить заказ\"]</div>\r\n<div class=\"form-group requaired\"><p>* Поля, отмеченные звездочкой, обязательны для заполнения.</p></div>\r\n\r\n<div class=\"order-additional-conditions\">\r\nПри сумме заказа <strong>от 550 грн</strong> доставка <strong>бесплатна</strong>.\r\nПри сумме заказа <strong>менее 550 грн</strong> стоимость доставки составит <strong>49 грн</strong>.\r\n</div>\r\n<hr />\r\n<p class=\"align-center\">Время работы колл-центра с 9:00 до 18:00</p>\n1\nНовый заказ (ReO)\nsend@reo.ua\nn.tanchyk@aquamarket.ua, so@aquamarket.ua, zakupka@ksb-global.com, tetiana.filipchuk@uf.ua\n<p><strong>Количество:</strong> [products]</p>\r\n<p><strong>Имя:</strong> [nname]</p>\r\n<p><strong>Телефон:</strong> [tel]</p>\r\n<p><strong>E-mail:</strong> [email]</p>\r\n<p><strong>Адрес доставки:</strong> [adress]</p>\n\n\n1\n1\n1\nReO - Вода для медицинских целей\nsend@reo.ua\n[email]\nСпасибо за заказ! В ближайшее время с Вами свяжется call-центр для подтверждения заказа и уточнения деталей!\r\n\r\nС уважением, компания «Юрия - Фарм»\r\n<img src=\"https://reo.ua/wp-content/themes/reo/images/uria-pharm.jpg\" width=\"231\" alt=\"Юрия - Фарм\" />\n\n\n1\n\nСпасибо за заказ! В ближайшее время с Вами свяжется call-центр для подтверждения заказа и уточнения деталей!\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nОдно или несколько полей содержат ошибочные данные. Пожалуйста, проверьте их и попробуйте ещё раз.\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nВы должны принять условия и положения перед отправкой вашего сообщения.\nПоле обязательно для заполнения.\nПоле слишком длинное.\nПоле слишком короткое.\nПри загрузке файла произошла неизвестная ошибка.\nВам не разрешено загружать файлы этого типа.\nФайл слишком большой.\nПри загрузке файла произошла ошибка.\nФормат даты некорректен.\nВведённая дата слишком далеко в прошлом.\nВведённая дата слишком далеко в будущем.\nФормат числа некорректен.\nЧисло меньше минимально допустимого.\nЧисло больше максимально допустимого.\nНеверный ответ на проверочный вопрос.\nНеверно введён электронный адрес.\nВведён некорректный URL адрес.\nВведён некорректный телефонный номер.','Форма заказа (ру)','','publish','closed','closed','','obratnaya-svyaz-ru_copy','','','2022-07-27 16:22:41','2022-07-27 13:22:41','',0,'https://reo.ua/?post_type=wpcf7_contact_form&#038;p=313',0,'wpcf7_contact_form','',0),(752,1,'2021-07-14 14:00:12','2021-07-02 11:20:34',' ','','','publish','closed','closed','','752','','','2021-07-14 14:00:12','2021-07-14 11:00:12','',0,'https://reo.ua/?p=752',3,'nav_menu_item','',0),(330,1,'2021-06-17 13:06:03','2021-06-17 10:06:03','<h2>Главный офис международной специализированной фармацевтической корпорации «ЮРіЯ-ФАРМ»</h2>\n\n<hr />\n\n<i class=\"fas fa-map-marker-alt\"></i> <strong>Адреса:</strong> 03038, Украина, г. 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Найближчим часом з Вами зв\'яжеться call-центр для підтвердження замовлення та уточнення деталей!\r\n\r\nЗ повагою, компанія «Юрія – Фарм»\r\n<img src=\"https://reo.ua/wp-content/themes/reo/images/uria-pharm.jpg\" width=\"231\" alt=\"Юрия - Фарм\" />\n\n\n1\n\nДякуємо за замовлення! Найближчим часом з Вами зв\'яжеться call-центр для підтвердження замовлення та уточнення деталей!\nСталася помилка під час спроби відправити Ваше повідомлення. Будь ласка спробуйте ще раз пізніше.\nОдне або декілька полів містять помилкові дані. Будь ласка перевірте їх і спробуйте ще раз.\nСталася помилка під час спроби відправити Ваше повідомлення. 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Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричинені бактеріями, вірусами чи паразитами. Здебільшого антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. Під час оцінювання ступеня зневоднення варто звернути увагу на об’єми спожитої рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїновмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява \"крапчастого\" червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих небезпечними симптомами є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів у дітей або довше 5 днів у дорослих.\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз в 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для регідратації фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при нудоті, яка досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','publish','open','open','','znevodnennya-pri-kishkovih-infekcziyah','','','2021-07-13 16:48:21','2021-07-13 13:48:21','',0,'https://reo.ua/?p=368',45,'post','',0),(369,1,'2021-06-24 13:21:34','2021-06-24 10:21:34','','infograph-1','','inherit','open','closed','','infograph-1','','','2021-06-24 13:21:34','2021-06-24 10:21:34','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg',0,'attachment','image/jpeg',0),(370,1,'2021-06-24 13:21:34','2021-06-24 10:21:34','','infograph-1','','inherit','open','closed','','infograph-1-2','','','2021-06-24 13:21:34','2021-06-24 10:21:34','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg',0,'attachment','image/jpeg',0),(371,1,'2021-06-24 13:21:35','2021-06-24 10:21:35','','infograph-2','','inherit','open','closed','','infograph-2','','','2021-06-24 13:21:35','2021-06-24 10:21:35','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg',0,'attachment','image/jpeg',0),(372,1,'2021-06-24 13:21:35','2021-06-24 10:21:35','','infograph-2','','inherit','open','closed','','infograph-2-2','','','2021-06-24 13:21:35','2021-06-24 10:21:35','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg',0,'attachment','image/jpeg',0),(375,1,'2021-06-24 13:31:34','2021-06-24 10:31:34','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n\r\n<strong>Що робити при кишкових інфекціях?</strong>\r\n\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n\r\n<strong>Коли варто звернутися до лікаря?</strong>\r\n\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th><strong>Вага</strong></th>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n\r\n<strong>Як запобігти кишковим інфекціям?</strong>\r\n\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','При кишечных инфекциях','','inherit','closed','closed','','368-revision-v1','','','2021-06-24 13:31:34','2021-06-24 10:31:34','',368,'https://reo.ua/?p=375',0,'revision','',0),(373,1,'2021-06-24 13:23:17','2021-06-24 10:23:17','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n\r\n<strong>Що робити при кишкових інфекціях?</strong>\r\n\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n\r\n<strong>Коли варто звернутися до лікаря?</strong>\r\n\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table width=\"100%\">\r\n<thead>\r\n<tr>\r\n<td width=\"18%\"><strong>Вага</strong></td>\r\n<td width=\"19%\"><strong>Вік</strong></td>\r\n<td width=\"62%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></td>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td width=\"18%\">&lt;5 кг</td>\r\n<td width=\"19%\">&lt;4 місяців</td>\r\n<td width=\"62%\">200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"18%\">5-7,9 кг</td>\r\n<td width=\"19%\">4-11 місяців</td>\r\n<td width=\"62%\">400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"18%\">8-10,9 кг</td>\r\n<td width=\"19%\">12-23 місяці</td>\r\n<td width=\"62%\">600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"18%\">11-15,9 кг</td>\r\n<td width=\"19%\">2-4 роки</td>\r\n<td width=\"62%\">800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"18%\">16-29,9 кг</td>\r\n<td width=\"19%\">5-14 років</td>\r\n<td width=\"62%\">1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"18%\">≥30 кг</td>\r\n<td width=\"19%\">≥15 років</td>\r\n<td width=\"62%\">2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n\r\n<strong>Як запобігти кишковим інфекціям?</strong>\r\n\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','При кишечных инфекциях','','inherit','closed','closed','','368-revision-v1','','','2021-06-24 13:23:17','2021-06-24 10:23:17','',368,'https://reo.ua/?p=373',0,'revision','',0),(374,1,'2021-07-14 11:03:22','2021-06-24 10:27:00',' ','','','publish','closed','closed','','374','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=374',4,'nav_menu_item','',0),(376,1,'2021-06-24 13:33:02','2021-06-24 10:33:02','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n\r\n<strong>Що робити при кишкових інфекціях?</strong>\r\n\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n\r\n<strong>Коли варто звернутися до лікаря?</strong>\r\n\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n\r\n<strong>Як запобігти кишковим інфекціям?</strong>\r\n\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','При кишечных инфекциях','','inherit','closed','closed','','368-revision-v1','','','2021-06-24 13:33:02','2021-06-24 10:33:02','',368,'https://reo.ua/?p=376',0,'revision','',0),(377,1,'2021-06-24 13:23:17','2021-06-24 10:23:17','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых опасными симптомами являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней у детей или дольше 5 дней у взрослых.\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца (без иглы), малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для регидратации фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','publish','open','open','','obezvozhivanie-pri-kishechnyh-infekcziyah','','','2021-07-13 16:52:35','2021-07-13 13:52:35','',0,'https://reo.ua/bez-kategorii/pri-kishechnyh-infekcziyah/',47,'post','',0),(557,1,'2021-06-29 11:59:21','2021-06-29 08:59:21','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом під пахви та на пахові ділянки;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО - це маломінералізована вода, що містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','publish','open','open','','yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku','','','2021-07-14 02:30:42','2021-07-13 23:30:42','',0,'https://reo.ua/?p=557',20,'post','',0),(558,1,'2021-06-29 11:56:02','2021-06-29 08:56:02','','infograph30','','inherit','open','closed','','infograph30','','','2021-06-29 11:56:02','2021-06-29 08:56:02','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg',0,'attachment','image/jpeg',0),(559,1,'2021-06-29 11:56:02','2021-06-29 08:56:02','','infograph30','','inherit','open','closed','','infograph30-2','','','2021-06-29 11:56:02','2021-06-29 08:56:02','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg',0,'attachment','image/jpeg',0),(560,1,'2021-06-29 11:56:47','2021-06-29 08:56:47','','infograph31','','inherit','open','closed','','infograph31','','','2021-06-29 11:56:47','2021-06-29 08:56:47','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg',0,'attachment','image/jpeg',0),(561,1,'2021-06-29 11:56:47','2021-06-29 08:56:47','','infograph31','','inherit','open','closed','','infograph31-2','','','2021-06-29 11:56:47','2021-06-29 08:56:47','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg',0,'attachment','image/jpeg',0),(562,1,'2021-06-29 11:57:53','2021-06-29 08:57:53','','infograph32','','inherit','open','closed','','infograph32','','','2021-06-29 11:57:53','2021-06-29 08:57:53','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg',0,'attachment','image/jpeg',0),(563,1,'2021-06-29 11:57:53','2021-06-29 08:57:53','','infograph32','','inherit','open','closed','','infograph32-2','','','2021-06-29 11:57:53','2021-06-29 08:57:53','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg',0,'attachment','image/jpeg',0),(564,1,'2021-06-29 11:59:21','2021-06-29 08:59:21','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<img class=\"aligncenter size-full wp-image-558\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg\" alt=\"\" width=\"683\" height=\"502\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n<img class=\"aligncenter size-full wp-image-560\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg\" alt=\"\" width=\"778\" height=\"445\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-562\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg\" alt=\"\" width=\"873\" height=\"210\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-06-29 11:59:21','2021-06-29 08:59:21','',557,'https://reo.ua/?p=564',0,'revision','',0),(556,1,'2021-06-25 17:36:52','2021-06-25 14:36:52','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n<img class=\"aligncenter size-full wp-image-551\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg\" alt=\"\" width=\"1136\" height=\"710\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-06-25 17:36:52','2021-06-25 14:36:52','',368,'https://reo.ua/?p=556',0,'revision','',0),(527,1,'2021-06-25 13:58:59','2021-06-25 10:58:59','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-06-25 13:58:59','2021-06-25 10:58:59','',377,'https://reo.ua/?p=527',0,'revision','',0),(379,1,'2021-06-24 13:50:19','2021-06-24 10:50:19','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n\r\n<strong>Что делать при кишечных инфекциях?</strong>\r\n\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n\r\n<strong>Когда следует обратиться к врачу?</strong>\r\n\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n\r\n<strong>Сколько нужно пить?</strong>\r\n\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n<strong>Вода для медицинских целей РеО («Юрия-Фарм»)</strong>\r\n\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n\r\n<strong>Как предотвратить кишечные инфекции?</strong>\r\n\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n\r\n<strong>Список литературы</strong>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-06-24 13:50:19','2021-06-24 10:50:19','',377,'https://reo.ua/?p=379',0,'revision','',0),(521,1,'2021-06-25 13:56:02','2021-06-25 10:56:02','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-06-25 13:56:02','2021-06-25 10:56:02','',368,'https://reo.ua/?p=521',0,'revision','',0),(380,1,'2021-06-24 13:50:39','2021-06-24 10:50:39','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-369\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg\" alt=\"\" width=\"542\" height=\"201\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n\r\n<strong>Що робити при кишкових інфекціях?</strong>\r\n\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n\r\n<strong>Коли варто звернутися до лікаря?</strong>\r\n\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-371\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg\" alt=\"\" width=\"591\" height=\"343\" />\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n\r\n<strong>Як запобігти кишковим інфекціям?</strong>\r\n\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-06-24 13:50:39','2021-06-24 10:50:39','',368,'https://reo.ua/?p=380',0,'revision','',0),(381,1,'2021-06-24 13:51:32','2021-06-24 10:51:32',' ','','','publish','closed','closed','','381','','','2021-06-24 13:51:32','2021-06-24 10:51:32','',0,'https://reo.ua/bez-kategori%d1%97/381/',4,'nav_menu_item','',0),(382,1,'2021-07-14 11:03:22','2021-06-24 11:15:10',' ','','','publish','closed','closed','','382','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=382',3,'nav_menu_item','',0),(385,1,'2021-06-24 14:26:36','2021-06-24 11:26:36','','infograph-3','','inherit','open','closed','','infograph-3','','','2021-06-24 14:26:36','2021-06-24 11:26:36','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg',0,'attachment','image/jpeg',0),(386,1,'2021-06-24 14:26:36','2021-06-24 11:26:36','','infograph-3','','inherit','open','closed','','infograph-3-2','','','2021-06-24 14:26:36','2021-06-24 11:26:36','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg',0,'attachment','image/jpeg',0),(387,1,'2021-06-24 14:27:13','2021-06-24 11:27:13','','infograph-4','','inherit','open','closed','','infograph-4','','','2021-06-24 14:27:13','2021-06-24 11:27:13','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg',0,'attachment','image/jpeg',0),(388,1,'2021-06-24 14:27:13','2021-06-24 11:27:13','','infograph-4','','inherit','open','closed','','infograph-4-2','','','2021-06-24 14:27:13','2021-06-24 11:27:13','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg',0,'attachment','image/jpeg',0),(522,1,'2021-06-25 13:56:31','2021-06-25 10:56:31','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-385\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg\" alt=\"\" width=\"602\" height=\"459\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-387\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg\" alt=\"\" width=\"601\" height=\"389\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-06-25 13:56:31','2021-06-25 10:56:31','',384,'https://reo.ua/?p=522',0,'revision','',0),(389,1,'2021-06-24 14:27:25','2021-06-24 11:27:25','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n\r\n<strong>Коли варто звернутися до лікаря?</strong>\r\n\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-385\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg\" alt=\"\" width=\"602\" height=\"459\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n\r\n<strong>Що робити при харчовому отруєнні?</strong>\r\n\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО</strong><strong> для регідратації</strong><strong> при харчовому отруєнні:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<strong>Як запобігти харчовим отруєнням?</strong>\r\n\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-387\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg\" alt=\"\" width=\"601\" height=\"389\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-06-24 14:27:25','2021-06-24 11:27:25','',384,'https://reo.ua/?p=389',0,'revision','',0),(390,1,'2021-06-24 14:27:25','2021-06-24 11:27:25','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура больше 38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или резкое нарушение речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n&nbsp;\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать лекарства против диареи и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются: соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты.\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при тошноте;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n&nbsp;\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','publish','open','open','','obezvozhivanie-pri-pishhevyh-otravleniyah','','','2021-07-13 16:39:21','2021-07-13 13:39:21','',0,'https://reo.ua/bez-kategorii/znevodnennya-pri-harchovih-otruennyah/',43,'post','',0),(543,1,'2021-06-25 17:33:53','2021-06-25 14:33:53','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-06-25 17:33:53','2021-06-25 14:33:53','',390,'https://reo.ua/?p=543',0,'revision','',0),(528,1,'2021-06-25 13:59:49','2021-06-25 10:59:49','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-385\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg\" alt=\"\" width=\"602\" height=\"459\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-387\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg\" alt=\"\" width=\"601\" height=\"389\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-06-25 13:59:49','2021-06-25 10:59:49','',390,'https://reo.ua/?p=528',0,'revision','',0),(393,1,'2021-06-24 14:32:16','2021-06-24 11:32:16','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n\r\n<strong>Когда следует обратиться к врачу?</strong>\r\n\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-385\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg\" alt=\"\" width=\"602\" height=\"459\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n<strong>Что делать при пищевом отравлении?</strong>\r\n\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n\r\n<strong>Сколько нужно пить?</strong>\r\n\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n\r\n<strong>Вода для медицинских целей РеО </strong>\r\n\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Преимущества воды РеО для регидратации при пищевом отравлении:</strong>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<strong>Как избежать пищевых отравлений?</strong>\r\n\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-387\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg\" alt=\"\" width=\"601\" height=\"389\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n<strong>Список литературы</strong>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-06-24 14:32:16','2021-06-24 11:32:16','',390,'https://reo.ua/?p=393',0,'revision','',0),(392,1,'2021-06-24 14:31:07','2021-06-24 11:31:07','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n\r\n<strong>Когда следует обратиться к врачу?</strong>\r\n\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-385\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg\" alt=\"\" width=\"602\" height=\"459\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n<strong>Что делать при пищевом отравлении?</strong>\r\n\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n\r\n<strong>Сколько нужно пить?</strong>\r\n\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n\r\n<strong>Вода для медицинских целей РеО </strong>\r\n\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Преимущества воды РеО для регидратации при пищевом отравлении:</strong>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<strong>Как избежать пищевых отравлений?</strong>\r\n\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-387\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg\" alt=\"\" width=\"601\" height=\"389\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n<strong>Список литературы</strong>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: <a href=\"https://www.nhs.uk/conditions/food-poisoning/\">https://www.nhs.uk/conditions/food-poisoning.</a></li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: <a href=\"https://www.healthline.com/health/food-poisoning\">https://www.healthline.com/health/food-poisoning</a>.</li>\r\n 	<li>Available at: <a href=\"https://www.verywellhealth.com/food-poisoning-overview-1958818\">https://www.verywellhealth.com/food-poisoning-overview-1958818</a>.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-06-24 14:31:07','2021-06-24 11:31:07','',390,'https://reo.ua/?p=392',0,'revision','',0),(394,1,'2021-07-14 11:03:22','2021-06-24 11:35:44',' ','','','publish','closed','closed','','394','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=394',2,'nav_menu_item','',0),(397,1,'2021-06-24 14:42:42','2021-06-24 11:42:42','','infograph-5','','inherit','open','closed','','infograph-5','','','2021-06-24 14:42:42','2021-06-24 11:42:42','',396,'https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg',0,'attachment','image/jpeg',0),(398,1,'2021-06-24 14:42:42','2021-06-24 11:42:42','','infograph-5','','inherit','open','closed','','infograph-5-2','','','2021-06-24 14:42:42','2021-06-24 11:42:42','',405,'https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg',0,'attachment','image/jpeg',0),(400,1,'2021-06-24 14:45:07','2021-06-24 11:45:07','','infograph-6','','inherit','open','closed','','infograph-6','','','2021-06-24 14:45:07','2021-06-24 11:45:07','',396,'https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg',0,'attachment','image/jpeg',0),(401,1,'2021-06-24 14:45:07','2021-06-24 11:45:07','','infograph-6','','inherit','open','closed','','infograph-6-2','','','2021-06-24 14:45:07','2021-06-24 11:45:07','',405,'https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg',0,'attachment','image/jpeg',0),(523,1,'2021-06-25 13:56:57','2021-06-25 10:56:57','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-25 13:56:57','2021-06-25 10:56:57','',396,'https://reo.ua/?p=523',0,'revision','',0),(403,1,'2021-06-24 14:47:19','2021-06-24 11:47:19','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n\r\n<strong>Що робити при підвищеній температурі?</strong>\r\n\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n\r\n<strong>Вода для медичних цілей РеО</strong>\r\n\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n\r\n<strong>Вода РеО при підвищеній температурі:</strong>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-24 14:47:19','2021-06-24 11:47:19','',396,'https://reo.ua/?p=403',0,'revision','',0),(402,1,'2021-06-24 14:46:03','2021-06-24 11:46:03','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n\r\n<strong>Що робити при підвищеній температурі?</strong>\r\n\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n\r\n<strong>Вода для медичних цілей РеО</strong>\r\n\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\"><strong>Складник</strong></td>\r\n<td width=\"151\"><strong>Вміст</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Вода РеО при підвищеній температурі:</strong>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-24 14:46:03','2021-06-24 11:46:03','',396,'https://reo.ua/?p=402',0,'revision','',0),(404,1,'2021-06-24 14:48:07','2021-06-24 11:48:07','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n\r\n<strong>Що робити при підвищеній температурі?</strong>\r\n\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n<strong>Скільки потрібно пити?</strong>\r\n\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n\r\n<strong>Вода для медичних цілей РеО</strong>\r\n\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Вода РеО при підвищеній температурі:</strong>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-24 14:48:07','2021-06-24 11:48:07','',396,'https://reo.ua/?p=404',0,'revision','',0),(405,1,'2021-06-24 14:46:03','2021-06-24 11:46:03','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потоотделение. Потеря жидкости с потом и учащенным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение. У детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания; у новорожденных – сухой подгузник в течение ≥3 часов.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png\"><img class=\"aligncenter size-large wp-image-1115\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1024x661.png\" alt=\"\" width=\"1024\" height=\"661\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потоотделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','publish','open','open','','pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature','','','2021-07-13 17:42:03','2021-07-13 14:42:03','',0,'https://reo.ua/bez-kategorii/chomu-potribno-bagato-piti-pri-pidvishhenij-temperaturi/',40,'post','',0),(406,1,'2021-07-13 17:41:33','2021-07-13 14:41:33','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\n\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потоотделение. Потеря жидкости с потом и учащенным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение. У детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания; у новорожденных – сухой подгузник в течение ≥3 часов.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\n&nbsp;\n\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\n<h2>Что делать при повышенной температуре?</h2>\n&nbsp;\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\n&nbsp;\n<h2>Сколько нужно пить?</h2>\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\n<h2>Что необходимо пить?</h2>\nПоскольку при высокой температуре и сильном потоотделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th><strong>Составляющая</strong></th>\n<th><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Вода РеО при повышенной температуре:</h2>\n<ul>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-autosave-v1','','','2021-07-13 17:41:33','2021-07-13 14:41:33','',405,'https://reo.ua/?p=406',0,'revision','',0),(529,1,'2021-06-25 14:00:28','2021-06-25 11:00:28','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-25 14:00:28','2021-06-25 11:00:28','',405,'https://reo.ua/?p=529',0,'revision','',0),(407,1,'2021-06-24 14:52:45','2021-06-24 11:52:45','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n<img class=\"aligncenter size-full wp-image-397\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg\" alt=\"\" width=\"627\" height=\"487\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n\r\n<strong>Что делать при повышенной температуре?</strong>\r\n\r\n<img class=\"aligncenter size-full wp-image-400\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg\" alt=\"\" width=\"676\" height=\"858\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n<strong>Сколько нужно пить?</strong>\r\n\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n\r\n<strong>Вода для медицинских целей РеО </strong>\r\n\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Вода РеО при повышенной температуре:</strong>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<strong>Список</strong> <strong>литературы</strong>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-24 14:52:45','2021-06-24 11:52:45','',405,'https://reo.ua/?p=407',0,'revision','',0),(1792,1,'2021-09-30 20:24:30','2021-09-30 17:24:30','','Главная','','inherit','closed','closed','','176-revision-v1','','','2021-09-30 20:24:30','2021-09-30 17:24:30','',176,'https://reo.ua/?p=1792',0,'revision','',0),(409,1,'2021-07-14 11:03:22','2021-06-25 07:17:21',' ','','','publish','closed','closed','','409','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=409',6,'nav_menu_item','',0),(412,1,'2021-06-25 10:20:03','2021-06-25 07:20:03','','infograph-8','','inherit','open','closed','','infograph-8','','','2021-06-25 10:20:03','2021-06-25 07:20:03','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg',0,'attachment','image/jpeg',0),(413,1,'2021-06-25 10:20:03','2021-06-25 07:20:03','','infograph-8','','inherit','open','closed','','infograph-8-2','','','2021-06-25 10:20:03','2021-06-25 07:20:03','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg',0,'attachment','image/jpeg',0),(414,1,'2021-06-25 10:20:46','2021-06-25 07:20:46','','infograph-9','','inherit','open','closed','','infograph-9','','','2021-06-25 10:20:46','2021-06-25 07:20:46','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg',0,'attachment','image/jpeg',0),(415,1,'2021-06-25 10:20:46','2021-06-25 07:20:46','','infograph-9','','inherit','open','closed','','infograph-9-2','','','2021-06-25 10:20:46','2021-06-25 07:20:46','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg',0,'attachment','image/jpeg',0),(416,1,'2021-06-25 10:21:19','2021-06-25 07:21:19','','infograph-10','','inherit','open','closed','','infograph-10','','','2021-06-25 10:21:19','2021-06-25 07:21:19','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg',0,'attachment','image/jpeg',0),(417,1,'2021-06-25 10:21:19','2021-06-25 07:21:19','','infograph-10','','inherit','open','closed','','infograph-10-2','','','2021-06-25 10:21:19','2021-06-25 07:21:19','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg',0,'attachment','image/jpeg',0),(524,1,'2021-06-25 13:57:21','2021-06-25 10:57:21','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n<img class=\"aligncenter size-full wp-image-412\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg\" alt=\"\" width=\"602\" height=\"574\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n<img class=\"aligncenter size-full wp-image-414\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg\" alt=\"\" width=\"500\" height=\"184\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n<img class=\"aligncenter size-full wp-image-416\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg\" alt=\"\" width=\"405\" height=\"296\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-06-25 13:57:21','2021-06-25 10:57:21','',411,'https://reo.ua/?p=524',0,'revision','',0),(418,1,'2021-06-25 10:22:53','2021-06-25 07:22:53','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n<img class=\"aligncenter size-full wp-image-412\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg\" alt=\"\" width=\"602\" height=\"574\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n<strong>Чим небезпечна втрата рідини?</strong>\r\n\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n<img class=\"aligncenter size-full wp-image-414\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg\" alt=\"\" width=\"500\" height=\"184\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n<img class=\"aligncenter size-full wp-image-416\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg\" alt=\"\" width=\"405\" height=\"296\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n<strong>Скільки необхідно пити?</strong>\r\n\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n\r\n<strong>Вода для медичних цілей РеО</strong>\r\n\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Як запобігти втраті рідини при спортивних навантаженнях?</strong>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-06-25 10:22:53','2021-06-25 07:22:53','',411,'https://reo.ua/?p=418',0,'revision','',0),(419,1,'2021-06-25 10:22:53','2021-06-25 07:22:53','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при частом дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО - это маломинерализированная вода, которая содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанавливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','publish','open','open','','skolko-nuzhno-pit-vo-vremya-trenirovok','','','2021-07-14 02:34:23','2021-07-13 23:34:23','',0,'https://reo.ua/bez-kategorii/skilki-potribno-piti-pid-chas-trenuvan/',38,'post','',0),(420,1,'2021-07-09 14:57:39','2021-07-09 11:57:39','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\n&nbsp;\n<h2>Чем опасна потеря жидкости?</h2>\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\n\n&nbsp;\n\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\n&nbsp;\n\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\n&nbsp;\n<h2>Сколько необходимо пить?</h2>\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\n<ul>\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\n</ul>\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\n<h2>Что необходимо пить?</h2>\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\n\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\n\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Составляющая</strong></th>\n<th width=\"50%\"><strong>Содержимое</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\n<ul>\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\n 	<li>пейте до, во время и после тренировки.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-autosave-v1','','','2021-07-09 14:57:39','2021-07-09 11:57:39','',419,'https://reo.ua/?p=420',0,'revision','',0),(530,1,'2021-06-25 14:01:09','2021-06-25 11:01:09','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n<img class=\"aligncenter size-full wp-image-412\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg\" alt=\"\" width=\"602\" height=\"574\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n<img class=\"aligncenter size-full wp-image-414\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg\" alt=\"\" width=\"500\" height=\"184\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n<img class=\"aligncenter size-full wp-image-416\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg\" alt=\"\" width=\"405\" height=\"296\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-25 14:01:09','2021-06-25 11:01:09','',419,'https://reo.ua/?p=530',0,'revision','',0),(421,1,'2021-06-25 10:26:19','2021-06-25 07:26:19','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n<img class=\"aligncenter size-full wp-image-412\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg\" alt=\"\" width=\"602\" height=\"574\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n<strong>Чем опасна потеря жидкости?</strong>\r\n\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n<img class=\"aligncenter size-full wp-image-414\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg\" alt=\"\" width=\"500\" height=\"184\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n<img class=\"aligncenter size-full wp-image-416\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg\" alt=\"\" width=\"405\" height=\"296\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n<strong>Сколько необходимо пить?</strong>\r\n\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n\r\n<strong>Вода для медицинских целей РеО </strong>\r\n\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Как предотвратить потерю жидкости при спортивных нагрузках?</strong>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<strong>Список литературы</strong>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-25 10:26:19','2021-06-25 07:26:19','',419,'https://reo.ua/?p=421',0,'revision','',0),(422,1,'2021-06-25 10:39:27','2021-06-25 07:39:27','У людини температура підтримується на постійному рівні (температурний баланс), й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\"><img class=\"aligncenter size-full wp-image-1090\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\" alt=\"\" width=\"1007\" height=\"560\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','publish','open','open','','shho-potribno-ta-ne-potribno-robiti-pri-pidvishhenni-temperaturi-tila','','','2021-07-13 17:07:14','2021-07-13 14:07:14','',0,'https://reo.ua/?p=422',33,'post','',0),(423,1,'2021-06-25 10:34:16','2021-06-25 07:34:16','','infograph-11','','inherit','open','closed','','infograph-11','','','2021-06-25 10:34:16','2021-06-25 07:34:16','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg',0,'attachment','image/jpeg',0),(424,1,'2021-06-25 10:34:16','2021-06-25 07:34:16','','infograph-11','','inherit','open','closed','','infograph-11-2','','','2021-06-25 10:34:16','2021-06-25 07:34:16','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg',0,'attachment','image/jpeg',0),(425,1,'2021-06-25 10:35:09','2021-06-25 07:35:09','','infograph-12','','inherit','open','closed','','infograph-12','','','2021-06-25 10:35:09','2021-06-25 07:35:09','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg',0,'attachment','image/jpeg',0),(426,1,'2021-06-25 10:35:09','2021-06-25 07:35:09','','infograph-12','','inherit','open','closed','','infograph-12-2','','','2021-06-25 10:35:09','2021-06-25 07:35:09','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg',0,'attachment','image/jpeg',0),(427,1,'2021-06-25 10:35:45','2021-06-25 07:35:45','','infograph-13','','inherit','open','closed','','infograph-13','','','2021-06-25 10:35:45','2021-06-25 07:35:45','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg',0,'attachment','image/jpeg',0),(428,1,'2021-06-25 10:35:45','2021-06-25 07:35:45','','infograph-13','','inherit','open','closed','','infograph-13-2','','','2021-06-25 10:35:45','2021-06-25 07:35:45','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg',0,'attachment','image/jpeg',0),(429,1,'2021-06-25 10:36:45','2021-06-25 07:36:45','','infograph-13','','inherit','open','closed','','infograph-13-2','','','2021-06-25 10:36:45','2021-06-25 07:36:45','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg',0,'attachment','image/jpeg',0),(430,1,'2021-06-25 10:36:45','2021-06-25 07:36:45','','infograph-13','','inherit','open','closed','','infograph-13-2-2','','','2021-06-25 10:36:45','2021-06-25 07:36:45','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg',0,'attachment','image/jpeg',0),(525,1,'2021-06-25 13:57:54','2021-06-25 10:57:54','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n<img class=\"aligncenter size-full wp-image-423\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg\" alt=\"\" width=\"520\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-425\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg\" alt=\"\" width=\"480\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n<img class=\"aligncenter size-full wp-image-427\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg\" alt=\"\" width=\"412\" height=\"330\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<img class=\"aligncenter size-full wp-image-429\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg\" alt=\"\" width=\"439\" height=\"388\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-25 13:57:54','2021-06-25 10:57:54','',422,'https://reo.ua/?p=525',0,'revision','',0),(431,1,'2021-06-25 10:39:27','2021-06-25 07:39:27','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n<img class=\"aligncenter size-full wp-image-423\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg\" alt=\"\" width=\"520\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-425\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg\" alt=\"\" width=\"480\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n<img class=\"aligncenter size-full wp-image-427\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg\" alt=\"\" width=\"412\" height=\"330\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<img class=\"aligncenter size-full wp-image-429\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg\" alt=\"\" width=\"439\" height=\"388\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n<strong>В яких випадках при підвищенні температури варто звернутися до лікаря?</strong>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<strong>Який зв’язок між водою та високою температурою?</strong>\r\n\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n\r\n<strong>Що робити при підвищенні температури тіла?</strong>\r\n\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n\r\n<strong>Скільки необхідно пити?</strong>\r\n\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n\r\n<strong>Вода для медичних цілей РеО</strong>\r\n\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО при підвищеній температурі:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-25 10:39:27','2021-06-25 07:39:27','',422,'https://reo.ua/?p=431',0,'revision','',0),(432,1,'2021-06-25 10:39:27','2021-06-25 07:39:27','У человека температура тела поддерживается на постоянном уровне (температурный баланс), и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png\"><img class=\"aligncenter size-large wp-image-1098\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1-1024x557.png\" alt=\"\" width=\"1024\" height=\"557\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, повышенное потоотделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','publish','open','open','','chto-nuzhno-i-ne-nuzhno-delat-pri-povyshenii-temperatury-tela','','','2021-07-13 16:19:31','2021-07-13 13:19:31','',0,'https://reo.ua/bez-kategorii/shho-potribno-ta-ne-potribno-robiti-pri-pidvishhenni-temperaturi-tila/',34,'post','',0),(433,1,'2021-08-27 17:21:23','2021-08-27 14:21:23','У человека температура тела поддерживается на постоянном уровне (температурный баланс), и любое снижение или повышение температуры тела может быть свидетельством заболевания.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\n&nbsp;\n\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png\"><img class=\"aligncenter size-large wp-image-1098\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1-1024x557.png\" alt=\"\" width=\"1024\" height=\"557\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\n&nbsp;\n\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\n&nbsp;\n\nВысокую температуру нередко сопровождают боль в мышцах и суставах, повышенное потоотделение, учащение сердцебиения и т. д.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\n&nbsp;\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\n<ul>\n 	<li>Сыпь, которая усиливается</li>\n 	<li>Головокружение</li>\n 	<li>Рвота</li>\n 	<li>Одышка</li>\n 	<li>Боль при мочеиспускании</li>\n 	<li>Боль в животе</li>\n 	<li>Невозможность прижать подбородок к груди</li>\n 	<li>Сильная головная боль</li>\n 	<li>Приступы судорог</li>\n</ul>\n<h2>Какая связь между водой и высокой температурой?</h2>\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\n\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\n<h2>Что делать при повышении температуры тела?</h2>\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\n\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\n<h2>Сколько необходимо пить?</h2>\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\n<h2>Что необходимо пить?</h2>\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Составляющая</strong></th>\n<th width=\"50%\"><strong>Содержимое</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-autosave-v1','','','2021-08-27 17:21:23','2021-08-27 14:21:23','',432,'https://reo.ua/?p=433',0,'revision','',0),(655,1,'2021-06-29 18:15:37','2021-06-29 15:15:37','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<img class=\"aligncenter wp-image-637 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"1024\" height=\"687\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"1021\" height=\"572\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"815\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"710\" height=\"729\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:15:37','2021-06-29 15:15:37','',432,'https://reo.ua/?p=655',0,'revision','',0),(653,1,'2021-06-29 18:14:14','2021-06-29 15:14:14','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\" alt=\"\" width=\"1149\" height=\"771\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"1021\" height=\"572\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"1015\" height=\"532\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"960\" height=\"986\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:14:14','2021-06-29 15:14:14','',432,'https://reo.ua/?p=653',0,'revision','',0),(531,1,'2021-06-25 14:01:40','2021-06-25 11:01:40','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<img class=\"aligncenter size-full wp-image-423\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg\" alt=\"\" width=\"520\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-425\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg\" alt=\"\" width=\"480\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<img class=\"aligncenter size-full wp-image-427\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg\" alt=\"\" width=\"412\" height=\"330\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<img class=\"aligncenter size-full wp-image-429\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg\" alt=\"\" width=\"439\" height=\"388\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-25 14:01:40','2021-06-25 11:01:40','',432,'https://reo.ua/?p=531',0,'revision','',0),(434,1,'2021-06-25 10:45:28','2021-06-25 07:45:28','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<img class=\"aligncenter size-full wp-image-423\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg\" alt=\"\" width=\"520\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-425\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg\" alt=\"\" width=\"480\" height=\"538\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<img class=\"aligncenter size-full wp-image-427\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg\" alt=\"\" width=\"412\" height=\"330\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<img class=\"aligncenter size-full wp-image-429\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-13-1.jpg\" alt=\"\" width=\"439\" height=\"388\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n<strong>В каких случаях при повышении температуры следует обратиться к врачу?</strong>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<strong>Какая связь между водой и высокой температурой?</strong>\r\n\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n\r\n<strong>Что делать при повышении температуры тела?</strong>\r\n\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n\r\n<strong>Сколько необходимо пить?</strong>\r\n\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n\r\n<strong>Вода для медицинских целей РеО</strong>\r\n\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Преимущества воды РеО при повышенной температуре:</strong>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<strong>Список</strong> <strong>литературы</strong>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-25 10:45:28','2021-06-25 07:45:28','',432,'https://reo.ua/?p=434',0,'revision','',0),(435,1,'2021-07-14 11:03:22','2021-06-25 07:49:48',' ','','','publish','closed','closed','','435','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',0,'https://reo.ua/?p=435',1,'nav_menu_item','',0),(437,1,'2021-07-14 11:03:22','2021-06-25 07:50:58',' ','','','publish','closed','closed','','437','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',15,'https://reo.ua/?p=437',7,'nav_menu_item','',0),(441,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','441','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=441',15,'nav_menu_item','',0),(442,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','442','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=442',10,'nav_menu_item','',0),(443,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','443','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=443',11,'nav_menu_item','',0),(444,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','444','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=444',9,'nav_menu_item','',0),(445,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','445','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',19,'https://reo.ua/?p=445',12,'nav_menu_item','',0),(446,1,'2021-07-14 11:03:22','2021-06-25 07:55:56',' ','','','publish','closed','closed','','446','','','2021-07-14 11:03:22','2021-07-14 08:03:22','',0,'https://reo.ua/?p=446',16,'nav_menu_item','',0),(1290,1,'2021-07-27 10:27:42','2021-07-27 07:27:42','','slide-1','','inherit','open','closed','','slide-1-2','','','2021-07-27 10:27:42','2021-07-27 07:27:42','',8,'https://reo.ua/wp-content/uploads/2021/07/slide-1.webp',0,'attachment','image/webp',0),(1291,1,'2021-07-27 10:27:42','2021-07-27 07:27:42','','slide-1','','inherit','open','closed','','slide-1-2-2','','','2021-07-27 10:27:42','2021-07-27 07:27:42','',176,'https://reo.ua/wp-content/uploads/2021/07/slide-1.webp',0,'attachment','image/webp',0),(461,1,'2021-06-25 11:18:02','2021-06-25 08:18:02','a:7:{s:8:\"location\";a:1:{i:0;a:1:{i:0;a:3:{s:5:\"param\";s:9:\"post_type\";s:8:\"operator\";s:2:\"==\";s:5:\"value\";s:4:\"post\";}}}s:8:\"position\";s:6:\"normal\";s:5:\"style\";s:7:\"default\";s:15:\"label_placement\";s:3:\"top\";s:21:\"instruction_placement\";s:5:\"label\";s:14:\"hide_on_screen\";s:0:\"\";s:11:\"description\";s:0:\"\";}','Статьи','stati','publish','closed','closed','','group_60d590f4c5f8a','','','2021-06-29 17:11:57','2021-06-29 14:11:57','',0,'https://reo.ua/?post_type=acf-field-group&#038;p=461',0,'acf-field-group','',0),(462,1,'2021-06-25 11:18:02','2021-06-25 08:18:02','a:7:{s:4:\"type\";s:3:\"tab\";s:12:\"instructions\";s:0:\"\";s:8:\"required\";i:0;s:17:\"conditional_logic\";i:0;s:7:\"wrapper\";a:3:{s:5:\"width\";s:0:\"\";s:5:\"class\";s:0:\"\";s:2:\"id\";s:0:\"\";}s:9:\"placement\";s:3:\"top\";s:8:\"endpoint\";i:0;}','Скачать как PDF','skachat_kak_pdf','publish','closed','closed','','field_60d591244d880','','','2021-06-25 11:18:02','2021-06-25 08:18:02','',461,'https://reo.ua/?post_type=acf-field&p=462',0,'acf-field','',0),(463,1,'2021-06-25 11:18:02','2021-06-25 08:18:02','a:10:{s:4:\"type\";s:4:\"file\";s:12:\"instructions\";s:0:\"\";s:8:\"required\";i:0;s:17:\"conditional_logic\";i:0;s:7:\"wrapper\";a:3:{s:5:\"width\";s:0:\"\";s:5:\"class\";s:0:\"\";s:2:\"id\";s:0:\"\";}s:13:\"return_format\";s:3:\"url\";s:7:\"library\";s:3:\"all\";s:8:\"min_size\";s:0:\"\";s:8:\"max_size\";s:0:\"\";s:10:\"mime_types\";s:0:\"\";}','Прикрепите PDF файл','dwn-pdf','publish','closed','closed','','field_60d5912c4d881','','','2021-06-29 17:11:57','2021-06-29 14:11:57','',461,'https://reo.ua/?post_type=acf-field&#038;p=463',1,'acf-field','',0),(465,1,'2021-06-25 11:47:32','2021-06-25 08:47:32','Токсикоз вагітних – це комплекс патологічних змін в організмі вагітної, що зазвичай з’являються на 13–16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози на 34-40-й тижні. Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що охоплює не тільки надзвичайно сильну нудоту та блювання (&gt;4 разів на день), а й падіння артеріального тиску під час переходу у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричину надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався під час попередньої вагітності чи у близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО – це готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додаткова перевага – її приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти рідку їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','publish','open','open','','toksikoz-yak-povernutisya-do-zvichajnogo-perebigu-vagitnosti','','','2021-07-19 16:44:53','2021-07-19 13:44:53','',0,'https://reo.ua/?p=465',32,'post','',0),(466,1,'2021-06-25 11:44:26','2021-06-25 08:44:26','','infograph-15','','inherit','open','closed','','infograph-15','','','2021-06-25 11:44:26','2021-06-25 08:44:26','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg',0,'attachment','image/jpeg',0),(467,1,'2021-06-25 11:44:26','2021-06-25 08:44:26','','infograph-15','','inherit','open','closed','','infograph-15-2','','','2021-06-25 11:44:26','2021-06-25 08:44:26','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg',0,'attachment','image/jpeg',0),(468,1,'2021-06-25 11:45:12','2021-06-25 08:45:12','','infograph-16','','inherit','open','closed','','infograph-16','','','2021-06-25 11:45:12','2021-06-25 08:45:12','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg',0,'attachment','image/jpeg',0),(469,1,'2021-06-25 11:45:12','2021-06-25 08:45:12','','infograph-16','','inherit','open','closed','','infograph-16-2','','','2021-06-25 11:45:12','2021-06-25 08:45:12','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg',0,'attachment','image/jpeg',0),(526,1,'2021-06-25 13:58:24','2021-06-25 10:58:24','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n<img class=\"aligncenter size-full wp-image-466\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg\" alt=\"\" width=\"498\" height=\"454\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n<img class=\"aligncenter size-full wp-image-468\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg\" alt=\"\" width=\"440\" height=\"264\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-25 13:58:24','2021-06-25 10:58:24','',465,'https://reo.ua/?p=526',0,'revision','',0),(472,1,'2021-06-25 11:47:32','2021-06-25 08:47:32','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n<img class=\"aligncenter size-full wp-image-466\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg\" alt=\"\" width=\"498\" height=\"454\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n<strong>Чим небезпечне зневоднення у вагітних?</strong>\r\n\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n<img class=\"aligncenter size-full wp-image-468\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg\" alt=\"\" width=\"440\" height=\"264\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n<strong>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</strong>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<strong>Скільки необхідно пити?</strong>\r\n\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Що необхідно пити?</strong>\r\n\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n\r\n<strong>Вода для медичних цілей РеО </strong>\r\n\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО для вагітних:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<strong>Як запобігти зневодненню у вагітних?</strong>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-25 11:47:32','2021-06-25 08:47:32','',465,'https://reo.ua/?p=472',0,'revision','',0),(470,1,'2021-06-25 11:47:29','2021-06-25 08:47:29','','infograph-15','','inherit','open','closed','','infograph-15-2','','','2021-06-25 11:47:29','2021-06-25 08:47:29','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-15-1.jpg',0,'attachment','image/jpeg',0),(471,1,'2021-06-25 11:47:29','2021-06-25 08:47:29','','infograph-15','','inherit','open','closed','','infograph-15-2-2','','','2021-06-25 11:47:29','2021-06-25 08:47:29','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-15-1.jpg',0,'attachment','image/jpeg',0),(473,1,'2021-06-25 11:47:32','2021-06-25 08:47:32','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутанности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','publish','open','open','','toksikoz-kak-vernutsya-k-obychnomu-techeniyu-beremennosti','','','2021-07-13 09:56:20','2021-07-13 06:56:20','',0,'https://reo.ua/bez-kategorii/toksikoz-yak-povernutisya-do-zvichajnogo-perebigu-vagitnosti/',31,'post','',0),(474,1,'2021-07-13 09:55:47','2021-07-13 06:55:47','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели, хотя у некоторых женщин могут продолжаться и дольше.\n\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\n&nbsp;\n<h2>Чем опасно обезвоживание у беременных?</h2>\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\n\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\n&nbsp;\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\n<ul>\n 	<li>При изменении обычных движений плода.</li>\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\n 	<li>При потере сознания, приступах судорог, спутанности сознания.</li>\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\n</ul>\n<h2>Сколько необходимо пить?</h2>\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\n\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\n\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\n<table>\n<tbody>\n<tr>\n<th width=\"50%\"><strong>Группа женщин</strong></th>\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\n</tr>\n<tr>\n<td>Взрослые женщины</td>\n<td>2200 мл</td>\n<td>2700 мл</td>\n<td>2000 мл</td>\n</tr>\n<tr>\n<td>Беременные</td>\n<td>4800 мл</td>\n<td>3000 мл</td>\n<td>2300 мл</td>\n</tr>\n<tr>\n<td>Женщины, кормящие грудью</td>\n<td>5500 мл</td>\n<td>3800 мл</td>\n<td>2700 мл</td>\n</tr>\n</tbody>\n</table>\n<h2>Что необходимо пить?</h2>\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Составляющая</strong></th>\n<th width=\"50%\"><strong>Содержимое</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО для беременных:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пьется даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания.</li>\n</ul>\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\n<ul>\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\n 	<li>обращать внимание на ощущение жажды;</li>\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\n 	<li>всегда носить с собой бутылку воды.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-autosave-v1','','','2021-07-13 09:55:47','2021-07-13 06:55:47','',473,'https://reo.ua/?p=474',0,'revision','',0),(662,1,'2021-06-29 18:26:48','2021-06-29 15:26:48','','infograph-40-ru','','inherit','open','closed','','infograph-40-ru','','','2021-06-29 18:26:48','2021-06-29 15:26:48','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg',0,'attachment','image/jpeg',0),(532,1,'2021-06-25 14:02:21','2021-06-25 11:02:21','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n<img class=\"aligncenter size-full wp-image-466\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg\" alt=\"\" width=\"498\" height=\"454\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n<img class=\"aligncenter size-full wp-image-468\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg\" alt=\"\" width=\"440\" height=\"264\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-25 14:02:21','2021-06-25 11:02:21','',473,'https://reo.ua/?p=532',0,'revision','',0),(475,1,'2021-06-25 11:50:46','2021-06-25 08:50:46','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n<img class=\"aligncenter size-full wp-image-466\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg\" alt=\"\" width=\"498\" height=\"454\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n<strong>Чем опасно обезвоживание у беременных?</strong>\r\n\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n<img class=\"aligncenter size-full wp-image-468\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg\" alt=\"\" width=\"440\" height=\"264\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n<strong>В каких случаях при обезвоживании беременной следует обратиться к врачу?</strong>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<strong>Сколько необходимо пить?</strong>\r\n\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Что необходимо пить?</strong>\r\n\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n\r\n<strong>Вода для медицинских целей РеО</strong>\r\n\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Преимущества воды РеО для беременных:</strong>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<strong>Как препятствовать обезвоживанию у беременных?</strong>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<strong>Список литературы</strong>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-25 11:50:46','2021-06-25 08:50:46','',473,'https://reo.ua/?p=475',0,'revision','',0),(478,1,'2021-06-25 13:03:00','2021-06-25 10:03:00','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їхній дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Причини, що зумовлюють дегідратацію у дітей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западання очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Немає</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спраги немає</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки наявна втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком молодше 2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині старше 10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й немає ознак надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз в 1-2 години. Якщо покращення стану немає, пришвидшіть введення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що містив 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','publish','open','open','','oralna-regidratacziya-u-ditej','','','2021-07-13 01:34:15','2021-07-12 22:34:15','',0,'https://reo.ua/?p=478',29,'post','',0),(479,1,'2021-06-25 12:57:42','2021-06-25 09:57:42','','infograph-20','','inherit','open','closed','','infograph-20','','','2021-06-25 12:57:42','2021-06-25 09:57:42','',478,'https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg',0,'attachment','image/jpeg',0),(480,1,'2021-06-25 12:57:42','2021-06-25 09:57:42','','infograph-20','','inherit','open','closed','','infograph-20-2','','','2021-06-25 12:57:42','2021-06-25 09:57:42','',571,'https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg',0,'attachment','image/jpeg',0),(481,1,'2021-06-25 13:02:55','2021-06-25 10:02:55','','prew','','inherit','open','closed','','prew','','','2021-06-25 13:02:55','2021-06-25 10:02:55','',478,'https://reo.ua/wp-content/uploads/2021/06/prew.jpg',0,'attachment','image/jpeg',0),(482,1,'2021-06-25 13:02:55','2021-06-25 10:02:55','','prew','','inherit','open','closed','','prew-2','','','2021-06-25 13:02:55','2021-06-25 10:02:55','',571,'https://reo.ua/wp-content/uploads/2021/06/prew.jpg',0,'attachment','image/jpeg',0),(488,1,'2021-06-25 13:11:36','2021-06-25 10:11:36','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:11:36','2021-06-25 10:11:36','',478,'https://reo.ua/?p=488',0,'revision','',0),(487,1,'2021-06-25 13:10:37','2021-06-25 10:10:37','<strong>Дегідратація: визначення, причини, патогенез</strong>\r\n\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<strong>Патогенез дегідратації</strong>\r\n\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n\r\n<strong>Клінічна картина та ступені дегідратації</strong>\r\n\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>План А: оральна регідратація</strong>\r\n\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n\r\n<strong>Скільки рідини давати?</strong>\r\n\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n\r\n<strong>Вода для медичних цілей РеО («Юрія-Фарм»)</strong>\r\n\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<strong>Профілактика дегідратації</strong>\r\n\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n\r\n<strong>Потреби дитини в рідині розраховуються таким чином:</strong>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:10:37','2021-06-25 10:10:37','',478,'https://reo.ua/?p=487',0,'revision','',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (486,1,'2021-06-25 13:06:58','2021-06-25 10:06:58','<strong>Дегідратація: визначення, причини, патогенез</strong>\r\n\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<strong>Патогенез дегідратації</strong>\r\n\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n\r\n<strong>Клінічна картина та ступені дегідратації</strong>\r\n\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна\r\n\r\nчи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання\r\n\r\nз формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Критерій оцінки</strong></td>\r\n<td width=\"155\"><strong>А</strong></td>\r\n<td width=\"155\"><strong>В</strong></td>\r\n<td width=\"155\"><strong>С</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nП’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується швидко</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n<strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна\r\n\r\nпрофілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак\r\n\r\nіз цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак із цього списку,\r\n\r\nнаявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Тактика дій</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nПлан А</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо можливо, зважте дитину\r\n\r\nта застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно\r\n\r\nрозпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>План А: оральна регідратація</strong>\r\n\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n\r\n<strong>Скільки рідини давати?</strong>\r\n\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вік</strong></td>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вага</strong></td>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Мл</strong></td>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>Вік</strong></td>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>До 12 міс.</strong></td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n5 годин</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>Понад 12 міс.</strong></td>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n\r\n<strong>Вода для медичних цілей РеО («Юрія-Фарм»)</strong>\r\n\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\"><strong>Складник</strong></td>\r\n<td width=\"151\"><strong>Вміст</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3\r\n\r\n-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<strong>Профілактика дегідратації</strong>\r\n\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n\r\n<strong>Потреби дитини в рідині розраховуються таким чином:</strong>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:06:58','2021-06-25 10:06:58','',478,'https://reo.ua/?p=486',0,'revision','',0),(483,1,'2021-06-25 13:03:00','2021-06-25 10:03:00','<strong>Дегідратація: визначення, причини, патогенез</strong>\r\n\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<strong>Патогенез дегідратації</strong>\r\n\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n\r\n<strong>Клінічна картина та ступені дегідратації</strong>\r\n\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Критерій</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\n<strong>Незначна дегідратація (&lt;5%)</strong></td>\r\n<td width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></td>\r\n<td width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nЛетаргія, дратівливість</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nРозлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальна</td>\r\n<td width=\"166\">Нормальна\r\n\r\nчи незначна тахікардія</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nТахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Частота дихання</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальна</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nПідвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання\r\n\r\nз формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nПомірно знижений</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nЗнижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальний</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nЗбільшений</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nЗначно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\"><strong>Ознаки дегідратації</strong></td>\r\n<td width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></td>\r\n<td width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Критерій оцінки</strong></td>\r\n<td width=\"155\"><strong>А</strong></td>\r\n<td width=\"155\"><strong>В</strong></td>\r\n<td width=\"155\"><strong>С</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nП’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується швидко</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n<strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна\r\n\r\nпрофілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак\r\n\r\nіз цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак із цього списку,\r\n\r\nнаявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Тактика дій</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nПлан А</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо можливо, зважте дитину\r\n\r\nта застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно\r\n\r\nрозпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>План А: оральна регідратація</strong>\r\n\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n\r\n<strong>Скільки рідини давати?</strong>\r\n\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вік</strong></td>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вага</strong></td>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Мл</strong></td>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>Вік</strong></td>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>До 12 міс.</strong></td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n5 годин</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>Понад 12 міс.</strong></td>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n\r\n<strong>Вода для медичних цілей РеО («Юрія-Фарм»)</strong>\r\n\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\"><strong>Складник</strong></td>\r\n<td width=\"151\"><strong>Вміст</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3\r\n\r\n-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<strong>Профілактика дегідратації</strong>\r\n\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n\r\n<strong>Потреби дитини в рідині розраховуються таким чином:</strong>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:03:00','2021-06-25 10:03:00','',478,'https://reo.ua/?p=483',0,'revision','',0),(785,1,'2021-07-02 16:09:01','2021-07-02 13:09:01','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Своєю чергою, поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та по- кращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повно- цінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води у цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного статусу, прийом значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язова/жирова тканина (це важливо, оскільки у м’язах зберігається у 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западіння очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання вна- слідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>вживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Підвищений ризик дегідратації у осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. при переході з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прийом певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої\r\n\r\nта виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (рис. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації виступають зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Фактори ризику дегідратації у осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та зумовленим цим небажанням вживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому у цього контингенту особливе значення має безпечність тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, прийом ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання страв, багатих на рідину (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-02 16:09:01','2021-07-02 13:09:01','',506,'https://reo.ua/?p=785',0,'revision','',0),(686,1,'2021-06-29 18:39:07','2021-06-29 15:39:07','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-29 18:39:07','2021-06-29 15:39:07','',465,'https://reo.ua/?p=686',0,'revision','',0),(485,1,'2021-06-25 13:05:14','2021-06-25 10:05:14','<strong>Дегідратація: визначення, причини, патогенез</strong>\r\n\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<strong>Патогенез дегідратації</strong>\r\n\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n\r\n<strong>Клінічна картина та ступені дегідратації</strong>\r\n\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\">&nbsp;\r\n\r\n<strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nЛетаргія, дратівливість</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nРозлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальна</td>\r\n<td width=\"166\">Нормальна\r\n\r\nчи незначна тахікардія</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nТахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Частота дихання</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальна</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nПідвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання\r\n\r\nз формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\">&nbsp;\r\n\r\n<strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nПомірно знижений</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nЗнижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">&nbsp;\r\n\r\nНормальний</td>\r\n<td width=\"166\">&nbsp;\r\n\r\nЗбільшений</td>\r\n<td width=\"151\">&nbsp;\r\n\r\nЗначно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\"><strong>Ознаки дегідратації</strong></td>\r\n<td width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></td>\r\n<td width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Критерій оцінки</strong></td>\r\n<td width=\"155\"><strong>А</strong></td>\r\n<td width=\"155\"><strong>В</strong></td>\r\n<td width=\"155\"><strong>С</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nП’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується швидко</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nСкладка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n<strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна\r\n\r\nпрофілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак\r\n\r\nіз цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо є ≥2 ознак із цього списку,\r\n\r\nнаявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\">&nbsp;\r\n\r\n<strong>Тактика дій</strong></td>\r\n<td width=\"155\">&nbsp;\r\n\r\nПлан А</td>\r\n<td width=\"155\">&nbsp;\r\n\r\nЯкщо можливо, зважте дитину\r\n\r\nта застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно\r\n\r\nрозпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>План А: оральна регідратація</strong>\r\n\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n\r\n<strong>Скільки рідини давати?</strong>\r\n\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вік</strong></td>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вага</strong></td>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Мл</strong></td>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>Вік</strong></td>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n<strong>До 12 міс.</strong></td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>\r\n\r\n5 годин</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>Понад 12 міс.</strong></td>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n\r\n<strong>Вода для медичних цілей РеО («Юрія-Фарм»)</strong>\r\n\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\"><strong>Складник</strong></td>\r\n<td width=\"151\"><strong>Вміст</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3\r\n\r\n-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Переваги води РеО:</strong>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<strong>Профілактика дегідратації</strong>\r\n\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n\r\n<strong>Потреби дитини в рідині розраховуються таким чином:</strong>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<strong>Список літератури</strong>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:05:14','2021-06-25 10:05:14','',478,'https://reo.ua/?p=485',0,'revision','',0),(489,1,'2021-06-25 13:36:57','2021-06-25 10:36:57','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>розсмоктуйте заморожений сік або інші напої;</li>\r\n 	<li>розсмоктуйте шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter wp-image-1054 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\" alt=\"\" width=\"1170\" height=\"2234\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png\"><img class=\"aligncenter size-large wp-image-1087\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1-726x1024.png\" alt=\"\" width=\"726\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку води (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','publish','open','open','','oralna-regidratacziya-u-doroslih','','','2021-07-13 15:42:15','2021-07-13 12:42:15','',0,'https://reo.ua/?p=489',26,'post','',0),(490,1,'2021-06-25 13:13:30','2021-06-25 10:13:30','','Оральна регідратація у дітей_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-ditej_doctor-star_2021','','','2021-06-25 13:13:30','2021-06-25 10:13:30','',478,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-ditej_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(491,1,'2021-06-25 13:13:30','2021-06-25 10:13:30','','Оральна регідратація у дітей_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-ditej_doctor-star_2021-2','','','2021-06-25 13:13:30','2021-06-25 10:13:30','',571,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-ditej_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(492,1,'2021-06-25 13:13:37','2021-06-25 10:13:37','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжу- ється дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (на- приклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зу- мовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які харак- теризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дра- тівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на проме- невій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для ораль- ної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непід- солодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких га- зованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпет- кою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідра- тацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації від- сутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідрата- ції, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-06-25 13:13:37','2021-06-25 10:13:37','',478,'https://reo.ua/?p=492',0,'revision','',0),(493,1,'2021-06-25 13:19:21','2021-06-25 10:19:21','','prew2','','inherit','open','closed','','prew2','','','2021-06-25 13:19:21','2021-06-25 10:19:21','',489,'https://reo.ua/wp-content/uploads/2021/06/prew2.jpg',0,'attachment','image/jpeg',0),(494,1,'2021-06-25 13:19:21','2021-06-25 10:19:21','','prew2','','inherit','open','closed','','prew2-2','','','2021-06-25 13:19:21','2021-06-25 10:19:21','',582,'https://reo.ua/wp-content/uploads/2021/06/prew2.jpg',0,'attachment','image/jpeg',0),(495,1,'2021-06-25 13:30:45','2021-06-25 10:30:45','','infograph-21','','inherit','open','closed','','infograph-21','','','2021-06-25 13:30:45','2021-06-25 10:30:45','',489,'https://reo.ua/wp-content/uploads/2021/06/infograph-21.jpg',0,'attachment','image/jpeg',0),(496,1,'2021-06-25 13:30:45','2021-06-25 10:30:45','','infograph-21','','inherit','open','closed','','infograph-21-2','','','2021-06-25 13:30:45','2021-06-25 10:30:45','',582,'https://reo.ua/wp-content/uploads/2021/06/infograph-21.jpg',0,'attachment','image/jpeg',0),(497,1,'2021-06-25 13:33:50','2021-06-25 10:33:50','','infograph-22','','inherit','open','closed','','infograph-22','','','2021-06-25 13:33:50','2021-06-25 10:33:50','',489,'https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg',0,'attachment','image/jpeg',0),(498,1,'2021-06-25 13:33:50','2021-06-25 10:33:50','','infograph-22','','inherit','open','closed','','infograph-22-2','','','2021-06-25 13:33:50','2021-06-25 10:33:50','',582,'https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg',0,'attachment','image/jpeg',0),(499,1,'2021-06-25 13:36:19','2021-06-25 10:36:19','','Оральна регідратація у дорослих_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-doroslih_doctor-star_2021','','','2021-06-25 13:36:19','2021-06-25 10:36:19','',489,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-doroslih_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(500,1,'2021-06-25 13:36:19','2021-06-25 10:36:19','','Оральна регідратація у дорослих_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-doroslih_doctor-star_2021-2','','','2021-06-25 13:36:19','2021-06-25 10:36:19','',582,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-doroslih_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(501,1,'2021-06-25 13:36:57','2021-06-25 10:36:57','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, при якому втрати води перевищують поповнення її запасів. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>Окрім втрати води, при дегідратації організм втрачає і електроліти, передусім, натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити втрату рідини: порушення мислення та психічного статусу, ім- мобілізація, розлади формування відчуття спраги, передозування ліків із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. при переході з гори- зонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації включають:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотий стандарт діагностики дегідратації відсутній, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть мати місце не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміни діаметра вени при диханні\r\n\r\n&gt;50% свідчать про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<h1>Рекомендації щодо профілактики дегідратації:</h1>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>при перебуванні на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини при спортивних навантаженнях на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку що 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-06-25 13:36:57','2021-06-25 10:36:57','',489,'https://reo.ua/?p=501',0,'revision','',0),(502,1,'2021-06-25 13:38:06','2021-06-25 10:38:06','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, при якому втрати води перевищують поповнення її запасів. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>Окрім втрати води, при дегідратації організм втрачає і електроліти, передусім, натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити втрату рідини: порушення мислення та психічного статусу, ім- мобілізація, розлади формування відчуття спраги, передозування ліків із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. при переході з гори- зонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації включають:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотий стандарт діагностики дегідратації відсутній, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть мати місце не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміни діаметра вени при диханні\r\n\r\n&gt;50% свідчать про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>при перебуванні на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини при спортивних навантаженнях на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку що 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-06-25 13:38:06','2021-06-25 10:38:06','',489,'https://reo.ua/?p=502',0,'revision','',0),(503,1,'2021-06-25 13:39:35','2021-06-25 10:39:35','','infograph-21','','inherit','open','closed','','infograph-21-2','','','2021-06-25 13:39:35','2021-06-25 10:39:35','',489,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg',0,'attachment','image/jpeg',0),(504,1,'2021-06-25 13:39:35','2021-06-25 10:39:35','','infograph-21','','inherit','open','closed','','infograph-21-2-2','','','2021-06-25 13:39:35','2021-06-25 10:39:35','',582,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg',0,'attachment','image/jpeg',0),(505,1,'2021-06-25 13:39:53','2021-06-25 10:39:53','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, при якому втрати води перевищують поповнення її запасів. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>Окрім втрати води, при дегідратації організм втрачає і електроліти, передусім, натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити втрату рідини: порушення мислення та психічного статусу, ім- мобілізація, розлади формування відчуття спраги, передозування ліків із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. при переході з гори- зонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації включають:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотий стандарт діагностики дегідратації відсутній, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть мати місце не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміни діаметра вени при диханні\r\n\r\n&gt;50% свідчать про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>при перебуванні на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини при спортивних навантаженнях на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку що 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-06-25 13:39:53','2021-06-25 10:39:53','',489,'https://reo.ua/?p=505',0,'revision','',0),(506,1,'2021-06-25 13:53:50','2021-06-25 10:53:50','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість слизової оболонки ротової порожнини, очей і сухість шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png\"><img class=\"aligncenter size-large wp-image-1046\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1-1024x360.png\" alt=\"\" width=\"1024\" height=\"360\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','publish','open','open','','oralna-regidratacziya-u-osib-pohilogo-ta-starechogo-viku','','','2021-07-13 00:56:25','2021-07-12 21:56:25','',0,'https://reo.ua/?p=506',23,'post','',0),(507,1,'2021-06-25 13:42:13','2021-06-25 10:42:13','','Оральна регідратація у осіб похилого віку_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021','','','2021-06-25 13:42:13','2021-06-25 10:42:13','',506,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(508,1,'2021-06-25 13:42:13','2021-06-25 10:42:13','','Оральна регідратація у осіб похилого віку_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021-2','','','2021-06-25 13:42:13','2021-06-25 10:42:13','',577,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(509,1,'2021-06-25 13:42:40','2021-06-25 10:42:40','','prew3','','inherit','open','closed','','prew3','','','2021-06-25 13:42:40','2021-06-25 10:42:40','',506,'https://reo.ua/wp-content/uploads/2021/06/prew3.jpg',0,'attachment','image/jpeg',0),(510,1,'2021-06-25 13:42:40','2021-06-25 10:42:40','','prew3','','inherit','open','closed','','prew3-2','','','2021-06-25 13:42:40','2021-06-25 10:42:40','',577,'https://reo.ua/wp-content/uploads/2021/06/prew3.jpg',0,'attachment','image/jpeg',0),(511,1,'2021-06-25 13:43:31','2021-06-25 10:43:31','','infograph-23','','inherit','open','closed','','infograph-23','','','2021-06-25 13:43:31','2021-06-25 10:43:31','',506,'https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg',0,'attachment','image/jpeg',0),(512,1,'2021-06-25 13:43:31','2021-06-25 10:43:31','','infograph-23','','inherit','open','closed','','infograph-23-2','','','2021-06-25 13:43:31','2021-06-25 10:43:31','',577,'https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg',0,'attachment','image/jpeg',0),(513,1,'2021-06-25 13:45:08','2021-06-25 10:45:08','','infograph-24','','inherit','open','closed','','infograph-24','','','2021-06-25 13:45:08','2021-06-25 10:45:08','',506,'https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg',0,'attachment','image/jpeg',0),(514,1,'2021-06-25 13:45:08','2021-06-25 10:45:08','','infograph-24','','inherit','open','closed','','infograph-24-2','','','2021-06-25 13:45:08','2021-06-25 10:45:08','',577,'https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg',0,'attachment','image/jpeg',0),(515,1,'2021-06-25 13:48:59','2021-06-25 10:48:59','','infograph-25','','inherit','open','closed','','infograph-25','','','2021-06-25 13:48:59','2021-06-25 10:48:59','',506,'https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg',0,'attachment','image/jpeg',0),(516,1,'2021-06-25 13:48:59','2021-06-25 10:48:59','','infograph-25','','inherit','open','closed','','infograph-25-2','','','2021-06-25 13:48:59','2021-06-25 10:48:59','',577,'https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg',0,'attachment','image/jpeg',0),(517,1,'2021-06-25 13:52:09','2021-06-25 10:52:09','','infograph-26','','inherit','open','closed','','infograph-26','','','2021-06-25 13:52:09','2021-06-25 10:52:09','',506,'https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg',0,'attachment','image/jpeg',0),(518,1,'2021-06-25 13:52:09','2021-06-25 10:52:09','','infograph-26','','inherit','open','closed','','infograph-26-2','','','2021-06-25 13:52:09','2021-06-25 10:52:09','',577,'https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg',0,'attachment','image/jpeg',0),(519,1,'2021-06-25 13:53:50','2021-06-25 10:53:50','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Своєю чергою, поняття «ге- ріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та по- кращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повно- цінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л ріди- ни щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води у цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного статусу, прийом значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язова/жирова тканина (це важливо, оскільки у м’язах зберіга- ється у 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западіння очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання вна- слідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>вживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Підвищений ризик дегідратації у осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. при переході з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прийом певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої\r\n\r\nта виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (рис. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації виступають зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіпо- волемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Фактори ризику дегідратації у осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та зумовленим цим небажанням вживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідра- тації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньо- венної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захво- рювань та загальною ослабленістю. Тому у цього контингенту особливе значення має безпечність тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити де- фіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, прийом ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання страв, багатих на рідину (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-06-25 13:53:50','2021-06-25 10:53:50','',506,'https://reo.ua/?p=519',0,'revision','',0),(831,1,'2021-07-06 17:37:50','2021-07-06 14:37:50','','Web_REO_T1_1','','inherit','open','closed','','web_reo_t1_1','','','2021-07-06 17:37:50','2021-07-06 14:37:50','',368,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png',0,'attachment','image/png',0),(545,1,'2021-06-25 17:35:03','2021-06-25 14:35:03','','infograph-1-ru','','inherit','open','closed','','infograph-1-ru','','','2021-06-25 17:35:03','2021-06-25 14:35:03','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg',0,'attachment','image/jpeg',0),(533,1,'2021-06-25 17:32:54','2021-06-25 14:32:54','','infograph-3-ru','','inherit','open','closed','','infograph-3-ru','','','2021-06-25 17:32:54','2021-06-25 14:32:54','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg',0,'attachment','image/jpeg',0),(534,1,'2021-06-25 17:32:54','2021-06-25 14:32:54','','infograph-3-ru','','inherit','open','closed','','infograph-3-ru-2','','','2021-06-25 17:32:54','2021-06-25 14:32:54','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg',0,'attachment','image/jpeg',0),(535,1,'2021-06-25 17:32:55','2021-06-25 14:32:55','','infograph-3-ua','','inherit','open','closed','','infograph-3-ua','','','2021-06-25 17:32:55','2021-06-25 14:32:55','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg',0,'attachment','image/jpeg',0),(536,1,'2021-06-25 17:32:55','2021-06-25 14:32:55','','infograph-3-ua','','inherit','open','closed','','infograph-3-ua-2','','','2021-06-25 17:32:55','2021-06-25 14:32:55','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg',0,'attachment','image/jpeg',0),(537,1,'2021-06-25 17:32:56','2021-06-25 14:32:56','','infograph-4-ru','','inherit','open','closed','','infograph-4-ru','','','2021-06-25 17:32:56','2021-06-25 14:32:56','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg',0,'attachment','image/jpeg',0),(538,1,'2021-06-25 17:32:56','2021-06-25 14:32:56','','infograph-4-ru','','inherit','open','closed','','infograph-4-ru-2','','','2021-06-25 17:32:56','2021-06-25 14:32:56','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg',0,'attachment','image/jpeg',0),(539,1,'2021-06-25 17:32:57','2021-06-25 14:32:57','','infograph-4-ua','','inherit','open','closed','','infograph-4-ua','','','2021-06-25 17:32:57','2021-06-25 14:32:57','',384,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg',0,'attachment','image/jpeg',0),(540,1,'2021-06-25 17:32:57','2021-06-25 14:32:57','','infograph-4-ua','','inherit','open','closed','','infograph-4-ua-2','','','2021-06-25 17:32:57','2021-06-25 14:32:57','',390,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg',0,'attachment','image/jpeg',0),(685,1,'2021-06-29 18:37:22','2021-06-29 15:37:22','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-06-29 18:37:22','2021-06-29 15:37:22','',384,'https://reo.ua/?p=685',0,'revision','',0),(541,1,'2021-06-25 17:33:20','2021-06-25 14:33:20','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-06-25 17:33:20','2021-06-25 14:33:20','',384,'https://reo.ua/?p=541',0,'revision','',0),(605,1,'2021-06-29 18:00:23','2021-06-29 15:00:23','','infograph-10-ru','','inherit','open','closed','','infograph-10-ru','','','2021-06-29 18:00:23','2021-06-29 15:00:23','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru.jpg',0,'attachment','image/jpeg',0),(606,1,'2021-06-29 18:00:23','2021-06-29 15:00:23','','infograph-10-ru','','inherit','open','closed','','infograph-10-ru-2','','','2021-06-29 18:00:23','2021-06-29 15:00:23','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru.jpg',0,'attachment','image/jpeg',0),(607,1,'2021-06-29 18:00:24','2021-06-29 15:00:24','','infograph-10-ua','','inherit','open','closed','','infograph-10-ua','','','2021-06-29 18:00:24','2021-06-29 15:00:24','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua.jpg',0,'attachment','image/jpeg',0),(608,1,'2021-06-29 18:00:24','2021-06-29 15:00:24','','infograph-10-ua','','inherit','open','closed','','infograph-10-ua-2','','','2021-06-29 18:00:24','2021-06-29 15:00:24','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua.jpg',0,'attachment','image/jpeg',0),(609,1,'2021-06-29 18:00:26','2021-06-29 15:00:26','','infograph-11-ru','','inherit','open','closed','','infograph-11-ru','','','2021-06-29 18:00:26','2021-06-29 15:00:26','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg',0,'attachment','image/jpeg',0),(610,1,'2021-06-29 18:00:26','2021-06-29 15:00:26','','infograph-11-ru','','inherit','open','closed','','infograph-11-ru-2','','','2021-06-29 18:00:26','2021-06-29 15:00:26','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg',0,'attachment','image/jpeg',0),(611,1,'2021-06-29 18:00:27','2021-06-29 15:00:27','','infograph-11-ua','','inherit','open','closed','','infograph-11-ua','','','2021-06-29 18:00:27','2021-06-29 15:00:27','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua.jpg',0,'attachment','image/jpeg',0),(612,1,'2021-06-29 18:00:27','2021-06-29 15:00:27','','infograph-11-ua','','inherit','open','closed','','infograph-11-ua-2','','','2021-06-29 18:00:27','2021-06-29 15:00:27','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua.jpg',0,'attachment','image/jpeg',0),(613,1,'2021-07-14 10:18:22','2021-07-14 07:18:22','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\n\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і частим диханням може призвести до зневоднення. Симптомами зневоднення у дорослих виступають - відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення. У дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання; у немовлят – сухий підгузок протягом 3 годин.\n\n&nbsp;\n\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\n&nbsp;\n\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\n<h2>Що робити при підвищеній температурі?</h2>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png\"><img class=\"aligncenter size-large wp-image-1114\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1-1024x663.png\" alt=\"\" width=\"1024\" height=\"663\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\n&nbsp;\n<h2>Скільки потрібно пити?</h2>\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищеної температури слід пити не менш як 10 склянок рідини на день.\n<h2>Що необхідно пити?</h2>\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Складник</strong></th>\n<th width=\"50%\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбітол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Вуглекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Вода РеО при підвищеній температурі:</h2>\n<ul>\n 	<li>усуває симптоми зневоднення;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\n</ul>\n<h2>Список літератури</h2>\n<ul>\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-autosave-v1','','','2021-07-14 10:18:22','2021-07-14 07:18:22','',396,'https://reo.ua/?p=613',0,'revision','',0),(618,1,'2021-06-29 18:04:59','2021-06-29 15:04:59','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-611\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-29 18:04:59','2021-06-29 15:04:59','',396,'https://reo.ua/?p=618',0,'revision','',0),(614,1,'2021-06-29 18:03:00','2021-06-29 15:03:00','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-611\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-29 18:03:00','2021-06-29 15:03:00','',396,'https://reo.ua/?p=614',0,'revision','',0),(694,1,'2021-06-29 18:41:23','2021-06-29 15:41:23','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n<img class=\"aligncenter size-full wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n<img class=\"aligncenter size-full wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n<img class=\"aligncenter size-full wp-image-630\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg\" alt=\"\" width=\"994\" height=\"636\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-29 18:41:23','2021-06-29 15:41:23','',419,'https://reo.ua/?p=694',0,'revision','',0),(695,1,'2021-06-29 18:41:30','2021-06-29 15:41:30','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-29 18:41:30','2021-06-29 15:41:30','',405,'https://reo.ua/?p=695',0,'revision','',0),(546,1,'2021-06-25 17:35:03','2021-06-25 14:35:03','','infograph-1-ru','','inherit','open','closed','','infograph-1-ru-2','','','2021-06-25 17:35:03','2021-06-25 14:35:03','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg',0,'attachment','image/jpeg',0),(547,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-1-ua','','inherit','open','closed','','infograph-1-ua','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg',0,'attachment','image/jpeg',0),(548,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-1-ua','','inherit','open','closed','','infograph-1-ua-2','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg',0,'attachment','image/jpeg',0),(549,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-2-ru','','inherit','open','closed','','infograph-2-ru','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg',0,'attachment','image/jpeg',0),(550,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-2-ru','','inherit','open','closed','','infograph-2-ru-2','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg',0,'attachment','image/jpeg',0),(551,1,'2021-06-25 17:35:06','2021-06-25 14:35:06','','infograph-2-ua','','inherit','open','closed','','infograph-2-ua','','','2021-06-25 17:35:06','2021-06-25 14:35:06','',368,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg',0,'attachment','image/jpeg',0),(552,1,'2021-06-25 17:35:06','2021-06-25 14:35:06','','infograph-2-ua','','inherit','open','closed','','infograph-2-ua-2','','','2021-06-25 17:35:06','2021-06-25 14:35:06','',377,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg',0,'attachment','image/jpeg',0),(553,1,'2021-06-25 17:35:28','2021-06-25 14:35:28','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n<img class=\"aligncenter size-full wp-image-551\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg\" alt=\"\" width=\"1136\" height=\"710\" />\r\n<p style=\"text-align: center;\">\r\n<strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-06-25 17:35:28','2021-06-25 14:35:28','',368,'https://reo.ua/?p=553',0,'revision','',0),(555,1,'2021-06-25 17:36:34','2021-06-25 14:36:34','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-550\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg\" alt=\"\" width=\"1180\" height=\"710\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-06-25 17:36:34','2021-06-25 14:36:34','',377,'https://reo.ua/?p=555',0,'revision','',0),(554,1,'2021-06-25 17:36:02','2021-06-25 14:36:02','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-550\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg\" alt=\"\" width=\"1180\" height=\"710\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-06-25 17:36:02','2021-06-25 14:36:02','',377,'https://reo.ua/?p=554',0,'revision','',0),(565,1,'2021-06-29 11:59:21','2021-06-29 08:59:21','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли вы заметили хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО - это маломинерализованная вода, которая, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','publish','open','open','','kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu','','','2021-07-14 02:29:23','2021-07-13 23:29:23','',0,'https://reo.ua/bez-kategorii/yak-zapobigti-teplovomu-udaru-ta-znevodnennyu-v-litnyu-speku/',19,'post','',0),(567,1,'2021-07-09 12:37:21','2021-07-09 09:37:21','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\n\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\n&nbsp;\n<h2>Что делать при тепловом поражении?</h2>\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\n<ul>\n 	<li>перейдите в затененное место;</li>\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\n</ul>\n<h2>Когда следует обратиться к врачу?</h2>\nЕсли вы заметили хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\n<h2>Сколько нужно пить?</h2>\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\n&nbsp;\n<h2>Что необходимо пить?</h2>\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Составляющие</strong></th>\n<th width=\"161\"><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"161\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"161\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"161\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"161\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"161\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"161\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"161\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"161\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\n<ul>\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\n</ul>\n<h2>Как предупредить обезвоживание в жару?</h2>\n<ul>\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\n</ul>\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\n&nbsp;\n<h2>Источники</h2>\n<ol>\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-autosave-v1','','','2021-07-09 12:37:21','2021-07-09 09:37:21','',565,'https://reo.ua/?p=567',0,'revision','',0),(568,1,'2021-06-29 12:01:38','2021-06-29 09:01:38','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<img class=\"aligncenter size-full wp-image-558\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg\" alt=\"\" width=\"683\" height=\"502\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n<img class=\"aligncenter size-full wp-image-560\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg\" alt=\"\" width=\"778\" height=\"445\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-562\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg\" alt=\"\" width=\"873\" height=\"210\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','565-revision-v1','','','2021-06-29 12:01:38','2021-06-29 09:01:38','',565,'https://reo.ua/?p=568',0,'revision','',0),(710,1,'2021-07-01 11:54:26','2021-07-01 08:54:26','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-562\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg\" alt=\"\" width=\"873\" height=\"210\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-01 11:54:26','2021-07-01 08:54:26','',557,'https://reo.ua/?p=710',0,'revision','',0),(569,1,'2021-06-29 12:02:14','2021-06-29 09:02:14','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<img class=\"aligncenter size-full wp-image-558\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg\" alt=\"\" width=\"683\" height=\"502\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n<img class=\"aligncenter size-full wp-image-560\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg\" alt=\"\" width=\"778\" height=\"445\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-562\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg\" alt=\"\" width=\"873\" height=\"210\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-06-29 12:02:14','2021-06-29 09:02:14','',557,'https://reo.ua/?p=569',0,'revision','',0),(570,1,'2021-06-29 12:05:40','2021-06-29 09:05:40','Организм человека постоянно поддерживает стабильную температуру, поэтому при нарастании температуры окружающей среды он требует охлаждения. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n\r\n<img class=\"aligncenter size-full wp-image-558\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg\" alt=\"\" width=\"683\" height=\"502\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте с приподнятыми ногами;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела (&gt;40 °С), красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n<img class=\"aligncenter size-full wp-image-560\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph31.jpg\" alt=\"\" width=\"778\" height=\"445\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации и содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>Рео имеет приятный вкус, ее легко пить даже при ощущении тошноты;</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-562\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph32.jpg\" alt=\"\" width=\"873\" height=\"210\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-06-29 12:05:40','2021-06-29 09:05:40','',565,'https://reo.ua/?p=570',0,'revision','',0),(571,1,'2021-06-25 13:03:00','2021-06-25 10:03:00','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','publish','open','open','','oralnaya-regidratacziya-u-detej','','','2021-07-14 10:17:03','2021-07-14 07:17:03','',0,'https://reo.ua/bez-kategorii/oralna-regidratacziya-u-ditej/',28,'post','',0),(573,1,'2021-06-29 12:33:55','2021-06-29 09:33:55','Обезвоживание или дегидратация - это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, возникает их дефицит [1]. В качестве причин дегидратации могут выступать - уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>ричины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * .В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, что имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, что имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в настоящее время;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точные количество и характер солевых(электролитных) потерь зависят от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей(электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку могут повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, какие характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживания является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический\r\n\r\nшок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим\r\n\r\nцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n\r\nТаблица 1 Оценка тяжести дегидратации\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"156\"><strong>Критерий</strong></td>\r\n<td width=\"156\"><strong>Незначительная дегидратация (5%)</strong></td>\r\n<td width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></td>\r\n<td width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"208\"><strong>Признаки дегидратации</strong></td>\r\n<td width=\"208\"><strong>Дефицит жидкости в % массы тела</strong></td>\r\n<td width=\"208\"><strong>Дефицит жидкости в мл/кг массы тела</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n\r\n<strong>Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"164\"><strong>Критерии оценки</strong></td>\r\n<td width=\"152\"><strong>А</strong></td>\r\n<td width=\"154\"><strong>В</strong></td>\r\n<td width=\"152\"><strong>С</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойный, раздражительный</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">нормальные</td>\r\n<td width=\"154\">запавшие</td>\r\n<td width=\"152\">запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фрэш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет - 100-200 мл(1/2-1 большой чашки), ребенку &gt;10 лет - столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствующие признаки чрезмерной гидратации (прежде всего отек ввек), можно дать больше.\r\n\r\n<strong>Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"89\"><strong>Возраст</strong></td>\r\n<td width=\"89\">До 4 мес</td>\r\n<td width=\"89\">4-11 мес</td>\r\n<td width=\"89\">12-23 мес</td>\r\n<td width=\"89\">2-4 года</td>\r\n<td width=\"89\">5-14 лет</td>\r\n<td width=\"89\">&gt;15 лет</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вес</strong></td>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Мл</strong></td>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<h2>План С: внутривенная регидратация</h2>\r\n<strong>Таблица 5 Схема внутривенной дегидратации (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"208\"><strong>Возраст</strong></td>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течении</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течении</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>До 12 мес</strong></td>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>Старше 12 мес</strong></td>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регідратації. Оценивайте состояние пациента раз на 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев - 6 часов, у старших детей - 3 часа) оцените состояние пациента согласно таблицы 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациента, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация - назначатся в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, который является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних примі- щеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-06-29 12:33:55','2021-06-29 09:33:55','',571,'https://reo.ua/?p=573',0,'revision','',0),(574,1,'2021-06-29 12:36:23','2021-06-29 09:36:23','Обезвоживание или дегидратация - это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, возникает их дефицит [1]. В качестве причин дегидратации могут выступать - уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>ричины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * .В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, что имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, что имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в настоящее время;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точные количество и характер солевых(электролитных) потерь зависят от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей(электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку могут повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, какие характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживания является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический\r\n\r\nшок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим\r\n\r\nцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n\r\nТаблица 1 Оценка тяжести дегидратации\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"156\"><strong>Критерий</strong></td>\r\n<td width=\"156\"><strong>Незначительная дегидратация (5%)</strong></td>\r\n<td width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></td>\r\n<td width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"208\"><strong>Признаки дегидратации</strong></td>\r\n<td width=\"208\"><strong>Дефицит жидкости в % массы тела</strong></td>\r\n<td width=\"208\"><strong>Дефицит жидкости в мл/кг массы тела</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n\r\n<strong>Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"164\"><strong>Критерии оценки</strong></td>\r\n<td width=\"152\"><strong>А</strong></td>\r\n<td width=\"154\"><strong>В</strong></td>\r\n<td width=\"152\"><strong>С</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойный, раздражительный</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">нормальные</td>\r\n<td width=\"154\">запавшие</td>\r\n<td width=\"152\">запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фрэш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет - 100-200 мл(1/2-1 большой чашки), ребенку &gt;10 лет - столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствующие признаки чрезмерной гидратации (прежде всего отек ввек), можно дать больше.\r\n\r\n<strong>Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"89\"><strong>Возраст</strong></td>\r\n<td width=\"89\">До 4 мес</td>\r\n<td width=\"89\">4-11 мес</td>\r\n<td width=\"89\">12-23 мес</td>\r\n<td width=\"89\">2-4 года</td>\r\n<td width=\"89\">5-14 лет</td>\r\n<td width=\"89\">&gt;15 лет</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Вес</strong></td>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<td width=\"89\"><strong>Мл</strong></td>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<h2>План С: внутривенная регидратация</h2>\r\n<strong>Таблица 5 Схема внутривенной дегидратации (1)</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td width=\"208\"><strong>Возраст</strong></td>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течении</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течении</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>До 12 мес</strong></td>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\"><strong>Старше 12 мес</strong></td>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регідратації. Оценивайте состояние пациента раз на 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев - 6 часов, у старших детей - 3 часа) оцените состояние пациента согласно таблицы 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациента, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация - назначатся в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, который является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установлены хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально - давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-06-29 12:36:23','2021-06-29 09:36:23','',571,'https://reo.ua/?p=574',0,'revision','',0),(943,1,'2021-07-08 11:23:53','2021-07-08 08:23:53','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2','','','2021-07-08 11:23:53','2021-07-08 08:23:53','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2.png',0,'attachment','image/png',0),(575,1,'2021-06-29 12:43:16','2021-06-29 09:43:16','Обезвоживание или дегидратация - это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, возникает их дефицит [1]. В качестве причин дегидратации могут выступать - уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>ричины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * .В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, что имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, что имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в настоящее время;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точные количество и характер солевых(электролитных) потерь зависят от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей(электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку могут повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, какие характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживания является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический\r\n\r\nшок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим\r\n\r\nцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1 Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<th width=\"208\"><strong>Признаки дегидратации</strong></th>\r\n<th width=\"208\"><strong>Дефицит жидкости в % массы тела</strong></th>\r\n<th width=\"208\"><strong>Дефицит жидкости в мл/кг массы тела</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойный, раздражительный</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">нормальные</td>\r\n<td width=\"154\">запавшие</td>\r\n<td width=\"152\">запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фрэш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет - 100-200 мл(1/2-1 большой чашки), ребенку &gt;10 лет - столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствующие признаки чрезмерной гидратации (прежде всего отек ввек), можно дать больше.\r\n\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<strong></strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5 Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течении</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течении</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регідратації. Оценивайте состояние пациента раз на 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев - 6 часов, у старших детей - 3 часа) оцените состояние пациента согласно таблицы 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациента, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация - назначатся в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, который является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установлены хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально - давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-06-29 12:43:16','2021-06-29 09:43:16','',571,'https://reo.ua/?p=575',0,'revision','',0),(576,1,'2021-06-29 12:44:23','2021-06-29 09:44:23','Обезвоживание или дегидратация - это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, возникает их дефицит [1]. В качестве причин дегидратации могут выступать - уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>ричины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * .В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, что имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, что имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в настоящее время;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точные количество и характер солевых(электролитных) потерь зависят от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей(электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку могут повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, какие характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживания является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический\r\n\r\nшок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим\r\n\r\nцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<th width=\"208\"><strong>Признаки дегидратации</strong></th>\r\n<th width=\"208\"><strong>Дефицит жидкости в % массы тела</strong></th>\r\n<th width=\"208\"><strong>Дефицит жидкости в мл/кг массы тела</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойный, раздражительный</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">нормальные</td>\r\n<td width=\"154\">запавшие</td>\r\n<td width=\"152\">запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фрэш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет - 100-200 мл(1/2-1 большой чашки), ребенку &gt;10 лет - столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствующие признаки чрезмерной гидратации (прежде всего отек ввек), можно дать больше.\r\n\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<strong></strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5 Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течении</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течении</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регідратації. Оценивайте состояние пациента раз на 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев - 6 часов, у старших детей - 3 часа) оцените состояние пациента согласно таблицы 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациента, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация - назначатся в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, который является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установлены хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально - давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-06-29 12:44:23','2021-06-29 09:44:23','',571,'https://reo.ua/?p=576',0,'revision','',0),(577,1,'2021-06-25 13:53:50','2021-06-25 10:53:50','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>используйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','publish','open','open','','oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta','','','2021-07-14 10:17:31','2021-07-14 07:17:31','',0,'https://reo.ua/bez-kategorii/oralna-regidratacziya-u-osib-pohilogo-ta-starechogo-viku/',22,'post','',0),(579,1,'2021-06-29 13:12:21','2021-06-29 10:12:21','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленостью и множественными заболеваниями. Основная цель ведения гериатрических пациентов - улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста есть дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости, однако с возрастом происходит уменьшение общего содержимого воды в организме, который ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет - приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержание воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам - 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического статуса, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшей частью ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечная/жировая ткань (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержимого коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышен риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы(табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшения потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи, и предопределенным этим - нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной - комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности - в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент(кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленостью. Поэтому у этого контингента особенное значение имеет беспечность тактики любого лечения. Оральная регидратация дает возможность постепенно пополнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, прийом ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання страв, багатих на рідину (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-06-29 13:12:21','2021-06-29 10:12:21','',577,'https://reo.ua/?p=579',0,'revision','',0),(580,1,'2021-06-29 13:16:32','2021-06-29 10:16:32','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленостью и множественными заболеваниями. Основная цель ведения гериатрических пациентов - улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста есть дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости, однако с возрастом происходит уменьшение общего содержимого воды в организме, который ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет - приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержание воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам - 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического статуса, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшей частью ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечная/жировая ткань (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержимого коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышен риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы(табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшения потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи, и предопределенным этим - нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной - комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности - в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент(кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленостью. Поэтому у этого контингента особенное значение имеет беспечность тактики любого лечения. Оральная регидратация дает возможность постепенно пополнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулери и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз на 1,5 часы и после определенных действий (принятие душа, посещения туалета, прием лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление еды, богатой на жидкость (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная региратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3 Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащий все необходимые электролиты и сорбитол, который является дополнительным источником энергии, усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-06-29 13:16:32','2021-06-29 10:16:32','',577,'https://reo.ua/?p=580',0,'revision','',0),(581,1,'2021-06-29 13:17:13','2021-06-29 10:17:13','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленостью и множественными заболеваниями. Основная цель ведения гериатрических пациентов - улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста есть дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости, однако с возрастом происходит уменьшение общего содержимого воды в организме, который ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет - приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержание воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам - 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического статуса, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшей частью ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечная/жировая ткань (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержимого коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышен риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы(табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста(7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшения потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи, и предопределенным этим - нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной - комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности - в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент(кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленостью. Поэтому у этого контингента особенное значение имеет беспечность тактики любого лечения. Оральная регидратация дает возможность постепенно пополнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулери и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз на 1,5 часы и после определенных действий (принятие душа, посещения туалета, прием лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление еды, богатой на жидкость (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная региратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3 Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащий все необходимые электролиты и сорбитол, который является дополнительным источником энергии, усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-06-29 13:17:13','2021-06-29 10:17:13','',577,'https://reo.ua/?p=581',0,'revision','',0),(582,1,'2021-06-25 13:36:57','2021-06-25 10:36:57','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','publish','open','open','','oralnaya-regidratacziya-u-vzroslyh','','','2021-07-14 10:17:13','2021-07-14 07:17:13','',0,'https://reo.ua/bez-kategorii/oralna-regidratacziya-u-doroslih/',25,'post','',0),(584,1,'2021-06-29 13:27:34','2021-06-29 10:27:34','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором потери воды превышают восполнение ее запасов.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека, как осложнение разнообразных заболеваний и состояний, например: при гипергликемии (1). Потери воды - через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>Кроме потери воды, при дегидратации организм теряет и электролиты, прежде всего, натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n• Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывания желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического статуса, иммобилизация, расстройства формирования ощущения жажды, передозировки лекарств с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту</li>\r\n 	<li>утомляемость, сонливость</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи</li>\r\n 	<li>темный цвет мочи</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некрозу этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течении суток</li>\r\n 	<li>тахикардия</li>\r\n 	<li>судороги (4)</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют: причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижения массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину, выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является - различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированы растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>при перебуванні на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини при спортивних навантаженнях на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку що 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-06-29 13:27:34','2021-06-29 10:27:34','',582,'https://reo.ua/?p=584',0,'revision','',0),(585,1,'2021-06-29 13:32:18','2021-06-29 10:32:18','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором потери воды превышают восполнение ее запасов.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека, как осложнение разнообразных заболеваний и состояний, например: при гипергликемии (1). Потери воды - через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>Кроме потери воды, при дегидратации организм теряет и электролиты, прежде всего, натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n• Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывания желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического статуса, иммобилизация, расстройства формирования ощущения жажды, передозировки лекарств с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту</li>\r\n 	<li>утомляемость, сонливость</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи</li>\r\n 	<li>темный цвет мочи</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некрозу этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течении суток</li>\r\n 	<li>тахикардия</li>\r\n 	<li>судороги (4)</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют: причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижения массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину, выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является - различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированы растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль в рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендовано употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице пытайтесь быть в тени</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить, даже при ощущении тошноты</li>\r\n 	<li>устраняет симптомы обезвоживания</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-06-29 13:32:18','2021-06-29 10:32:18','',582,'https://reo.ua/?p=585',0,'revision','',0),(586,1,'2021-06-29 14:07:29','2021-06-29 11:07:29','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби розсмоктуйте лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії для організму. Вода РeО - це маломінералізована вода, яка містить іони натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','publish','open','open','','blyuvannya-yak-prichina-znevodnennya','','','2021-07-14 02:25:06','2021-07-13 23:25:06','',0,'https://reo.ua/?p=586',17,'post','',0),(587,1,'2021-06-29 14:04:52','2021-06-29 11:04:52','','infograph40','','inherit','open','closed','','infograph40','','','2021-06-29 14:04:52','2021-06-29 11:04:52','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph40.jpg',0,'attachment','image/jpeg',0),(588,1,'2021-06-29 14:04:52','2021-06-29 11:04:52','','infograph40','','inherit','open','closed','','infograph40-2','','','2021-06-29 14:04:52','2021-06-29 11:04:52','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph40.jpg',0,'attachment','image/jpeg',0),(589,1,'2021-06-29 14:06:05','2021-06-29 11:06:05','','infograph41','','inherit','open','closed','','infograph41','','','2021-06-29 14:06:05','2021-06-29 11:06:05','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph41.jpg',0,'attachment','image/jpeg',0),(590,1,'2021-06-29 14:06:05','2021-06-29 11:06:05','','infograph41','','inherit','open','closed','','infograph41-2','','','2021-06-29 14:06:05','2021-06-29 11:06:05','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph41.jpg',0,'attachment','image/jpeg',0),(591,1,'2021-06-29 14:07:29','2021-06-29 11:07:29','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n<img class=\"aligncenter size-full wp-image-587\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph40.jpg\" alt=\"\" width=\"478\" height=\"626\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\nЗагалом блювання є захисним механізмом, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте при блюванні втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n<img class=\"aligncenter size-full wp-image-589\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів (для дорослих і дітей віком понад 2 роки), ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують впродовж ≥1 місяця;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити при блюванні?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями: це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників (диму, надмірного перегрівання та вологості, поїздок у автотранспорті, перебування в задушливих приміщеннях).\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід що 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена у таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПри блюванні втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, вживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-06-29 14:07:29','2021-06-29 11:07:29','',586,'https://reo.ua/?p=591',0,'revision','',0),(592,1,'2021-06-29 14:07:29','2021-06-29 11:07:29','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы выглядят как «кофейная гуща», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО - это маломинерализированная вода, которая содержит ионы натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Рассасывайте кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','publish','open','open','','rvota-kak-prichina-obezvozhivaniya','','','2021-07-14 02:27:01','2021-07-13 23:27:01','',0,'https://reo.ua/bez-kategorii/blyuvannya-yak-prichina-znevodnennya/',16,'post','',0),(716,1,'2021-07-01 12:12:47','2021-07-01 09:12:47','','infograph-81-ru','','inherit','open','closed','','infograph-81-ru-2','','','2021-07-01 12:12:47','2021-07-01 09:12:47','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg',0,'attachment','image/jpeg',0),(717,1,'2021-07-01 12:12:48','2021-07-01 09:12:48','','infograph-81-ua','','inherit','open','closed','','infograph-81-ua','','','2021-07-01 12:12:48','2021-07-01 09:12:48','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg',0,'attachment','image/jpeg',0),(718,1,'2021-07-01 12:12:48','2021-07-01 09:12:48','','infograph-81-ua','','inherit','open','closed','','infograph-81-ua-2','','','2021-07-01 12:12:48','2021-07-01 09:12:48','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg',0,'attachment','image/jpeg',0),(719,1,'2021-07-01 12:12:49','2021-07-01 09:12:49','','infograph-82-ru','','inherit','open','closed','','infograph-82-ru','','','2021-07-01 12:12:49','2021-07-01 09:12:49','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg',0,'attachment','image/jpeg',0),(720,1,'2021-07-01 12:12:49','2021-07-01 09:12:49','','infograph-82-ru','','inherit','open','closed','','infograph-82-ru-2','','','2021-07-01 12:12:49','2021-07-01 09:12:49','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg',0,'attachment','image/jpeg',0),(721,1,'2021-07-01 12:12:50','2021-07-01 09:12:50','','infograph-82-ua','','inherit','open','closed','','infograph-82-ua','','','2021-07-01 12:12:50','2021-07-01 09:12:50','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg',0,'attachment','image/jpeg',0),(722,1,'2021-07-01 12:12:50','2021-07-01 09:12:50','','infograph-82-ua','','inherit','open','closed','','infograph-82-ua-2','','','2021-07-01 12:12:50','2021-07-01 09:12:50','',592,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg',0,'attachment','image/jpeg',0),(723,1,'2021-07-14 02:24:27','2021-07-13 23:24:27','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\n&nbsp;\n\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\n&nbsp;\n<h2>Коли варто звернутися до лікаря?</h2>\nЗверніться до лікаря, якщо:\n<ul>\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\n</ul>\n<h2><strong>Що робити під час блювання?</strong></h2>\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\n\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\n\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\n\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\n\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\n<h2>Скільки потрібно пити?</h2>\nПийте кілька ковтків рідини аби розсмоктуйте лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\n\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\n\n&nbsp;\n<table width=\"569\">\n<tbody>\n<tr>\n<th><strong>Вік</strong></th>\n<th><strong>Стать</strong></th>\n<th><strong>Кількість склянок води на день</strong></th>\n</tr>\n<tr>\n<td>4-8 років</td>\n<td>Дівчата та хлопці</td>\n<td>7</td>\n</tr>\n<tr>\n<td rowspan=\"2\">9-13 років</td>\n<td>Дівчата</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Хлопці</td>\n<td>10</td>\n</tr>\n<tr>\n<td rowspan=\"2\">14-18 років</td>\n<td>Дівчата</td>\n<td>10</td>\n</tr>\n<tr>\n<td>Хлопці</td>\n<td>14</td>\n</tr>\n<tr>\n<td rowspan=\"2\">&gt;19 років</td>\n<td>Жінки</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Чоловіки</td>\n<td>13</td>\n</tr>\n</tbody>\n</table>\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\n<h2>Що необхідно пити?</h2>\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії для організму. Вода РeО - це маломінералізована вода  за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\n<h2>Як запобігти блюванню?</h2>\n<ul>\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\n</ul>\n<h2>Джерела</h2>\n<ol>\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-autosave-v1','','','2021-07-14 02:24:27','2021-07-13 23:24:27','',586,'https://reo.ua/?p=723',0,'revision','',0),(594,1,'2021-06-29 14:10:52','2021-06-29 11:10:52','Рвота является симптомом многих заболеваний и состояний, причинами которых считаются внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы) и внешние (отравление) факторы.\r\n\r\n<img class=\"aligncenter size-full wp-image-587\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph40.jpg\" alt=\"\" width=\"478\" height=\"626\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\nВ целом рвота является защитным механизмом, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n<img class=\"aligncenter size-full wp-image-589\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры теля, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней (для взрослых и детей старше 2 лет), ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении ≥1 месяца;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы имеют вид «кофейной гущи», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями: это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей (дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях).\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-06-29 14:10:52','2021-06-29 11:10:52','',592,'https://reo.ua/?p=594',0,'revision','',0),(595,1,'2021-06-29 17:06:44','2021-06-29 14:06:44','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму організму подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>необхідно виспатися;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та призвести до подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода і солодкі газовані напої містять електроліти в дуже низьких концентраціях, тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу в організмі. Збалансованний склад води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які здебільшого минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак, якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку води перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема банани й авокадо містять калій, горіхи – магній, квашені продукти – натрій.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','publish','open','open','','yak-podolati-pohmillya-ta-znevodnennya-shho-jogo-suprovodzhu%d1%94','','','2021-07-14 02:37:44','2021-07-13 23:37:44','',0,'https://reo.ua/?p=595',13,'post','',0),(596,1,'2021-06-29 17:04:43','2021-06-29 14:04:43','','infograph41','','inherit','open','closed','','infograph41-2','','','2021-06-29 17:04:43','2021-06-29 14:04:43','',595,'https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg',0,'attachment','image/jpeg',0),(597,1,'2021-06-29 17:04:43','2021-06-29 14:04:43','','infograph41','','inherit','open','closed','','infograph41-2-2','','','2021-06-29 17:04:43','2021-06-29 14:04:43','',601,'https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg',0,'attachment','image/jpeg',0),(598,1,'2021-06-29 17:06:08','2021-06-29 14:06:08','','infograph43','','inherit','open','closed','','infograph43','','','2021-06-29 17:06:08','2021-06-29 14:06:08','',595,'https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg',0,'attachment','image/jpeg',0),(599,1,'2021-06-29 17:06:08','2021-06-29 14:06:08','','infograph43','','inherit','open','closed','','infograph43-2','','','2021-06-29 17:06:08','2021-06-29 14:06:08','',601,'https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg',0,'attachment','image/jpeg',0),(808,1,'2021-07-06 13:42:33','2021-07-06 10:42:33','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях, і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак, якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-06 13:42:33','2021-07-06 10:42:33','',595,'https://reo.ua/?p=808',0,'revision','',0),(600,1,'2021-06-29 17:06:44','2021-06-29 14:06:44','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Крім того, втрату рідини та солей зумовлює і поширене при надмірному вживанні алкоголю блювання. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Із цією метою варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано рідини, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при похміллі відсутні. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід що кілька хвилин робити 1-2 ковтки води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять так звані електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть при відчутті нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникнення вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема, на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профілактика похмілля</strong></p>\r\n<strong>Джерела</strong>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-06-29 17:06:44','2021-06-29 14:06:44','',595,'https://reo.ua/?p=600',0,'revision','',0),(601,1,'2021-06-29 17:06:44','2021-06-29 14:06:44','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему организму преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>необходимо выспаться;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и вызвать раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода и сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Сбалансированный состав воды РеО позволяет восполнить утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько способов избежать развития похмельного синдрома или облегчить его.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте еду, богатую на углеводы. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, бананы и авокадо содержат много калия, орехи – магния, квашенные продукты – натрия.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','publish','open','open','','kak-preodolet-pohmele-i-obezvozhivanie-kotoroe-ego-soprovozhdaet','','','2021-07-14 02:36:46','2021-07-13 23:36:46','',0,'https://reo.ua/bez-kategorii/yak-podolati-pohmillya-ta-znevodnennya-shho-jogo-suprovodzhu%d1%94/',14,'post','',0),(602,1,'2021-07-13 00:26:58','2021-07-12 21:26:58','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\n\n<h2>Что делать при похмелье?</h2>\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему организму преодолеть похмельный синдром легче. Стоит попробовать такие меры:\n<ul>\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\n 	<li>необходимо выспаться;</li>\n 	<li>примите безрецептурный препарат от головной боли;</li>\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и вызвать раздражение слизистой оболочки желудка;</li>\n 	<li>избегайте чрезмерного солнечного света;</li>\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\n</ul>\n<h2>Сколько нужно пить?</h2>\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\n<h2>Что необходимо пить?</h2>\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода и сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\n<h2>Вода для медицинских целей РеО</h2>\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет восполнить утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\n<ul>\n 	<li>нарушение сознания;</li>\n 	<li>судороги;</li>\n 	<li>снижение температуры тела;</li>\n 	<li>замедленное или нерегулярное дыхание.</li>\n</ul>\n<h2>Как предотвратить похмелье?</h2>\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько способов избежать развития похмельного синдрома или облегчить его.\n<ul>\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\n 	<li>Ешьте еду, богатую на углеводы. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\n 	<li>Старайтесь пополнить дефицит электролитов. Например, бананы и авокадо содержат много калия, орехи – магния, квашенные продукты – натрия.</li>\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\n\n<h2>Источники</h2>\n<ol>\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-autosave-v1','','','2021-07-13 00:26:58','2021-07-12 21:26:58','',601,'https://reo.ua/?p=602',0,'revision','',0),(809,1,'2021-07-06 14:05:07','2021-07-06 11:05:07','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему телу преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>выспитесь;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать по 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода, а тем более сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет пополнять утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько возможностей избежать развития похмельного синдрома или хотя бы облегчить его течение.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте богатую углеводами еду. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, калием богаты бананы и авокадо, магнием – орехи, натрием – квашенные продукты.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-06 14:05:07','2021-07-06 11:05:07','',601,'https://reo.ua/?p=809',0,'revision','',0),(603,1,'2021-06-29 17:08:41','2021-06-29 14:08:41','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Кроме того, к потере жидкости и солей ведет и распространенная при чрезмерном употреблении алкоголя рвота. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему телу преодолеть похмельный синдром легче. С этой целью стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно жидкости, которая содержит электролиты (соли);</li>\r\n 	<li>выспитесь;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать по 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие так называемые электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода, а тем более сладкие газированные напитки содержат электролиты в очень низких концентрациях и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержки водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет пополнять утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при ощущении тошноты.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев, проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько возможностей избежать развития похмельного синдрома или хотя бы облегчить его течение.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте богатую углеводами еду. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, калием богаты бананы и авокадо, магнием – орехи, натрием – квашенные продукты.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-06-29 17:08:41','2021-06-29 14:08:41','',601,'https://reo.ua/?p=603',0,'revision','',0),(604,1,'2021-06-29 17:09:02','2021-06-29 14:09:02','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Крім того, втрату рідини та солей зумовлює і поширене при надмірному вживанні алкоголю блювання. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Із цією метою варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано рідини, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при похміллі відсутні. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід що кілька хвилин робити 1-2 ковтки води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять так звані електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть при відчутті нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникнення вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема, на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-06-29 17:09:02','2021-06-29 14:09:02','',595,'https://reo.ua/?p=604',0,'revision','',0),(615,1,'2021-06-29 18:03:40','2021-06-29 15:03:40','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru-1024x627.jpg\" alt=\"\" width=\"1024\" height=\"627\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-29 18:03:40','2021-06-29 15:03:40','',405,'https://reo.ua/?p=615',0,'revision','',0),(616,1,'2021-06-29 18:04:00','2021-06-29 15:04:00','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-29 18:04:00','2021-06-29 15:04:00','',405,'https://reo.ua/?p=616',0,'revision','',0),(617,1,'2021-06-29 18:04:19','2021-06-29 15:04:19','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-29 18:04:19','2021-06-29 15:04:19','',405,'https://reo.ua/?p=617',0,'revision','',0),(619,1,'2021-06-29 18:05:16','2021-06-29 15:05:16','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-06-29 18:05:16','2021-06-29 15:05:16','',405,'https://reo.ua/?p=619',0,'revision','',0),(620,1,'2021-06-29 18:07:00','2021-06-29 15:07:00','','infograph-20-ru','','inherit','open','closed','','infograph-20-ru','','','2021-06-29 18:07:00','2021-06-29 15:07:00','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg',0,'attachment','image/jpeg',0),(621,1,'2021-06-29 18:07:00','2021-06-29 15:07:00','','infograph-20-ru','','inherit','open','closed','','infograph-20-ru-2','','','2021-06-29 18:07:00','2021-06-29 15:07:00','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg',0,'attachment','image/jpeg',0),(622,1,'2021-06-29 18:07:02','2021-06-29 15:07:02','','infograph-20-ua','','inherit','open','closed','','infograph-20-ua','','','2021-06-29 18:07:02','2021-06-29 15:07:02','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg',0,'attachment','image/jpeg',0),(623,1,'2021-06-29 18:07:02','2021-06-29 15:07:02','','infograph-20-ua','','inherit','open','closed','','infograph-20-ua-2','','','2021-06-29 18:07:02','2021-06-29 15:07:02','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg',0,'attachment','image/jpeg',0),(624,1,'2021-06-29 18:07:04','2021-06-29 15:07:04','','infograph-21-ru','','inherit','open','closed','','infograph-21-ru','','','2021-06-29 18:07:04','2021-06-29 15:07:04','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg',0,'attachment','image/jpeg',0),(625,1,'2021-06-29 18:07:04','2021-06-29 15:07:04','','infograph-21-ru','','inherit','open','closed','','infograph-21-ru-2','','','2021-06-29 18:07:04','2021-06-29 15:07:04','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg',0,'attachment','image/jpeg',0),(626,1,'2021-06-29 18:07:05','2021-06-29 15:07:05','','infograph-21-ua','','inherit','open','closed','','infograph-21-ua','','','2021-06-29 18:07:05','2021-06-29 15:07:05','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ua.jpg',0,'attachment','image/jpeg',0),(627,1,'2021-06-29 18:07:05','2021-06-29 15:07:05','','infograph-21-ua','','inherit','open','closed','','infograph-21-ua-2','','','2021-06-29 18:07:05','2021-06-29 15:07:05','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ua.jpg',0,'attachment','image/jpeg',0),(628,1,'2021-06-29 18:07:06','2021-06-29 15:07:06','','infograph-22-ru','','inherit','open','closed','','infograph-22-ru','','','2021-06-29 18:07:06','2021-06-29 15:07:06','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg',0,'attachment','image/jpeg',0),(629,1,'2021-06-29 18:07:06','2021-06-29 15:07:06','','infograph-22-ru','','inherit','open','closed','','infograph-22-ru-2','','','2021-06-29 18:07:06','2021-06-29 15:07:06','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg',0,'attachment','image/jpeg',0),(630,1,'2021-06-29 18:07:07','2021-06-29 15:07:07','','infograph-22-ua','','inherit','open','closed','','infograph-22-ua','','','2021-06-29 18:07:07','2021-06-29 15:07:07','',419,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg',0,'attachment','image/jpeg',0),(631,1,'2021-06-29 18:07:07','2021-06-29 15:07:07','','infograph-22-ua','','inherit','open','closed','','infograph-22-ua-2','','','2021-06-29 18:07:07','2021-06-29 15:07:07','',411,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg',0,'attachment','image/jpeg',0),(636,1,'2021-06-29 18:10:57','2021-06-29 15:10:57','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n<img class=\"aligncenter size-full wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n<img class=\"aligncenter size-full wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n<img class=\"aligncenter size-full wp-image-630\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg\" alt=\"\" width=\"994\" height=\"636\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-29 18:10:57','2021-06-29 15:10:57','',419,'https://reo.ua/?p=636',0,'revision','',0),(632,1,'2021-06-29 18:08:22','2021-06-29 15:08:22','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-626\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ua.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-630\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg\" alt=\"\" width=\"994\" height=\"636\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-29 18:08:22','2021-06-29 15:08:22','',419,'https://reo.ua/?p=632',0,'revision','',0),(633,1,'2021-06-29 18:08:54','2021-06-29 15:08:54','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n<img class=\"aligncenter size-full wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n<img class=\"aligncenter size-full wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n<img class=\"aligncenter size-full wp-image-630\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg\" alt=\"\" width=\"994\" height=\"636\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-06-29 18:08:54','2021-06-29 15:08:54','',419,'https://reo.ua/?p=633',0,'revision','',0),(635,1,'2021-06-29 18:10:37','2021-06-29 15:10:37','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n<img class=\"aligncenter size-full wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n<img class=\"aligncenter size-full wp-image-625\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n<img class=\"aligncenter size-full wp-image-629\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg\" alt=\"\" width=\"1154\" height=\"641\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-06-29 18:10:37','2021-06-29 15:10:37','',411,'https://reo.ua/?p=635',0,'revision','',0),(634,1,'2021-06-29 18:09:38','2021-06-29 15:09:38','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-625\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-629\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg\" alt=\"\" width=\"1154\" height=\"641\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-06-29 18:09:38','2021-06-29 15:09:38','',411,'https://reo.ua/?p=634',0,'revision','',0),(637,1,'2021-06-29 18:13:22','2021-06-29 15:13:22','','infograph-30-ru','','inherit','open','closed','','infograph-30-ru','','','2021-06-29 18:13:22','2021-06-29 15:13:22','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg',0,'attachment','image/jpeg',0),(638,1,'2021-06-29 18:13:22','2021-06-29 15:13:22','','infograph-30-ru','','inherit','open','closed','','infograph-30-ru-2','','','2021-06-29 18:13:22','2021-06-29 15:13:22','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg',0,'attachment','image/jpeg',0),(639,1,'2021-06-29 18:13:24','2021-06-29 15:13:24','','infograph-30-ua','','inherit','open','closed','','infograph-30-ua','','','2021-06-29 18:13:24','2021-06-29 15:13:24','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg',0,'attachment','image/jpeg',0),(640,1,'2021-06-29 18:13:24','2021-06-29 15:13:24','','infograph-30-ua','','inherit','open','closed','','infograph-30-ua-2','','','2021-06-29 18:13:24','2021-06-29 15:13:24','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg',0,'attachment','image/jpeg',0),(641,1,'2021-06-29 18:13:25','2021-06-29 15:13:25','','infograph-31-ru','','inherit','open','closed','','infograph-31-ru','','','2021-06-29 18:13:25','2021-06-29 15:13:25','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg',0,'attachment','image/jpeg',0),(642,1,'2021-06-29 18:13:25','2021-06-29 15:13:25','','infograph-31-ru','','inherit','open','closed','','infograph-31-ru-2','','','2021-06-29 18:13:25','2021-06-29 15:13:25','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg',0,'attachment','image/jpeg',0),(643,1,'2021-06-29 18:13:25','2021-06-29 15:13:25','','infograph-31-ua','','inherit','open','closed','','infograph-31-ua','','','2021-06-29 18:13:25','2021-06-29 15:13:25','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-31-ua.jpg',0,'attachment','image/jpeg',0),(644,1,'2021-06-29 18:13:25','2021-06-29 15:13:25','','infograph-31-ua','','inherit','open','closed','','infograph-31-ua-2','','','2021-06-29 18:13:25','2021-06-29 15:13:25','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-31-ua.jpg',0,'attachment','image/jpeg',0),(645,1,'2021-06-29 18:13:27','2021-06-29 15:13:27','','infograph-32-ru','','inherit','open','closed','','infograph-32-ru','','','2021-06-29 18:13:27','2021-06-29 15:13:27','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg',0,'attachment','image/jpeg',0),(646,1,'2021-06-29 18:13:27','2021-06-29 15:13:27','','infograph-32-ru','','inherit','open','closed','','infograph-32-ru-2','','','2021-06-29 18:13:27','2021-06-29 15:13:27','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg',0,'attachment','image/jpeg',0),(647,1,'2021-06-29 18:13:28','2021-06-29 15:13:28','','infograph-32-ua','','inherit','open','closed','','infograph-32-ua','','','2021-06-29 18:13:28','2021-06-29 15:13:28','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-32-ua.jpg',0,'attachment','image/jpeg',0),(648,1,'2021-06-29 18:13:28','2021-06-29 15:13:28','','infograph-32-ua','','inherit','open','closed','','infograph-32-ua-2','','','2021-06-29 18:13:28','2021-06-29 15:13:28','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-32-ua.jpg',0,'attachment','image/jpeg',0),(649,1,'2021-06-29 18:13:29','2021-06-29 15:13:29','','infograph-33-ru','','inherit','open','closed','','infograph-33-ru','','','2021-06-29 18:13:29','2021-06-29 15:13:29','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg',0,'attachment','image/jpeg',0),(650,1,'2021-06-29 18:13:29','2021-06-29 15:13:29','','infograph-33-ru','','inherit','open','closed','','infograph-33-ru-2','','','2021-06-29 18:13:29','2021-06-29 15:13:29','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg',0,'attachment','image/jpeg',0),(651,1,'2021-06-29 18:13:31','2021-06-29 15:13:31','','infograph-33-ua','','inherit','open','closed','','infograph-33-ua','','','2021-06-29 18:13:31','2021-06-29 15:13:31','',432,'https://reo.ua/wp-content/uploads/2021/06/infograph-33-ua.jpg',0,'attachment','image/jpeg',0),(652,1,'2021-06-29 18:13:31','2021-06-29 15:13:31','','infograph-33-ua','','inherit','open','closed','','infograph-33-ua-2','','','2021-06-29 18:13:31','2021-06-29 15:13:31','',422,'https://reo.ua/wp-content/uploads/2021/06/infograph-33-ua.jpg',0,'attachment','image/jpeg',0),(654,1,'2021-06-29 18:15:11','2021-06-29 15:15:11','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-637 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"1024\" height=\"687\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"1021\" height=\"572\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"815\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"710\" height=\"729\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:15:11','2021-06-29 15:15:11','',432,'https://reo.ua/?p=654',0,'revision','',0),(656,1,'2021-07-13 10:50:27','2021-07-13 07:50:27','У людини температура підтримується на постійному рівні, та званний - температурний баланс, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\n&nbsp;\n\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1.png\"><img class=\"aligncenter size-large wp-image-1010\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\n&nbsp;\n\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\n&nbsp;\n\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\n&nbsp;\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\n<ul>\n 	<li>Висип, який посилюється.</li>\n 	<li>Запаморочення.</li>\n 	<li>Блювання.</li>\n 	<li>Задишка.</li>\n 	<li>Біль під час сечовипускання.</li>\n 	<li>Біль у животі.</li>\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\n 	<li>Сильний головний біль.</li>\n 	<li>Напади судом.</li>\n</ul>\n<h2>Який зв’язок між водою та високою температурою?</h2>\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\n\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\n<h2>Що робити при підвищенні температури тіла?</h2>\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\n\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\n<h2>Скільки необхідно пити?</h2>\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\n<h2>Що необхідно пити?</h2>\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Складник</strong></th>\n<th width=\"50%\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбітол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Вуглекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО при підвищеній температурі:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\n 	<li>має приємний смак і її легко п’ється навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення.</li>\n</ul>\n<h2>Список літератури</h2>\n<ol>\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-autosave-v1','','','2021-07-13 10:50:27','2021-07-13 07:50:27','',422,'https://reo.ua/?p=656',0,'revision','',0),(658,1,'2021-06-29 18:17:16','2021-06-29 15:17:16','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n<img class=\"aligncenter wp-image-640 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"1024\" height=\"700\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n<img class=\"aligncenter size-full wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"1021\" height=\"572\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n<img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"815\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"760\" height=\"781\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-29 18:17:16','2021-06-29 15:17:16','',422,'https://reo.ua/?p=658',0,'revision','',0),(657,1,'2021-06-29 18:16:59','2021-06-29 15:16:59','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-640 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"1024\" height=\"700\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"1021\" height=\"572\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"815\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"760\" height=\"781\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-29 18:16:59','2021-06-29 15:16:59','',422,'https://reo.ua/?p=657',0,'revision','',0),(659,1,'2021-06-29 18:18:37','2021-06-29 15:18:37','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-29 18:18:37','2021-06-29 15:18:37','',422,'https://reo.ua/?p=659',0,'revision','',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (660,1,'2021-06-29 18:20:20','2021-06-29 15:20:20','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"815\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:20:20','2021-06-29 15:20:20','',432,'https://reo.ua/?p=660',0,'revision','',0),(661,1,'2021-06-29 18:20:42','2021-06-29 15:20:42','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:20:42','2021-06-29 15:20:42','',432,'https://reo.ua/?p=661',0,'revision','',0),(715,1,'2021-07-01 12:12:47','2021-07-01 09:12:47','','infograph-81-ru','','inherit','open','closed','','infograph-81-ru','','','2021-07-01 12:12:47','2021-07-01 09:12:47','',586,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg',0,'attachment','image/jpeg',0),(663,1,'2021-06-29 18:26:48','2021-06-29 15:26:48','','infograph-40-ru','','inherit','open','closed','','infograph-40-ru-2','','','2021-06-29 18:26:48','2021-06-29 15:26:48','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg',0,'attachment','image/jpeg',0),(664,1,'2021-06-29 18:26:50','2021-06-29 15:26:50','','infograph-40-ua','','inherit','open','closed','','infograph-40-ua','','','2021-06-29 18:26:50','2021-06-29 15:26:50','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg',0,'attachment','image/jpeg',0),(665,1,'2021-06-29 18:26:50','2021-06-29 15:26:50','','infograph-40-ua','','inherit','open','closed','','infograph-40-ua-2','','','2021-06-29 18:26:50','2021-06-29 15:26:50','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg',0,'attachment','image/jpeg',0),(666,1,'2021-06-29 18:26:51','2021-06-29 15:26:51','','infograph-41-ru','','inherit','open','closed','','infograph-41-ru','','','2021-06-29 18:26:51','2021-06-29 15:26:51','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg',0,'attachment','image/jpeg',0),(667,1,'2021-06-29 18:26:51','2021-06-29 15:26:51','','infograph-41-ru','','inherit','open','closed','','infograph-41-ru-2','','','2021-06-29 18:26:51','2021-06-29 15:26:51','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg',0,'attachment','image/jpeg',0),(668,1,'2021-06-29 18:26:52','2021-06-29 15:26:52','','infograph-41-ua','','inherit','open','closed','','infograph-41-ua','','','2021-06-29 18:26:52','2021-06-29 15:26:52','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg',0,'attachment','image/jpeg',0),(669,1,'2021-06-29 18:26:52','2021-06-29 15:26:52','','infograph-41-ua','','inherit','open','closed','','infograph-41-ua-2','','','2021-06-29 18:26:52','2021-06-29 15:26:52','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg',0,'attachment','image/jpeg',0),(670,1,'2021-06-29 18:26:53','2021-06-29 15:26:53','','infograph-42-ru','','inherit','open','closed','','infograph-42-ru','','','2021-06-29 18:26:53','2021-06-29 15:26:53','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg',0,'attachment','image/jpeg',0),(671,1,'2021-06-29 18:26:53','2021-06-29 15:26:53','','infograph-42-ru','','inherit','open','closed','','infograph-42-ru-2','','','2021-06-29 18:26:53','2021-06-29 15:26:53','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg',0,'attachment','image/jpeg',0),(1053,1,'2021-07-09 14:28:28','2021-07-09 11:28:28','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-07-09 14:28:28','2021-07-09 11:28:28','',473,'https://reo.ua/?p=1053',0,'revision','',0),(672,1,'2021-06-29 18:28:04','2021-06-29 15:28:04','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-29 18:28:04','2021-06-29 15:28:04','',473,'https://reo.ua/?p=672',0,'revision','',0),(673,1,'2021-07-08 14:15:30','2021-07-08 11:15:30','Токсикоз вагітних – це комплекс патологічних змін в організмі вагітної, що зазвичай з’являються на 13–16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози на 34-40-й тижні. Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\n\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що охоплює не тільки надзвичайно сильну нудоту та блювання (&gt;4 разів на день), а й падіння артеріального тиску під час переходу у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\n\nПричину надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався під час попередньої вагітності чи у близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Гідратація у вагітних</strong></p>\n&nbsp;\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня окситоцину, який зумовлює скорочення матки.\n\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\n&nbsp;\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\n<ul>\n 	<li>При зміні звичних рухів плода.</li>\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\n</ul>\n<h2>Скільки необхідно пити?</h2>\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\n\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\n\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\n<table>\n<tbody>\n<tr>\n<th width=\"25%\"><strong>Група жінок</strong></th>\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\n</tr>\n<tr>\n<td>Дорослі жінки</td>\n<td>2200 мл</td>\n<td>2700 мл</td>\n<td>2000 мл</td>\n</tr>\n<tr>\n<td>Вагітні</td>\n<td>4800 мл</td>\n<td>3000 мл</td>\n<td>2300 мл</td>\n</tr>\n<tr>\n<td>Жінки, що годують грудьми</td>\n<td>5500 мл</td>\n<td>3800 мл</td>\n<td>2700 мл</td>\n</tr>\n</tbody>\n</table>\n<h2>Що необхідно пити?</h2>\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО – це готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додаткова перевага – її приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Складник</strong></th>\n<th width=\"50%\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбітол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Вуглекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО для вагітних:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення.</li>\n</ul>\n<h2>Як запобігти зневодненню у вагітних?</h2>\n<ul>\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\n 	<li>їсти рідку їжу (супи, фрукти, овочі);</li>\n 	<li>звертати увагу на відчуття спраги;</li>\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\n 	<li>завжди носити із собою пляшку води.</li>\n</ul>\n<h2>Список літератури</h2>\n<ol>\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-autosave-v1','','','2021-07-08 14:15:30','2021-07-08 11:15:30','',465,'https://reo.ua/?p=673',0,'revision','',0),(674,1,'2021-06-29 18:28:54','2021-06-29 15:28:54','','infograph-42-ua','','inherit','open','closed','','infograph-42-ua','','','2021-06-29 18:28:54','2021-06-29 15:28:54','',465,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg',0,'attachment','image/jpeg',0),(675,1,'2021-06-29 18:28:54','2021-06-29 15:28:54','','infograph-42-ua','','inherit','open','closed','','infograph-42-ua-2','','','2021-06-29 18:28:54','2021-06-29 15:28:54','',473,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg',0,'attachment','image/jpeg',0),(676,1,'2021-06-29 18:29:42','2021-06-29 15:29:42','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-29 18:29:42','2021-06-29 15:29:42','',465,'https://reo.ua/?p=676',0,'revision','',0),(677,1,'2021-06-29 18:30:03','2021-06-29 15:30:03','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-29 18:30:03','2021-06-29 15:30:03','',473,'https://reo.ua/?p=677',0,'revision','',0),(678,1,'2021-06-29 18:30:30','2021-06-29 15:30:30','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-29 18:30:30','2021-06-29 15:30:30','',465,'https://reo.ua/?p=678',0,'revision','',0),(679,1,'2021-06-29 18:30:36','2021-06-29 15:30:36','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-29 18:30:36','2021-06-29 15:30:36','',473,'https://reo.ua/?p=679',0,'revision','',0),(680,1,'2021-06-29 18:30:53','2021-06-29 15:30:53','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-06-29 18:30:53','2021-06-29 15:30:53','',465,'https://reo.ua/?p=680',0,'revision','',0),(681,1,'2021-06-29 18:34:55','2021-06-29 15:34:55','','infograph-11-ua','','inherit','open','closed','','infograph-11-ua-2','','','2021-06-29 18:34:55','2021-06-29 15:34:55','',396,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg',0,'attachment','image/jpeg',0),(682,1,'2021-06-29 18:34:55','2021-06-29 15:34:55','','infograph-11-ua','','inherit','open','closed','','infograph-11-ua-2-2','','','2021-06-29 18:34:55','2021-06-29 15:34:55','',405,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg',0,'attachment','image/jpeg',0),(684,1,'2021-06-29 18:35:22','2021-06-29 15:35:22','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-29 18:35:22','2021-06-29 15:35:22','',396,'https://reo.ua/?p=684',0,'revision','',0),(683,1,'2021-06-29 18:34:59','2021-06-29 15:34:59','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-29 18:34:59','2021-06-29 15:34:59','',396,'https://reo.ua/?p=683',0,'revision','',0),(687,1,'2021-06-29 18:39:30','2021-06-29 15:39:30','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-06-29 18:39:30','2021-06-29 15:39:30','',473,'https://reo.ua/?p=687',0,'revision','',0),(688,1,'2021-06-29 18:39:40','2021-06-29 15:39:40','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-06-29 18:39:40','2021-06-29 15:39:40','',422,'https://reo.ua/?p=688',0,'revision','',0),(689,1,'2021-06-29 18:40:07','2021-06-29 15:40:07','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-06-29 18:40:07','2021-06-29 15:40:07','',432,'https://reo.ua/?p=689',0,'revision','',0),(690,1,'2021-06-29 18:40:20','2021-06-29 15:40:20','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n<img class=\"aligncenter size-full wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n<img class=\"aligncenter size-full wp-image-625\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n<img class=\"aligncenter size-full wp-image-629\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg\" alt=\"\" width=\"1154\" height=\"641\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-06-29 18:40:20','2021-06-29 15:40:20','',411,'https://reo.ua/?p=690',0,'revision','',0),(691,1,'2021-06-29 18:40:29','2021-06-29 15:40:29','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-06-29 18:40:29','2021-06-29 15:40:29','',396,'https://reo.ua/?p=691',0,'revision','',0),(692,1,'2021-06-29 18:40:37','2021-06-29 15:40:37','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-06-29 18:40:37','2021-06-29 15:40:37','',384,'https://reo.ua/?p=692',0,'revision','',0),(693,1,'2021-06-29 18:40:44','2021-06-29 15:40:44','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n<img class=\"aligncenter size-full wp-image-551\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg\" alt=\"\" width=\"1136\" height=\"710\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-06-29 18:40:44','2021-06-29 15:40:44','',368,'https://reo.ua/?p=693',0,'revision','',0),(696,1,'2021-06-29 18:41:39','2021-06-29 15:41:39','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n&nbsp;\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n&nbsp;\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-06-29 18:41:39','2021-06-29 15:41:39','',390,'https://reo.ua/?p=696',0,'revision','',0),(697,1,'2021-06-29 18:41:46','2021-06-29 15:41:46','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-550\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg\" alt=\"\" width=\"1180\" height=\"710\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-06-29 18:41:46','2021-06-29 15:41:46','',377,'https://reo.ua/?p=697',0,'revision','',0),(698,1,'2021-07-01 11:53:14','2021-07-01 08:53:14','','infograph-61-ru','','inherit','open','closed','','infograph-61-ru','','','2021-07-01 11:53:14','2021-07-01 08:53:14','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg',0,'attachment','image/jpeg',0),(699,1,'2021-07-01 11:53:14','2021-07-01 08:53:14','','infograph-61-ru','','inherit','open','closed','','infograph-61-ru-2','','','2021-07-01 11:53:14','2021-07-01 08:53:14','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg',0,'attachment','image/jpeg',0),(700,1,'2021-07-01 11:53:16','2021-07-01 08:53:16','','infograph-61-ua','','inherit','open','closed','','infograph-61-ua','','','2021-07-01 11:53:16','2021-07-01 08:53:16','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg',0,'attachment','image/jpeg',0),(701,1,'2021-07-01 11:53:16','2021-07-01 08:53:16','','infograph-61-ua','','inherit','open','closed','','infograph-61-ua-2','','','2021-07-01 11:53:16','2021-07-01 08:53:16','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg',0,'attachment','image/jpeg',0),(702,1,'2021-07-01 11:53:18','2021-07-01 08:53:18','','infograph-62-ru','','inherit','open','closed','','infograph-62-ru','','','2021-07-01 11:53:18','2021-07-01 08:53:18','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg',0,'attachment','image/jpeg',0),(703,1,'2021-07-01 11:53:18','2021-07-01 08:53:18','','infograph-62-ru','','inherit','open','closed','','infograph-62-ru-2','','','2021-07-01 11:53:18','2021-07-01 08:53:18','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg',0,'attachment','image/jpeg',0),(704,1,'2021-07-01 11:53:19','2021-07-01 08:53:19','','infograph-62-ua','','inherit','open','closed','','infograph-62-ua','','','2021-07-01 11:53:19','2021-07-01 08:53:19','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg',0,'attachment','image/jpeg',0),(705,1,'2021-07-01 11:53:19','2021-07-01 08:53:19','','infograph-62-ua','','inherit','open','closed','','infograph-62-ua-2','','','2021-07-01 11:53:19','2021-07-01 08:53:19','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg',0,'attachment','image/jpeg',0),(706,1,'2021-07-01 11:53:20','2021-07-01 08:53:20','','infograph-63-ru','','inherit','open','closed','','infograph-63-ru','','','2021-07-01 11:53:20','2021-07-01 08:53:20','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg',0,'attachment','image/jpeg',0),(707,1,'2021-07-01 11:53:20','2021-07-01 08:53:20','','infograph-63-ru','','inherit','open','closed','','infograph-63-ru-2','','','2021-07-01 11:53:20','2021-07-01 08:53:20','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg',0,'attachment','image/jpeg',0),(708,1,'2021-07-01 11:53:21','2021-07-01 08:53:21','','infograph-63-ua','','inherit','open','closed','','infograph-63-ua','','','2021-07-01 11:53:21','2021-07-01 08:53:21','',557,'https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg',0,'attachment','image/jpeg',0),(709,1,'2021-07-01 11:53:21','2021-07-01 08:53:21','','infograph-63-ua','','inherit','open','closed','','infograph-63-ua-2','','','2021-07-01 11:53:21','2021-07-01 08:53:21','',565,'https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg',0,'attachment','image/jpeg',0),(711,1,'2021-07-01 11:55:13','2021-07-01 08:55:13','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-01 11:55:13','2021-07-01 08:55:13','',557,'https://reo.ua/?p=711',0,'revision','',0),(712,1,'2021-07-01 11:55:40','2021-07-01 08:55:40','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-01 11:55:40','2021-07-01 08:55:40','',557,'https://reo.ua/?p=712',0,'revision','',0),(713,1,'2021-07-01 11:57:28','2021-07-01 08:57:28','Организм человека постоянно поддерживает стабильную температуру, поэтому при нарастании температуры окружающей среды он требует охлаждения. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте с приподнятыми ногами;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела (&gt;40 °С), красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации и содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>Рео имеет приятный вкус, ее легко пить даже при ощущении тошноты;</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-01 11:57:28','2021-07-01 08:57:28','',565,'https://reo.ua/?p=713',0,'revision','',0),(714,1,'2021-07-01 11:58:57','2021-07-01 08:58:57','Организм человека постоянно поддерживает стабильную температуру, поэтому при нарастании температуры окружающей среды он требует охлаждения. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте с приподнятыми ногами;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела (&gt;40 °С), красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации и содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>Рео имеет приятный вкус, ее легко пить даже при ощущении тошноты;</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-01 11:58:57','2021-07-01 08:58:57','',565,'https://reo.ua/?p=714',0,'revision','',0),(724,1,'2021-07-01 12:13:59','2021-07-01 09:13:59','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nЗагалом блювання є захисним механізмом, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте при блюванні втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів (для дорослих і дітей віком понад 2 роки), ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують впродовж ≥1 місяця;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити при блюванні?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями: це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників (диму, надмірного перегрівання та вологості, поїздок у автотранспорті, перебування в задушливих приміщеннях).\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід що 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена у таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПри блюванні втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, вживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-01 12:13:59','2021-07-01 09:13:59','',586,'https://reo.ua/?p=724',0,'revision','',0),(725,1,'2021-07-01 12:14:30','2021-07-01 09:14:30','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nЗагалом блювання є захисним механізмом, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте при блюванні втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів (для дорослих і дітей віком понад 2 роки), ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують впродовж ≥1 місяця;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити при блюванні?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями: це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників (диму, надмірного перегрівання та вологості, поїздок у автотранспорті, перебування в задушливих приміщеннях).\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід що 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена у таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПри блюванні втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, вживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-01 12:14:30','2021-07-01 09:14:30','',586,'https://reo.ua/?p=725',0,'revision','',0),(726,1,'2021-07-01 12:14:55','2021-07-01 09:14:55','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nЗагалом блювання є захисним механізмом, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте при блюванні втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів (для дорослих і дітей віком понад 2 роки), ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують впродовж ≥1 місяця;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити при блюванні?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями: це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників (диму, надмірного перегрівання та вологості, поїздок у автотранспорті, перебування в задушливих приміщеннях).\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід що 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена у таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПри блюванні втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, вживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-01 12:14:55','2021-07-01 09:14:55','',586,'https://reo.ua/?p=726',0,'revision','',0),(727,1,'2021-07-01 12:15:56','2021-07-01 09:15:56','Рвота является симптомом многих заболеваний и состояний, причинами которых считаются внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы) и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nВ целом рвота является защитным механизмом, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры теля, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней (для взрослых и детей старше 2 лет), ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении ≥1 месяца;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы имеют вид «кофейной гущи», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями: это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей (дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях).\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-01 12:15:56','2021-07-01 09:15:56','',592,'https://reo.ua/?p=727',0,'revision','',0),(728,1,'2021-07-01 12:16:14','2021-07-01 09:16:14','Рвота является симптомом многих заболеваний и состояний, причинами которых считаются внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы) и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nВ целом рвота является защитным механизмом, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры теля, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней (для взрослых и детей старше 2 лет), ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении ≥1 месяца;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы имеют вид «кофейной гущи», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями: это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей (дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях).\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-01 12:16:14','2021-07-01 09:16:14','',592,'https://reo.ua/?p=728',0,'revision','',0),(729,1,'2021-07-01 12:56:29','2021-07-01 09:56:29','Организм человека постоянно поддерживает стабильную температуру, поэтому при нарастании температуры окружающей среды он требует охлаждения. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте с приподнятыми ногами;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела (&gt;40 °С), красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации и содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>Рео имеет приятный вкус, ее легко пить даже при ощущении тошноты;</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-01 12:56:29','2021-07-01 09:56:29','',565,'https://reo.ua/?p=729',0,'revision','',0),(730,1,'2021-07-01 12:57:19','2021-07-01 09:57:19','Организм человека постоянно поддерживает стабильную температуру, поэтому при нарастании температуры окружающей среды он требует охлаждения. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте с приподнятыми ногами;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела (&gt;40 °С), красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации и содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>Рео имеет приятный вкус, ее легко пить даже при ощущении тошноты;</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-01 12:57:19','2021-07-01 09:57:19','',565,'https://reo.ua/?p=730',0,'revision','',0),(996,1,'2021-07-08 14:25:24','2021-07-08 11:25:24','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-07-08 14:25:24','2021-07-08 11:25:24','',473,'https://reo.ua/?p=996',0,'revision','',0),(731,1,'2021-07-01 12:58:02','2021-07-01 09:58:02','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13 – 16 неделе беременности. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы (34 - 40-я недели). Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели беременности, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня гормона окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\"><img class=\"aligncenter wp-image-670\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутаности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть богатую жидкостью еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-07-01 12:58:02','2021-07-01 09:58:02','',473,'https://reo.ua/?p=731',0,'revision','',0),(732,1,'2021-07-01 12:58:22','2021-07-01 09:58:22','Організм людини постійно підтримує сталу температуру, тому при наростанні температури довкілля він потребує охолодження. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на відкритому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nПри подальшому перебуванні на спеці теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці з припіднятими ногами;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла (&gt;40 °С), червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПри фізичному навантаженні в спеку втрачається 1-2,5 літри поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації та містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при відчутті нудоти. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при відчутті нудоти;</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на відкритому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці у найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-01 12:58:22','2021-07-01 09:58:22','',557,'https://reo.ua/?p=732',0,'revision','',0),(994,1,'2021-07-08 14:13:26','2021-07-08 11:13:26','Токсикоз вагітних – це комплекс патологічних змін в організмі вагітної, що зазвичай з’являються на 13–16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози на 34-40-й тижні. Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 разів на день), а й падіння артеріального тиску під час переходу у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричину надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався під час попередньої вагітності чи у близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО – це готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додаткова перевага – її приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти рідку їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-07-08 14:13:26','2021-07-08 11:13:26','',465,'https://reo.ua/?p=994',0,'revision','',0),(733,1,'2021-07-01 12:58:53','2021-07-01 09:58:53','Токсикоз вагітних – це комплекс патологічних змін у організмі вагітної, що зазвичай з’являються на 13 – 16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози (34-40-й тижні). Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що включає не тільки надзвичайно сильну нудоту та блювання (&gt;4 рази на день), а й падіння артеріального тиску при переході у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричини надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався при попередній вагітності чи в близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня гормону окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО являє собою готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додатковою її перевагою виступає приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти багату на рідину їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-07-01 12:58:53','2021-07-01 09:58:53','',465,'https://reo.ua/?p=733',0,'revision','',0),(734,1,'2021-07-01 12:59:13','2021-07-01 09:59:13','Температурный баланс человека поддерживается организмом достаточно точно и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-01 12:59:13','2021-07-01 09:59:13','',432,'https://reo.ua/?p=734',0,'revision','',0),(735,1,'2021-07-01 12:59:50','2021-07-01 09:59:50','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-630\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg\" alt=\"\" width=\"994\" height=\"636\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-01 12:59:50','2021-07-01 09:59:50','',419,'https://reo.ua/?p=735',0,'revision','',0),(736,1,'2021-07-01 13:00:08','2021-07-01 10:00:08','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшення серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль при сечовипусканні</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Необхідна також належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти (натрій, калій, магній, кальцій).\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть у разі відчуття нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-01 13:00:08','2021-07-01 10:00:08','',422,'https://reo.ua/?p=736',0,'revision','',0),(737,1,'2021-07-01 13:00:48','2021-07-01 10:00:48','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"1181\" height=\"999\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-625\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-629\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg\" alt=\"\" width=\"1154\" height=\"641\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-01 13:00:48','2021-07-01 10:00:48','',411,'https://reo.ua/?p=737',0,'revision','',0),(738,1,'2021-07-01 13:00:55','2021-07-01 10:00:55','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно пополнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-01 13:00:55','2021-07-01 10:00:55','',405,'https://reo.ua/?p=738',0,'revision','',0),(739,1,'2021-07-01 13:01:03','2021-07-01 10:01:03','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n&nbsp;\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать скрепляющие и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются (соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты).\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n&nbsp;\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-07-01 13:01:03','2021-07-01 10:01:03','',390,'https://reo.ua/?p=739',0,'revision','',0),(740,1,'2021-07-01 13:01:12','2021-07-01 10:01:12','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><img class=\"aligncenter size-full wp-image-550\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg\" alt=\"\" width=\"1180\" height=\"710\" />\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-07-01 13:01:12','2021-07-01 10:01:12','',377,'https://reo.ua/?p=740',0,'revision','',0),(741,1,'2021-07-01 13:02:11','2021-07-01 10:02:11','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-01 13:02:11','2021-07-01 10:02:11','',396,'https://reo.ua/?p=741',0,'revision','',0),(742,1,'2021-07-01 13:02:19','2021-07-01 10:02:19','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-01 13:02:19','2021-07-01 10:02:19','',384,'https://reo.ua/?p=742',0,'revision','',0),(743,1,'2021-07-01 13:02:27','2021-07-01 10:02:27','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-551\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg\" alt=\"\" width=\"1136\" height=\"710\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-01 13:02:27','2021-07-01 10:02:27','',368,'https://reo.ua/?p=743',0,'revision','',0),(860,1,'2021-07-07 12:09:57','2021-07-07 09:09:57','','Обезвоживание при пищевых отравлениях','','inherit','open','closed','','obezvozhivanie-pri-pishhevyh-otravleniyah','','','2021-07-07 12:09:57','2021-07-07 09:09:57','',384,'https://reo.ua/wp-content/uploads/2021/06/obezvozhivanie-pri-pishhevyh-otravleniyah.jpg',0,'attachment','image/jpeg',0),(861,1,'2021-07-07 12:09:57','2021-07-07 09:09:57','','Обезвоживание при пищевых отравлениях','','inherit','open','closed','','obezvozhivanie-pri-pishhevyh-otravleniyah-2','','','2021-07-07 12:09:57','2021-07-07 09:09:57','',390,'https://reo.ua/wp-content/uploads/2021/06/obezvozhivanie-pri-pishhevyh-otravleniyah.jpg',0,'attachment','image/jpeg',0),(862,1,'2021-07-07 12:13:10','2021-07-07 09:13:10','','во время тренировок','','inherit','open','closed','','vo-vremya-trenirovok','','','2021-07-07 12:13:10','2021-07-07 09:13:10','',419,'https://reo.ua/wp-content/uploads/2021/06/vo-vremya-trenirovok.jpg',0,'attachment','image/jpeg',0),(863,1,'2021-07-07 12:13:10','2021-07-07 09:13:10','','во время тренировок','','inherit','open','closed','','vo-vremya-trenirovok-2','','','2021-07-07 12:13:10','2021-07-07 09:13:10','',411,'https://reo.ua/wp-content/uploads/2021/06/vo-vremya-trenirovok.jpg',0,'attachment','image/jpeg',0),(864,1,'2021-07-07 12:14:57','2021-07-07 09:14:57','','Почему необходимо много пить при повышенной температуре','','inherit','open','closed','','pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature','','','2021-07-07 12:14:57','2021-07-07 09:14:57','',396,'https://reo.ua/wp-content/uploads/2021/06/pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature.jpg',0,'attachment','image/jpeg',0),(865,1,'2021-07-07 12:14:57','2021-07-07 09:14:57','','Почему необходимо много пить при повышенной температуре','','inherit','open','closed','','pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature-2','','','2021-07-07 12:14:57','2021-07-07 09:14:57','',405,'https://reo.ua/wp-content/uploads/2021/06/pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature.jpg',0,'attachment','image/jpeg',0),(866,1,'2021-07-07 12:57:18','2021-07-07 09:57:18','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости, однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержимого коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленостью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно пополнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-07 12:57:18','2021-07-07 09:57:18','',577,'https://reo.ua/?p=866',0,'revision','',0),(817,1,'2021-07-13 16:47:14','2021-07-13 13:47:14','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\n&nbsp;\n\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричинені бактеріями, вірусами чи паразитами. Здебільшого антибіотики не потрібні й можуть лише погіршити стан хворого.\n<h2>Що робити при кишкових інфекціях?</h2>\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. Під час оцінювання ступеня зневоднення варто звернути увагу на об’єми спожитої рідини, сечовипускання, кількість епізодів діареї та блювання.\n\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\n\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїновмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\n<h2>Коли варто звернутися до лікаря?</h2>\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\n<ul>\n 	<li>порушення свідомості;</li>\n 	<li>поява крові чи жовчі в блювотних масах;</li>\n 	<li>посиніння обличчя;</li>\n 	<li>безперервний плач, сильна дратівливість;</li>\n 	<li>поява \"крапчастого\" червоного висипу;</li>\n 	<li>холодні кінцівки;</li>\n 	<li>часте дихання;</li>\n 	<li>температура ≥40 °С.</li>\n</ul>\nУ дорослих небезпечними симптомами є:\n<ul>\n 	<li>температура ≥40 °С;</li>\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\n 	<li>блювання тривалістю &gt;48 годин;</li>\n 	<li>поява крові в блювотних масах або калі;</li>\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\n</ul>\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів у дітей або довше 5 днів у дорослих.\n<h2>Скільки потрібно пити?</h2>\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\n<table>\n<thead>\n<tr>\n<th width=\"33%\"><strong>Вага</strong></th>\n<th width=\"33%\"><strong>Вік</strong></th>\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>&lt;5 кг</td>\n<td>&lt;4 місяців</td>\n<td>200-400 мл</td>\n</tr>\n<tr>\n<td>5-7,9 кг</td>\n<td>4-11 місяців</td>\n<td>400-600 мл</td>\n</tr>\n<tr>\n<td>8-10,9 кг</td>\n<td>12-23 місяці</td>\n<td>600-800 мл</td>\n</tr>\n<tr>\n<td>11-15,9 кг</td>\n<td>2-4 роки</td>\n<td>800-1200 мл</td>\n</tr>\n<tr>\n<td>16-29,9 кг</td>\n<td>5-14 років</td>\n<td>1200-2200 мл</td>\n</tr>\n<tr>\n<td>≥30 кг</td>\n<td>≥15 років</td>\n<td>2200-4000 мл</td>\n</tr>\n</tbody>\n</table>\nЯкщо людина хоче випити більше, можна дати більше.\n\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз в 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\n<h2>Що необхідно пити?</h2>\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для регідратації фруктові соки, оскільки вони не здатні компенсувати втрату солей.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\n&nbsp;\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при нудоті, яка досить часто супроводжує кишкові інфекції.\n<h2>Як запобігти кишковим інфекціям?</h2>\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед уживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\n<h2>Список літератури</h2>\n<ol>\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-autosave-v1','','','2021-07-13 16:47:14','2021-07-13 13:47:14','',368,'https://reo.ua/?p=817',0,'revision','',0),(754,1,'2021-07-02 14:37:24','2021-07-02 11:37:24','a:7:{s:8:\"location\";a:1:{i:0;a:1:{i:0;a:3:{s:5:\"param\";s:13:\"page_template\";s:8:\"operator\";s:2:\"==\";s:5:\"value\";s:19:\"page-wheretobuy.php\";}}}s:8:\"position\";s:6:\"normal\";s:5:\"style\";s:7:\"default\";s:15:\"label_placement\";s:3:\"top\";s:21:\"instruction_placement\";s:5:\"label\";s:14:\"hide_on_screen\";s:0:\"\";s:11:\"description\";s:0:\"\";}','Где купить','gde-kupit','publish','closed','closed','','group_60defa663b06f','','','2021-07-02 14:39:20','2021-07-02 11:39:20','',0,'https://reo.ua/?post_type=acf-field-group&#038;p=754',0,'acf-field-group','',0),(755,1,'2021-07-02 14:39:20','2021-07-02 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','','','publish','closed','closed','','778','','','2021-07-14 14:01:40','2021-07-14 11:01:40','',0,'https://reo.ua/bez-kategorii/778/',3,'nav_menu_item','',0),(779,1,'2021-07-13 01:26:44','2021-07-12 22:26:44','<h2>Дегідратація: визначення та типи</h2>\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\n<ul>\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\n</tr>\n<tr>\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\n</tr>\n<tr>\n<td width=\"127\">• Блювання\n\n• Пронос\n\n• Пітливість\n\n• Опіки\n\n• Хвороби нирок\n\n• Гіперглікемія\n\n•Гіпоальдостеронізм</td>\n<td width=\"113\">• Гарячка\n\n• Часте дихання\n\n• Нецукровий діабет</td>\n<td width=\"113\">• Вживання діуретиків</td>\n</tr>\n</tbody>\n</table>\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\n<ul>\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\n</ul>\n<h2>Клінічна картина</h2>\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\n<ul>\n 	<li>спрага;</li>\n 	<li>сухість у роті;</li>\n 	<li>втома, сонливість;</li>\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\n 	<li>темний колір сечі;</li>\n 	<li>головний біль;</li>\n 	<li>сухість шкіри;</li>\n 	<li>запаморочення;</li>\n 	<li>відсутність слізної рідини.</li>\n</ul>\n<strong>Для тяжкої дегідратації притаманним є:</strong>\n<ul>\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\n 	<li>тахікардія;</li>\n 	<li>гарячка;</li>\n 	<li>зниження еластичності шкіри;</li>\n 	<li>летаргія, сонливість;</li>\n 	<li>сплутаність свідомості;</li>\n 	<li>кома;</li>\n 	<li>напади судом;</li>\n 	<li>шок [3].</li>\n</ul>\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\n\n<strong>Ускладнення дегідратації охоплюють:</strong>\n<ul>\n 	<li>зміни психічного стану;</li>\n 	<li>ниркову недостатність;</li>\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\n 	<li>лактатацидоз;</li>\n 	<li>гіпотензію;</li>\n 	<li>смерть [1].</li>\n</ul>\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\n<ul>\n 	<li>дезорієнтація, сплутаність свідомості;</li>\n 	<li>сильне запаморочення;</li>\n 	<li>відсутність сечовипускання впродовж доби;</li>\n 	<li>тахікардія;</li>\n 	<li>судомні напади [4].</li>\n</ul>\n<h2>Діагностика</h2>\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\n\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\n\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\n\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\n\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\n<h2>Лікування</h2>\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\n<ul>\n 	<li>пийте воду маленькими ковтками;</li>\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\n 	<li>розсмоктуйте заморожений сік або інші напої;</li>\n 	<li>розсмоктуйте шматочки льоду;</li>\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\n</ul>\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter size-large wp-image-1054\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2-536x1024.png\" alt=\"\" width=\"536\" height=\"1024\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\n<h2>Профілактика</h2>\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\n<ul>\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\n<ul>\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\n 	<li>випивайте 0,5-1 чашку води (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\n</ul>\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Складник</strong></th>\n<th width=\"151\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбітол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Вуглекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення;</li>\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\n</ul>\n<h2>Список літератури</h2>\n<ol class=\"post-sources\">\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-autosave-v1','','','2021-07-13 01:26:44','2021-07-12 22:26:44','',489,'https://reo.ua/?p=779',0,'revision','',0),(780,1,'2021-07-02 15:49:53','2021-07-02 12:49:53','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, ім- мобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з гори- зонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 15:49:53','2021-07-02 12:49:53','',489,'https://reo.ua/?p=780',0,'revision','',0),(781,1,'2021-07-02 15:53:36','2021-07-02 12:53:36','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з гори- зонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 15:53:36','2021-07-02 12:53:36','',489,'https://reo.ua/?p=781',0,'revision','',0),(782,1,'2021-07-02 15:54:48','2021-07-02 12:54:48','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його усклад- нення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлю- ють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 15:54:48','2021-07-02 12:54:48','',489,'https://reo.ua/?p=782',0,'revision','',0),(783,1,'2021-07-02 15:56:50','2021-07-02 12:56:50','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове ви- значення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньо- венна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 15:56:50','2021-07-02 12:56:50','',489,'https://reo.ua/?p=783',0,'revision','',0),(784,1,'2021-07-02 15:57:44','2021-07-02 12:57:44','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи роз- чини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соло- минку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) пе- редбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барв- ників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 15:57:44','2021-07-02 12:57:44','',489,'https://reo.ua/?p=784',0,'revision','',0),(786,1,'2021-07-02 16:09:29','2021-07-02 13:09:29','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 16:09:29','2021-07-02 13:09:29','',489,'https://reo.ua/?p=786',0,'revision','',0),(787,1,'2021-07-13 01:33:12','2021-07-12 22:33:12','<h2>Дегідратація: визначення, причини, патогенез</h2>\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їхній дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Причини, що зумовлюють дегідратацію у дітей</strong></p>\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\n\n<strong>Групи ризику дегідратації [5]:</strong>\n<ul>\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\n 	<li>діти з низькою масою тіла при народженні;</li>\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\n 	<li>діти, які не можуть пити на даний час;</li>\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\n 	<li>діти з ознаками недостатньої вгодованості.</li>\n</ul>\n<h2>Патогенез дегідратації</h2>\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\n\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\n<h2>Клінічна картина та ступені дегідратації</h2>\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\n\n&nbsp;\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\n</tr>\n<tr>\n<th width=\"135\"><strong>Критерій</strong></th>\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\n</tr>\n<tr>\n<td width=\"135\"><strong>Стан свідомості</strong></td>\n<td width=\"171\">Жвавий, здатен до спілкування</td>\n<td width=\"166\">Летаргія, дратівливість</td>\n<td width=\"151\">Розлади свідомості</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\n<td width=\"171\">Нормальна</td>\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\n<td width=\"151\">Тахікардія</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Частота дихання</strong></td>\n<td width=\"171\">Нормальна</td>\n<td width=\"166\">Підвищена</td>\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\n<td width=\"171\">Нормальний</td>\n<td width=\"166\">Нормальний</td>\n<td width=\"151\">Гіпотензія</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Колір шкіри</strong></td>\n<td width=\"171\">Нормальний</td>\n<td width=\"166\">Нормальний</td>\n<td width=\"151\">Блідий, поява плям</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Кінцівки</strong></td>\n<td width=\"171\">Теплі</td>\n<td width=\"166\">Теплі</td>\n<td width=\"151\">Холодні</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\n<td width=\"171\">Нормальний</td>\n<td width=\"166\">Нормальний</td>\n<td width=\"151\">Ослаблений</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\n<td width=\"171\">Нормальні</td>\n<td width=\"166\">Запалі</td>\n<td width=\"151\">Глибоко запалі</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\n<td width=\"171\">Вологі</td>\n<td width=\"166\">Сухі</td>\n<td width=\"151\">Сухі</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\n<td width=\"171\">Складка негайно розгладжується</td>\n<td width=\"166\">Помірно знижений</td>\n<td width=\"151\">Знижений</td>\n</tr>\n<tr>\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\n<td width=\"171\">Нормальний</td>\n<td width=\"166\">Збільшений</td>\n<td width=\"151\">Значно збільшений</td>\n</tr>\n</tbody>\n</table>\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\n<ul>\n 	<li>прогресування погіршення стану;</li>\n 	<li>розлади свідомості;</li>\n 	<li>западання очей;</li>\n 	<li>тахікардія;</li>\n 	<li>тахіпное;</li>\n 	<li>зменшення тургору шкіри.</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\n</tr>\n<tr>\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\n</tr>\n<tr>\n<td width=\"213\">Немає</td>\n<td width=\"206\">&lt;5</td>\n<td width=\"203\">&lt;50</td>\n</tr>\n<tr>\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\n<td width=\"206\">5-10</td>\n<td width=\"203\">50-100</td>\n</tr>\n<tr>\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\n<td width=\"206\">&gt;10</td>\n<td width=\"203\">&gt;100</td>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\n</tr>\n</tbody>\n</table>\n&nbsp;\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\n</tr>\n<tr>\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\n<th width=\"155\"><strong>А</strong></th>\n<th width=\"155\"><strong>В</strong></th>\n<th width=\"155\"><strong>С</strong></th>\n</tr>\n<tr>\n<td width=\"155\"><strong>Загальний стан</strong></td>\n<td width=\"155\">Нормальний, жвавий</td>\n<td width=\"155\">Неспокійний, дратівливий</td>\n<td width=\"155\">Розлади свідомості</td>\n</tr>\n<tr>\n<td width=\"155\"><strong>Очі</strong></td>\n<td width=\"155\">Нормальні</td>\n<td width=\"155\">Запалі</td>\n<td width=\"155\">Запалі</td>\n</tr>\n<tr>\n<td width=\"155\"><strong>Спрага</strong></td>\n<td width=\"155\">П’є спокійно, спраги немає</td>\n<td width=\"155\">П’є жадібно, є спрага</td>\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\n</tr>\n<tr>\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\n</tr>\n<tr>\n<td width=\"155\"><strong>Висновок</strong></td>\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки наявна втрата води</td>\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\n</tr>\n<tr>\n<td width=\"155\"><strong>Тактика дій</strong></td>\n<td width=\"155\">План А</td>\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\n</tr>\n</tbody>\n</table>\n<h2>План А: оральна регідратація</h2>\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\n\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\n<h2>Скільки рідини давати?</h2>\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком молодше 2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині старше 10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\n\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\n\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й немає ознак надмірної гідратації (передусім набряк повік), можна дати більше.\n<table>\n<tbody>\n<tr>\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\n</tr>\n<tr>\n<th width=\"89\"><strong>Вік</strong></th>\n<td width=\"89\">До 4 міс.</td>\n<td width=\"89\">4-11 міс.</td>\n<td width=\"89\">12-23 міс.</td>\n<td width=\"89\">2-4 роки</td>\n<td width=\"89\">5-14 років</td>\n<td width=\"89\">&gt;15 років</td>\n</tr>\n<tr>\n<th width=\"89\"><strong>Вага</strong></th>\n<td width=\"89\">До 5 кг</td>\n<td width=\"89\">5-7,9 кг</td>\n<td width=\"89\">8-10,9 кг</td>\n<td width=\"89\">11-15,9 кг</td>\n<td width=\"89\">16-29,9 кг</td>\n<td width=\"89\">&gt;30 кг</td>\n</tr>\n<tr>\n<th width=\"89\"><strong>Мл</strong></th>\n<td width=\"89\">200-400</td>\n<td width=\"89\">400-600</td>\n<td width=\"89\">600-800</td>\n<td width=\"89\">800-1200</td>\n<td width=\"89\">1200-2200</td>\n<td width=\"89\">2200-4000</td>\n</tr>\n<tr>\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\n</tr>\n</tbody>\n</table>\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\n\n<strong>План С: внутрішньовенна регідратація </strong>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\n</tr>\n<tr>\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\n</tr>\n<tr>\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\n</tr>\n<tr>\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\n<td width=\"208\">30 хвилин*</td>\n<td width=\"208\">2,5 годин</td>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз в 1-2 години. Якщо покращення стану немає, пришвидшіть введення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\n</tr>\n</tbody>\n</table>\nЗа даними Кокранівського огляду, що містив 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\n\n&nbsp;\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Складник</strong></th>\n<th width=\"151\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбітол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Вуглекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення;</li>\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\n</ul>\n<h2>Профілактика дегідратації</h2>\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\n<ul>\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\n</ul>\n<h2>Список літератури</h2>\n<ol class=\"post-sources\">\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-autosave-v1','','','2021-07-13 01:33:12','2021-07-12 22:33:12','',478,'https://reo.ua/?p=787',0,'revision','',0),(788,1,'2021-07-02 16:10:47','2021-07-02 13:10:47','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (наприклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації відсутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-02 16:10:47','2021-07-02 13:10:47','',478,'https://reo.ua/?p=788',0,'revision','',0),(789,1,'2021-07-02 16:10:56','2021-07-02 13:10:56','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток шокової печінки та шокової нирки – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внут рішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 16:10:56','2021-07-02 13:10:56','',489,'https://reo.ua/?p=789',0,'revision','',0),(879,1,'2021-07-07 13:31:26','2021-07-07 10:31:26','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само, поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. </strong>Підвищений ризик дегідратації в осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (рис. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації є зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 3. </strong>Фактори ризику дегідратації в осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-07 13:31:26','2021-07-07 10:31:26','',506,'https://reo.ua/?p=879',0,'revision','',0),(790,1,'2021-07-02 16:11:07','2021-07-02 13:11:07','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Своєю чергою, поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та по- кращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повно- цінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води у цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного статусу, прийом значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язова/жирова тканина (це важливо, оскільки у м’язах зберігається у 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западіння очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання вна- слідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>вживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Підвищений ризик дегідратації у осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. при переході з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прийом певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої\r\n\r\nта виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (рис. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації виступають зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Фактори ризику дегідратації у осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та зумовленим цим небажанням вживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому у цього контингенту особливе значення має безпечність тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, прийом ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання страв, багатих на рідину (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-02 16:11:07','2021-07-02 13:11:07','',506,'https://reo.ua/?p=790',0,'revision','',0),(792,1,'2021-07-02 16:35:41','2021-07-02 13:35:41','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором потери воды превышают восполнение ее запасов.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека, как осложнение разнообразных заболеваний и состояний, например: при гипергликемии (1). Потери воды - через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>Кроме потери воды, при дегидратации организм теряет и электролиты, прежде всего, натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывания желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического статуса, иммобилизация, расстройства формирования ощущения жажды, передозировки лекарств с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту</li>\r\n 	<li>утомляемость, сонливость</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи</li>\r\n 	<li>темный цвет мочи</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некрозу этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течении суток</li>\r\n 	<li>тахикардия</li>\r\n 	<li>судороги (4)</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют: причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижения массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину, выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является - различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированы растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль в рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендовано употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице пытайтесь быть в тени</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить, даже при ощущении тошноты</li>\r\n 	<li>устраняет симптомы обезвоживания</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 16:35:41','2021-07-02 13:35:41','',582,'https://reo.ua/?p=792',0,'revision','',0),(793,1,'2021-07-02 16:39:34','2021-07-02 13:39:34','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препа- рати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 16:39:34','2021-07-02 13:39:34','',489,'https://reo.ua/?p=793',0,'revision','',0),(794,1,'2021-07-02 16:39:54','2021-07-02 13:39:54','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором потери воды превышают восполнение ее запасов.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека, как осложнение разнообразных заболеваний и состояний, например: при гипергликемии (1). Потери воды - через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>Кроме потери воды, при дегидратации организм теряет и электролиты, прежде всего, натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывания желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического статуса, иммобилизация, расстройства формирования ощущения жажды, передозировки лекарств с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту</li>\r\n 	<li>утомляемость, сонливость</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи</li>\r\n 	<li>темный цвет мочи</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некрозу этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течении суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют: причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижения массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину, выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является - различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированы растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль в рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендовано употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице пытайтесь быть в тени</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить, даже при ощущении тошноты</li>\r\n 	<li>устраняет симптомы обезвоживания</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 16:39:54','2021-07-02 13:39:54','',582,'https://reo.ua/?p=794',0,'revision','',0),(795,1,'2021-07-02 16:53:27','2021-07-02 13:53:27','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту</li>\r\n 	<li>утомляемость, сонливость</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи</li>\r\n 	<li>темный цвет мочи</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 16:53:27','2021-07-02 13:53:27','',582,'https://reo.ua/?p=795',0,'revision','',0),(796,1,'2021-07-02 16:54:29','2021-07-02 13:54:29','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 16:54:29','2021-07-02 13:54:29','',489,'https://reo.ua/?p=796',0,'revision','',0),(797,1,'2021-07-02 16:58:49','2021-07-02 13:58:49','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийомі їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і перебування на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-02 16:58:49','2021-07-02 13:58:49','',489,'https://reo.ua/?p=797',0,'revision','',0),(798,1,'2021-07-02 17:03:08','2021-07-02 14:03:08','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 17:03:08','2021-07-02 14:03:08','',582,'https://reo.ua/?p=798',0,'revision','',0),(801,1,'2021-07-02 17:23:46','2021-07-02 14:23:46','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 17:23:46','2021-07-02 14:23:46','',582,'https://reo.ua/?p=801',0,'revision','',0),(799,1,'2021-07-02 17:05:16','2021-07-02 14:05:16','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 17:05:16','2021-07-02 14:05:16','',582,'https://reo.ua/?p=799',0,'revision','',0),(800,1,'2021-07-02 17:06:07','2021-07-02 14:06:07','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты(соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты(соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-02 17:06:07','2021-07-02 14:06:07','',582,'https://reo.ua/?p=800',0,'revision','',0),(802,1,'2021-07-02 17:29:44','2021-07-02 14:29:44','<p style=\"text-align: center;\">Воду для медицинских целей РЭО можно приобрести в аптеках и магазинах вашего города:</p>','Где купить','','inherit','closed','closed','','776-revision-v1','','','2021-07-02 17:29:44','2021-07-02 14:29:44','',776,'https://reo.ua/?p=802',0,'revision','',0),(803,1,'2021-07-02 17:30:03','2021-07-02 14:30:03','<p style=\"text-align: center;\">Воду для медичних цілей РЕО можна придбати в аптеках та магазинах вашого міста:</p>','Де придбати','','inherit','closed','closed','','747-revision-v1','','','2021-07-02 17:30:03','2021-07-02 14:30:03','',747,'https://reo.ua/?p=803',0,'revision','',0),(804,1,'2021-07-02 17:30:12','2021-07-02 14:30:12','<p style=\"text-align: center;\">Воду для медицинских целей РЭО можно приобрести в аптеках и магазинах вашего города:</p>','Где купить','','inherit','closed','closed','','776-revision-v1','','','2021-07-02 17:30:12','2021-07-02 14:30:12','',776,'https://reo.ua/?p=804',0,'revision','',0),(806,1,'2021-07-02 17:31:07','2021-07-02 14:31:07','<p style=\"text-align: center;\">Воду для медицинских целей РЭО можно приобрести в аптеках и магазинах вашего города:</p>','Где купить','','inherit','closed','closed','','776-revision-v1','','','2021-07-02 17:31:07','2021-07-02 14:31:07','',776,'https://reo.ua/?p=806',0,'revision','',0),(807,1,'2021-07-13 00:22:01','2021-07-12 21:22:01','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\n\n<h2>Що робити при похміллі?</h2>\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму організму подолати похмільний синдром легше. Варто спробувати такі заходи:\n<ul>\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\n 	<li>необхідно виспатися;</li>\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та призвести до подразнення слизової оболонки шлунка;</li>\n 	<li>уникайте надмірного сонячного світла;</li>\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\n</ul>\n<h2>Скільки потрібно пити?</h2>\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\n<h2>Що необхідно пити?</h2>\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода і солодкі газовані напої містять електроліти в дуже низьких концентраціях, тому не здатні повноцінно відновити водно-сольовий баланс.\n<h2>Вода для медичних цілей РеО</h2>\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу в організмі. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\nПохмілля – це лише сукупність неприємних симптомів, які здебільшого минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\n<ul>\n 	<li>затьмарення свідомості;</li>\n 	<li>напади судом;</li>\n 	<li>зниження температури тіла;</li>\n 	<li>сповільнене чи нерегулярне дихання.</li>\n</ul>\n<h2>Як запобігти похміллю?</h2>\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак, якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи полегшити його перебіг.\n<ul>\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема банани й авокадо містять калій, горіхи – магній, квашені продукти – натрій.</li>\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\n</ul>\n&nbsp;\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\n\n<h2>Джерела</h2>\n<ol>\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-autosave-v1','','','2021-07-13 00:22:01','2021-07-12 21:22:01','',595,'https://reo.ua/?p=807',0,'revision','',0),(819,1,'2021-07-06 17:07:34','2021-07-06 14:07:34','','Web_REO_T12 Как преодолеть похмелье_1','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_1','','','2021-07-06 17:07:34','2021-07-06 14:07:34','',595,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png',0,'attachment','image/png',0),(810,1,'2021-07-06 14:05:29','2021-07-06 11:05:29','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях, і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-06 14:05:29','2021-07-06 11:05:29','',595,'https://reo.ua/?p=810',0,'revision','',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (1122,1,'2021-07-14 02:25:06','2021-07-13 23:25:06','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби розсмоктуйте лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії для організму. Вода РeО - це маломінералізована вода, яка містить іони натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-14 02:25:06','2021-07-13 23:25:06','',586,'https://reo.ua/?p=1122',0,'revision','',0),(811,1,'2021-07-06 15:01:43','2021-07-06 12:01:43','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nЗагалом блювання є захисним механізмом, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-06 15:01:43','2021-07-06 12:01:43','',586,'https://reo.ua/?p=811',0,'revision','',0),(812,1,'2021-07-14 02:26:26','2021-07-13 23:26:26','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\n&nbsp;\n\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\n&nbsp;\n<h2>Обратитесь к врачу, если:</h2>\n<ul>\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\n 	<li>рвотные массы выглядят как «кофейная гуща», содержат кровь или имеют зеленый цвет.</li>\n</ul>\n<h2>Что делать при рвоте?</h2>\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\n\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\n\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\n\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\n\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\n<h2>Сколько нужно пить?</h2>\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\n\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\n<table width=\"569\">\n<tbody>\n<tr>\n<th><strong>Возраст</strong></th>\n<th><strong>Пол</strong></th>\n<th><strong>Количество стаканов воды в день</strong></th>\n</tr>\n<tr>\n<td>4-8 лет</td>\n<td>Девочки и мальчики</td>\n<td>7</td>\n</tr>\n<tr>\n<td rowspan=\"2\">9-13 лет</td>\n<td>Девочки</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Мальчики</td>\n<td>10</td>\n</tr>\n<tr>\n<td rowspan=\"2\">14-18 лет</td>\n<td>Девочки</td>\n<td>10</td>\n</tr>\n<tr>\n<td>Мальчики</td>\n<td>14</td>\n</tr>\n<tr>\n<td rowspan=\"2\">&gt;19 лет</td>\n<td>Женщины</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Мужчины</td>\n<td>13</td>\n</tr>\n</tbody>\n</table>\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\n<h2>Что необходимо пить?</h2>\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО - єто маломинерализированная вода, которая содержит содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\n<h2>Как предупредить рвоту?</h2>\n<ul>\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\n 	<li>Рассасывайте кусочек льда или выпейте холодной воды.</li>\n</ul>\n<h2>Источники</h2>\n<ol>\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-autosave-v1','','','2021-07-14 02:26:26','2021-07-13 23:26:26','',592,'https://reo.ua/?p=812',0,'revision','',0),(813,1,'2021-07-06 15:08:06','2021-07-06 12:08:06','Рвота является симптомом многих заболеваний и состояний, причинами которых считаются внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы) и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nВ целом рвота является защитным механизмом, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы имеют вид «кофейной гущи», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-06 15:08:06','2021-07-06 12:08:06','',592,'https://reo.ua/?p=813',0,'revision','',0),(814,1,'2021-07-06 15:39:10','2021-07-06 12:39:10','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<img class=\"aligncenter size-full wp-image-596\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg\" alt=\"\" width=\"535\" height=\"219\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях, і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-598\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg\" alt=\"\" width=\"614\" height=\"491\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-06 15:39:10','2021-07-06 12:39:10','',595,'https://reo.ua/?p=814',0,'revision','',0),(815,1,'2021-07-06 15:40:53','2021-07-06 12:40:53','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы имеют вид «кофейной гущи», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-06 15:40:53','2021-07-06 12:40:53','',592,'https://reo.ua/?p=815',0,'revision','',0),(816,1,'2021-07-06 15:42:05','2021-07-06 12:42:05','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-06 15:42:05','2021-07-06 12:42:05','',586,'https://reo.ua/?p=816',0,'revision','',0),(818,1,'2021-07-06 16:22:08','2021-07-06 13:22:08','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-551\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg\" alt=\"\" width=\"1136\" height=\"710\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-06 16:22:08','2021-07-06 13:22:08','',368,'https://reo.ua/?p=818',0,'revision','',0),(820,1,'2021-07-06 17:07:34','2021-07-06 14:07:34','','Web_REO_T12 Как преодолеть похмелье_1','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_1-2','','','2021-07-06 17:07:34','2021-07-06 14:07:34','',601,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png',0,'attachment','image/png',0),(821,1,'2021-07-06 17:08:55','2021-07-06 14:08:55','','Web_REO_T8 Блювання_1','','inherit','open','closed','','web_reo_t8-blyuvannya_1','','','2021-07-06 17:08:55','2021-07-06 14:08:55','',595,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png',0,'attachment','image/png',0),(822,1,'2021-07-06 17:08:55','2021-07-06 14:08:55','','Web_REO_T8 Блювання_1','','inherit','open','closed','','web_reo_t8-blyuvannya_1-2','','','2021-07-06 17:08:55','2021-07-06 14:08:55','',601,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png',0,'attachment','image/png',0),(1037,1,'2021-07-09 12:13:58','2021-07-09 09:13:58','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода і солодкі газовані напої містять електроліти в дуже низьких концентраціях, тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які здебільшого минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема банани й авокадо містять калій, горіхи – магній, квашені продукти – натрій.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-09 12:13:58','2021-07-09 09:13:58','',595,'https://reo.ua/?p=1037',0,'revision','',0),(823,1,'2021-07-06 17:10:04','2021-07-06 14:10:04','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"size-large wp-image-821 alignnone\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"1024\" height=\"656\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях, і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-06 17:10:04','2021-07-06 14:10:04','',595,'https://reo.ua/?p=823',0,'revision','',0),(824,1,'2021-07-06 17:28:34','2021-07-06 14:28:34','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму тілу подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>виспіться;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, унаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода, а тим більше солодкі газовані напої містять електроліти в дуже низьких концентраціях, і тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу організму. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які в більшості випадків минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи хоча б полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема на калій багаті банани й авокадо, на магній – горіхи, на натрій – квашені продукти.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-06 17:28:34','2021-07-06 14:28:34','',595,'https://reo.ua/?p=824',0,'revision','',0),(825,1,'2021-07-06 17:29:25','2021-07-06 14:29:25','','Web_REO_T8 Блювання_2','','inherit','open','closed','','web_reo_t8-blyuvannya_2','','','2021-07-06 17:29:25','2021-07-06 14:29:25','',601,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png',0,'attachment','image/png',0),(826,1,'2021-07-06 17:29:25','2021-07-06 14:29:25','','Web_REO_T8 Блювання_2','','inherit','open','closed','','web_reo_t8-blyuvannya_2-2','','','2021-07-06 17:29:25','2021-07-06 14:29:25','',595,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png',0,'attachment','image/png',0),(827,1,'2021-07-06 17:30:20','2021-07-06 14:30:20','','Web_REO_T12 Как преодолеть похмелье_2','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_2','','','2021-07-06 17:30:20','2021-07-06 14:30:20','',601,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png',0,'attachment','image/png',0),(828,1,'2021-07-06 17:30:20','2021-07-06 14:30:20','','Web_REO_T12 Как преодолеть похмелье_2','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_2-2','','','2021-07-06 17:30:20','2021-07-06 14:30:20','',595,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png',0,'attachment','image/png',0),(1036,1,'2021-07-09 12:07:41','2021-07-09 09:07:41','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему телу преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>выспитесь;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода и сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет восполнить утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько способов избежать развития похмельного синдрома или облегчить его.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте еду, богатую на углеводы. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, бананы и авокадо содержат много калия, орехи – магния, квашенные продукты – натрия.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-09 12:07:41','2021-07-09 09:07:41','',601,'https://reo.ua/?p=1036',0,'revision','',0),(829,1,'2021-07-06 17:30:30','2021-07-06 14:30:30','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter  wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"612\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему телу преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>выспитесь;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать по 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода, а тем более сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет пополнять утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько возможностей избежать развития похмельного синдрома или хотя бы облегчить его течение.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте богатую углеводами еду. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, калием богаты бананы и авокадо, магнием – орехи, натрием – квашенные продукты.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-06 17:30:30','2021-07-06 14:30:30','',601,'https://reo.ua/?p=829',0,'revision','',0),(830,1,'2021-07-06 17:32:33','2021-07-06 14:32:33','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему телу преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>выспитесь;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать по 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода, а тем более сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет пополнять утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько возможностей избежать развития похмельного синдрома или хотя бы облегчить его течение.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте богатую углеводами еду. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, калием богаты бананы и авокадо, магнием – орехи, натрием – квашенные продукты.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-06 17:32:33','2021-07-06 14:32:33','',601,'https://reo.ua/?p=830',0,'revision','',0),(832,1,'2021-07-06 17:37:50','2021-07-06 14:37:50','','Web_REO_T1_1','','inherit','open','closed','','web_reo_t1_1','','','2021-07-06 17:37:50','2021-07-06 14:37:50','',377,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png',0,'attachment','image/png',0),(1066,1,'2021-07-09 15:20:39','2021-07-09 12:20:39','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричинені бактеріями, вірусами чи паразитами. Здебільшого антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. Під час оцінювання ступеня зневоднення варто звернути увагу на об’єми спожитої рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїновмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих небезпечними симптомами є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів у дітей або довше 5 днів у дорослих.\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз в 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для регідратації фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при нудоті, яка досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед уживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-09 15:20:39','2021-07-09 12:20:39','',368,'https://reo.ua/?p=1066',0,'revision','',0),(833,1,'2021-07-06 17:38:12','2021-07-06 14:38:12','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричиненими бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. При оцінці ступеня зневоднення варто звернути увагу на об’єми вживання рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїнвмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих симптомами небезпеки є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів (у дітей) або довше 5 днів (у дорослих).\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для наводнення фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter  wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при відчутті нудоти, яке досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій із цього приводу знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-06 17:38:12','2021-07-06 14:38:12','',368,'https://reo.ua/?p=833',0,'revision','',0),(834,1,'2021-07-06 17:39:22','2021-07-06 14:39:22','','Web_REO_T1_2','','inherit','open','closed','','web_reo_t1_2','','','2021-07-06 17:39:22','2021-07-06 14:39:22','',377,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png',0,'attachment','image/png',0),(835,1,'2021-07-06 17:39:22','2021-07-06 14:39:22','','Web_REO_T1_2','','inherit','open','closed','','web_reo_t1_2-2','','','2021-07-06 17:39:22','2021-07-06 14:39:22','',368,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png',0,'attachment','image/png',0),(836,1,'2021-07-06 17:39:56','2021-07-06 14:39:56','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых симптомами опасности являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней (у детей) или дольше 5 дней (у взрослых).\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для наводнения фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter  wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций по этому поводу снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-07-06 17:39:56','2021-07-06 14:39:56','',377,'https://reo.ua/?p=836',0,'revision','',0),(837,1,'2021-07-06 18:00:14','2021-07-06 15:00:14','','Web_REO_T9 Регідрадація у дорослих_2','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2','','','2021-07-06 18:00:14','2021-07-06 15:00:14','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png',0,'attachment','image/png',0),(838,1,'2021-07-06 18:00:14','2021-07-06 15:00:14','','Web_REO_T9 Регідрадація у дорослих_2','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-2','','','2021-07-06 18:00:14','2021-07-06 15:00:14','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png',0,'attachment','image/png',0),(840,1,'2021-07-06 18:01:12','2021-07-06 15:01:12','','Web_REO_T9 Регідрадація у дорослих_4','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_4','','','2021-07-06 18:01:12','2021-07-06 15:01:12','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png',0,'attachment','image/png',0),(841,1,'2021-07-06 18:01:12','2021-07-06 15:01:12','','Web_REO_T9 Регідрадація у дорослих_4','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_4-2','','','2021-07-06 18:01:12','2021-07-06 15:01:12','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png',0,'attachment','image/png',0),(842,1,'2021-07-06 18:02:13','2021-07-06 15:02:13','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» - некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png\"><img class=\"aligncenter size-large wp-image-837\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter  wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-06 18:02:13','2021-07-06 15:02:13','',582,'https://reo.ua/?p=842',0,'revision','',0),(843,1,'2021-07-07 11:22:06','2021-07-07 08:22:06','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на открытом воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при ощущении тошноты.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-07 11:22:06','2021-07-07 08:22:06','',565,'https://reo.ua/?p=843',0,'revision','',0),(844,1,'2021-07-13 00:44:32','2021-07-12 21:44:32','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\n\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\n&nbsp;\n<h2>Що робити при тепловому ураженні?</h2>\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\n<ul>\n 	<li>перейдіть у затінене місце;</li>\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\n 	<li>накладіть компреси з льодом піх пахви та на пахові ділянки;</li>\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\n 	<li>випийте води, щоб запобігти зневодненню.</li>\n</ul>\n<h2>Коли варто звернутися до лікаря?</h2>\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\n<h2>Скільки потрібно пити?</h2>\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\n&nbsp;\n<h2>Що необхідно пити?</h2>\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Складник</strong></th>\n<th width=\"151\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбітол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Вуглекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\n<ul>\n 	<li>РеО має збалансований водно-електролітний склад;</li>\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\n</ul>\n<h2>Як запобігти зневодненню в спеку?</h2>\n<ul>\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\n</ul>\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\n&nbsp;\n<h2>Джерела</h2>\n<ol>\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-autosave-v1','','','2021-07-13 00:44:32','2021-07-12 21:44:32','',557,'https://reo.ua/?p=844',0,'revision','',0),(845,1,'2021-07-07 11:42:12','2021-07-07 08:42:12','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\"><img class=\"aligncenter wp-image-699\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ru.jpg\" alt=\"\" width=\"996\" height=\"692\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-07 11:42:12','2021-07-07 08:42:12','',565,'https://reo.ua/?p=845',0,'revision','',0),(846,1,'2021-07-07 11:46:08','2021-07-07 08:46:08','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебувати на сонці, теплове ураження може перерости у небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 11:46:08','2021-07-07 08:46:08','',557,'https://reo.ua/?p=846',0,'revision','',0),(847,1,'2021-07-07 11:50:54','2021-07-07 08:50:54','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебувати на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 11:50:54','2021-07-07 08:50:54','',557,'https://reo.ua/?p=847',0,'revision','',0),(848,1,'2021-07-07 11:55:49','2021-07-07 08:55:49','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку  пити  воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 11:55:49','2021-07-07 08:55:49','',557,'https://reo.ua/?p=848',0,'revision','',0),(849,1,'2021-07-07 11:57:42','2021-07-07 08:57:42','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\"><img class=\"aligncenter wp-image-700\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-61-ua.jpg\" alt=\"\" width=\"902\" height=\"690\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\"><img class=\"aligncenter size-full wp-image-704\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ua.jpg\" alt=\"\" width=\"897\" height=\"437\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\"><img class=\"aligncenter size-full wp-image-708\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ua.jpg\" alt=\"\" width=\"961\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 11:57:42','2021-07-07 08:57:42','',557,'https://reo.ua/?p=849',0,'revision','',0),(850,1,'2021-07-07 11:57:58','2021-07-07 08:57:58','','Как преодолеть похмелье','','inherit','open','closed','','kak-preodolet-pohmele','','','2021-07-07 11:57:58','2021-07-07 08:57:58','',595,'https://reo.ua/wp-content/uploads/2021/06/kak-preodolet-pohmele.jpg',0,'attachment','image/jpeg',0),(851,1,'2021-07-07 11:57:58','2021-07-07 08:57:58','','Как преодолеть похмелье','','inherit','open','closed','','kak-preodolet-pohmele-2','','','2021-07-07 11:57:58','2021-07-07 08:57:58','',601,'https://reo.ua/wp-content/uploads/2021/06/kak-preodolet-pohmele.jpg',0,'attachment','image/jpeg',0),(852,1,'2021-07-07 12:01:58','2021-07-07 09:01:58','','Рвота как причина обезвоживания','','inherit','open','closed','','rvota-kak-prichina-obezvozhivaniya','','','2021-07-07 12:01:58','2021-07-07 09:01:58','',592,'https://reo.ua/wp-content/uploads/2021/06/rvota-kak-prichina-obezvozhivaniya.jpg',0,'attachment','image/jpeg',0),(853,1,'2021-07-07 12:01:58','2021-07-07 09:01:58','','Рвота как причина обезвоживания','','inherit','open','closed','','rvota-kak-prichina-obezvozhivaniya-2','','','2021-07-07 12:01:58','2021-07-07 09:01:58','',586,'https://reo.ua/wp-content/uploads/2021/06/rvota-kak-prichina-obezvozhivaniya.jpg',0,'attachment','image/jpeg',0),(854,1,'2021-07-07 12:03:21','2021-07-07 09:03:21','','Как предупредить тепловой удар','','inherit','open','closed','','kak-predupredit-teplovoj-udar','','','2021-07-07 12:03:21','2021-07-07 09:03:21','',557,'https://reo.ua/wp-content/uploads/2021/06/kak-predupredit-teplovoj-udar.jpg',0,'attachment','image/jpeg',0),(855,1,'2021-07-07 12:03:21','2021-07-07 09:03:21','','Как предупредить тепловой удар','','inherit','open','closed','','kak-predupredit-teplovoj-udar-2','','','2021-07-07 12:03:21','2021-07-07 09:03:21','',565,'https://reo.ua/wp-content/uploads/2021/06/kak-predupredit-teplovoj-udar.jpg',0,'attachment','image/jpeg',0),(856,1,'2021-07-07 12:07:24','2021-07-07 09:07:24','','Токсикоз','','inherit','open','closed','','toksikoz','','','2021-07-07 12:07:24','2021-07-07 09:07:24','',465,'https://reo.ua/wp-content/uploads/2021/06/toksikoz.jpg',0,'attachment','image/jpeg',0),(857,1,'2021-07-07 12:07:24','2021-07-07 09:07:24','','Токсикоз','','inherit','open','closed','','toksikoz-2','','','2021-07-07 12:07:24','2021-07-07 09:07:24','',473,'https://reo.ua/wp-content/uploads/2021/06/toksikoz.jpg',0,'attachment','image/jpeg',0),(858,1,'2021-07-07 12:08:22','2021-07-07 09:08:22','','повышении температуры тела','','inherit','open','closed','','povyshenii-temperatury-tela','','','2021-07-07 12:08:22','2021-07-07 09:08:22','',432,'https://reo.ua/wp-content/uploads/2021/06/povyshenii-temperatury-tela.jpg',0,'attachment','image/jpeg',0),(859,1,'2021-07-07 12:08:22','2021-07-07 09:08:22','','повышении температуры тела','','inherit','open','closed','','povyshenii-temperatury-tela-2','','','2021-07-07 12:08:22','2021-07-07 09:08:22','',422,'https://reo.ua/wp-content/uploads/2021/06/povyshenii-temperatury-tela.jpg',0,'attachment','image/jpeg',0),(867,1,'2021-07-07 13:04:12','2021-07-07 10:04:12','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\"></td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\"></td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\"></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-07 13:04:12','2021-07-07 10:04:12','',577,'https://reo.ua/?p=867',0,'revision','',0),(868,1,'2021-07-07 13:04:19','2021-07-07 10:04:19','','Web_REO_T7 Спека_3','','inherit','open','closed','','web_reo_t7-speka_3','','','2021-07-07 13:04:19','2021-07-07 10:04:19','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png',0,'attachment','image/png',0),(869,1,'2021-07-07 13:04:19','2021-07-07 10:04:19','','Web_REO_T7 Спека_3','','inherit','open','closed','','web_reo_t7-speka_3-2','','','2021-07-07 13:04:19','2021-07-07 10:04:19','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png',0,'attachment','image/png',0),(870,1,'2021-07-07 13:04:59','2021-07-07 10:04:59','','Web_REO_T7 Спека_2','','inherit','open','closed','','web_reo_t7-speka_2','','','2021-07-07 13:04:59','2021-07-07 10:04:59','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2.png',0,'attachment','image/png',0),(871,1,'2021-07-07 13:04:59','2021-07-07 10:04:59','','Web_REO_T7 Спека_2','','inherit','open','closed','','web_reo_t7-speka_2-2','','','2021-07-07 13:04:59','2021-07-07 10:04:59','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2.png',0,'attachment','image/png',0),(872,1,'2021-07-07 13:06:00','2021-07-07 10:06:00','','Web_REO_T7 Спека_1','','inherit','open','closed','','web_reo_t7-speka_1','','','2021-07-07 13:06:00','2021-07-07 10:06:00','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png',0,'attachment','image/png',0),(873,1,'2021-07-07 13:06:00','2021-07-07 10:06:00','','Web_REO_T7 Спека_1','','inherit','open','closed','','web_reo_t7-speka_1-2','','','2021-07-07 13:06:00','2021-07-07 10:06:00','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png',0,'attachment','image/png',0),(1077,1,'2021-07-13 00:40:47','2021-07-12 21:40:47','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом піх пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-13 00:40:47','2021-07-12 21:40:47','',557,'https://reo.ua/?p=1077',0,'revision','',0),(874,1,'2021-07-07 13:08:28','2021-07-07 10:08:28','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2.png\"><img class=\"aligncenter size-full wp-image-870\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2.png\" alt=\"\" width=\"1005\" height=\"463\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 13:08:28','2021-07-07 10:08:28','',557,'https://reo.ua/?p=874',0,'revision','',0),(875,1,'2021-07-14 02:32:31','2021-07-13 23:32:31','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при інтенсивному диханні ротом. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\n\n&nbsp;\n\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\n&nbsp;\n<h2>Чим небезпечна втрата рідини?</h2>\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце. Втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\n&nbsp;\n\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\n&nbsp;\n<h2>Скільки необхідно пити?</h2>\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\n<ul>\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\n</ul>\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\n<h2>Що необхідно пити?</h2>\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\n\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\n\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО - це маломінералізованна вода, що містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Складник</strong></th>\n<th width=\"50%\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбітол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Вуглекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\n<ul>\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\n 	<li>пийте до, під час і після тренування.</li>\n</ul>\n<h2>Список літератури</h2>\n<ol>\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-autosave-v1','','','2021-07-14 02:32:31','2021-07-13 23:32:31','',411,'https://reo.ua/?p=875',0,'revision','',0),(876,1,'2021-07-07 13:10:57','2021-07-07 10:10:57','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1]. Одной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-07 13:10:57','2021-07-07 10:10:57','',577,'https://reo.ua/?p=876',0,'revision','',0),(877,1,'2021-07-14 10:15:20','2021-07-14 07:15:20','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\n\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\n\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\n<strong>Пов’язані з віком особливості дегідратації:</strong>\n<ul>\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\n 	<li>зменшення інтенсивності відчуття спраги;</li>\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\n 	<li>деменція;</li>\n 	<li>уживання діуретиків [2].</li>\n</ul>\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\n\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\n<ul>\n 	<li>падіння та переломи;</li>\n 	<li>розлади свідомості та мислення;</li>\n 	<li>закрепи;</li>\n 	<li>інфекції сечовивідної системи;</li>\n 	<li>ниркова недостатність;</li>\n 	<li>інсульт;</li>\n 	<li>збільшення потенційної токсичності медикаментів;</li>\n 	<li>сповільнення загоєння ран;</li>\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\n 	<li>підвищення температури;</li>\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\n</ul>\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\n<table>\n<tbody>\n<tr>\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\n</tr>\n<tr>\n<td width=\"169\">Вік</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     70+</td>\n<td width=\"53\">✓     85+</td>\n<td width=\"68\">✓        85+</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     85+</td>\n</tr>\n<tr>\n<td width=\"169\">Закреп / нетримання сечі</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Пронос/блювання</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Харчові обмеження</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n&nbsp;\n<table>\n<tbody>\n<tr>\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Утруднене ковтання</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Запаморочення</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Відчуття спраги</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Поганий настрій</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Приймання певних ліків</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Множинні супутні захворювання</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      3+</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      4+</td>\n</tr>\n<tr>\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Біль</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Повторні інфекції сечової системи</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Розлади зору</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Артеріальний тиск / пульс</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Сплутаність свідомості</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Сонливість, летаргія</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Сухість слизової оболонки ротової порожнини, очей і сухість шкіри</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Гарячка</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Збільшена частота дихання</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Недостатня вгодованість</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Наявність відкритих ран</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Пітливість</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Гіперглікемія</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Темний колір сечі</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Підвищена густина сечі</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\n\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\n\n<h2>Особливості регідратації в осіб похилого віку</h2>\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\n\n&nbsp;\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\n</tr>\n<tr>\n<th width=\"94\"><strong>Розрахунок</strong></th>\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\n</tr>\n<tr>\n<td width=\"94\">Доба</td>\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\n<td width=\"180\">Базові щоденні потреби</td>\n</tr>\n<tr>\n<td width=\"94\">1</td>\n<td width=\"197\">50</td>\n<td width=\"180\">Не менш як 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">2</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Не менш як 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">3</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Не менш як 1500 мл</td>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\n</tr>\n</tbody>\n</table>\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\n<h2>Профілактика</h2>\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\n<ul>\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\n 	<li>висока ефективність;</li>\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\n 	<li>низька вартість.</li>\n</ul>\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\n<ul>\n 	<li>застосовуйте яскраві чашки;</li>\n 	<li>застосовуйте кулери та балони з водою;</li>\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\n</tr>\n<tr>\n<th width=\"137\"><strong>Вага (кг)</strong></th>\n<td width=\"30\">≤30</td>\n<td width=\"30\">35</td>\n<td width=\"30\">40</td>\n<td width=\"30\">45</td>\n<td width=\"30\">50</td>\n<td width=\"30\">55</td>\n<td width=\"30\">60</td>\n<td width=\"30\">65</td>\n<td width=\"30\">70</td>\n<td width=\"30\">75</td>\n<td width=\"30\">80</td>\n<td width=\"30\">85</td>\n<td width=\"30\">90</td>\n<td width=\"30\">95</td>\n<td width=\"30\">100</td>\n<td width=\"30\">105</td>\n</tr>\n<tr>\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,8</td>\n<td width=\"30\">1,9</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,1</td>\n<td width=\"30\">2,2</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,4</td>\n<td width=\"30\">2,5</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,7</td>\n<td width=\"30\">2,8</td>\n</tr>\n</tbody>\n</table>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png\"><img class=\"aligncenter size-large wp-image-1046\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1-1024x360.png\" alt=\"\" width=\"1024\" height=\"360\" /></a>\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\n\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Складник</strong></th>\n<th width=\"151\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбітол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Вуглекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\n 	<li>має приємний смак і легко пити навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення;</li>\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\n</ul>\n<h2>Список літератури</h2>\n<ol class=\"post-sources\">\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-autosave-v1','','','2021-07-14 10:15:20','2021-07-14 07:15:20','',506,'https://reo.ua/?p=877',0,'revision','',0),(951,1,'2021-07-08 11:28:04','2021-07-08 08:28:04','','Web_REO_T10 Регідрадація пожилого возраста__укр','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr','','','2021-07-08 11:28:04','2021-07-08 08:28:04','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png',0,'attachment','image/png',0),(878,1,'2021-07-07 13:14:31','2021-07-07 10:14:31','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-07 13:14:31','2021-07-07 10:14:31','',577,'https://reo.ua/?p=878',0,'revision','',0),(880,1,'2021-07-07 13:33:58','2021-07-07 10:33:58','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. </strong>Підвищений ризик дегідратації в осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (рис. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації є зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 3. </strong>Фактори ризику дегідратації в осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-07 13:33:58','2021-07-07 10:33:58','',506,'https://reo.ua/?p=880',0,'revision','',0),(881,1,'2021-07-09 13:38:03','2021-07-09 10:38:03','<h2>Дегидратация: определение и типы</h2>\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\n\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\n<ul>\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\n</tr>\n<tr>\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\n</tr>\n<tr>\n<td width=\"127\">• Рвота\n\n• Понос\n\n• Потливость\n\n• Ожоги\n\n• Болезни почек\n\n• Гипергликемия\n\n•Гипоальдостеронизм</td>\n<td width=\"113\">• Лихорадка\n\n• Частое дыхание\n\n• Несахарный диабет</td>\n<td width=\"113\">• Прием диуретиков</td>\n</tr>\n</tbody>\n</table>\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\n<ul>\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\n</ul>\n<h2>Клиническая картина</h2>\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\n<ul>\n 	<li>жажда;</li>\n 	<li>сухость во рту;</li>\n 	<li>утомляемость, сонливость;</li>\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\n 	<li>темный цвет мочи;</li>\n 	<li>головная боль;</li>\n 	<li>сухость кожи;</li>\n 	<li>головокружение;</li>\n 	<li>отсутствие слезной жидкости.</li>\n</ul>\n<strong>Для тяжелой дегидратации присущим является: </strong>\n<ul>\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\n 	<li>головокружение, которое препятствует передвижению;</li>\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\n 	<li>тахикардия;</li>\n 	<li>лихорадка;</li>\n 	<li>снижение эластичности кожи;</li>\n 	<li>летаргия, сонливость;</li>\n 	<li>спутанное сознание;</li>\n 	<li>кома;</li>\n 	<li>приступы судорог;</li>\n 	<li>шок [3].</li>\n</ul>\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\n\n<strong>Осложнения дегидратации включают: </strong>\n<ul>\n 	<li>изменения психического состояния;</li>\n 	<li>почечную недостаточность;</li>\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\n 	<li>лактатацидоз;</li>\n 	<li>гипотензию;</li>\n 	<li>смерть [1].</li>\n</ul>\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\n<ul>\n 	<li>дезориентация, спутанное сознание;</li>\n 	<li>сильное головокружение;</li>\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\n 	<li>тахикардия;</li>\n 	<li>судороги (4).</li>\n</ul>\n<h2>Диагностика</h2>\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\n\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\n\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\n\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\n<h2>Лечение</h2>\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\n\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\n<ul>\n 	<li>пейте воду маленькими глотками;</li>\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\n 	<li>рассасывайте кусочки льда;</li>\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\n</ul>\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter size-large wp-image-988\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\n<h2>Профилактика</h2>\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\n<ul>\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\n<ul>\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\n</ul>\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\n\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\n\nРeО не содержит консервантов, красителей и имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\">Составляющая</th>\n<th width=\"151\">Содержимое</th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\n</ul>\n<h3>Список литературы</h3>\n<ol>\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-autosave-v1','','','2021-07-09 13:38:03','2021-07-09 10:38:03','',582,'https://reo.ua/?p=881',0,'revision','',0),(884,1,'2021-07-07 14:01:01','2021-07-07 11:01:01','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png\"><img class=\"aligncenter size-large wp-image-837\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-07 14:01:01','2021-07-07 11:01:01','',582,'https://reo.ua/?p=884',0,'revision','',0),(882,1,'2021-07-07 13:49:28','2021-07-07 10:49:28','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, - внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png\"><img class=\"aligncenter size-large wp-image-837\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-07 13:49:28','2021-07-07 10:49:28','',582,'https://reo.ua/?p=882',0,'revision','',0),(883,1,'2021-07-07 13:50:35','2021-07-07 10:50:35','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости&gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt;потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png\"><img class=\"aligncenter size-large wp-image-837\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной/ умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>• выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>• выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РЭО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация(мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-07 13:50:35','2021-07-07 10:50:35','',582,'https://reo.ua/?p=883',0,'revision','',0),(886,1,'2021-07-07 14:14:33','2021-07-07 11:14:33','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-07 14:14:33','2021-07-07 11:14:33','',489,'https://reo.ua/?p=886',0,'revision','',0),(932,1,'2021-07-08 01:04:20','2021-07-07 22:04:20','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1','','','2021-07-08 01:04:20','2021-07-07 22:04:20','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-1.png',0,'attachment','image/png',0),(885,1,'2021-07-07 14:02:07','2021-07-07 11:02:07','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png\"><img class=\"aligncenter size-large wp-image-837\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-07 14:02:07','2021-07-07 11:02:07','',582,'https://reo.ua/?p=885',0,'revision','',0),(887,1,'2021-07-07 14:15:48','2021-07-07 11:15:48','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg\"><img class=\"aligncenter wp-image-503 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-1-785x1024.jpg\" alt=\"\" width=\"785\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-07 14:15:48','2021-07-07 11:15:48','',489,'https://reo.ua/?p=887',0,'revision','',0),(888,1,'2021-07-07 14:17:11','2021-07-07 11:17:11','','Web_REO_T7 Спека_3','','inherit','open','closed','','web_reo_t7-speka_3','','','2021-07-07 14:17:11','2021-07-07 11:17:11','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1.png',0,'attachment','image/png',0),(889,1,'2021-07-07 14:17:11','2021-07-07 11:17:11','','Web_REO_T7 Спека_3','','inherit','open','closed','','web_reo_t7-speka_3-3','','','2021-07-07 14:17:11','2021-07-07 11:17:11','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1.png',0,'attachment','image/png',0),(890,1,'2021-07-07 14:17:23','2021-07-07 11:17:23','','Web_REO_T7 Спека_4','','inherit','open','closed','','web_reo_t7-speka_4','','','2021-07-07 14:17:23','2021-07-07 11:17:23','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png',0,'attachment','image/png',0),(891,1,'2021-07-07 14:17:23','2021-07-07 11:17:23','','Web_REO_T7 Спека_4','','inherit','open','closed','','web_reo_t7-speka_4-2','','','2021-07-07 14:17:23','2021-07-07 11:17:23','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png',0,'attachment','image/png',0),(892,1,'2021-07-07 14:17:50','2021-07-07 11:17:50','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли у вас присутствует хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-07 14:17:50','2021-07-07 11:17:50','',565,'https://reo.ua/?p=892',0,'revision','',0),(893,1,'2021-07-07 14:19:20','2021-07-07 11:19:20','','Web_REO_T4 во время тренировок_2','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_2','','','2021-07-07 14:19:20','2021-07-07 11:19:20','',419,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png',0,'attachment','image/png',0),(894,1,'2021-07-07 14:19:20','2021-07-07 11:19:20','','Web_REO_T4 во время тренировок_2','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_2-2','','','2021-07-07 14:19:20','2021-07-07 11:19:20','',411,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png',0,'attachment','image/png',0),(895,1,'2021-07-07 14:20:12','2021-07-07 11:20:12','','Web_REO_T4 во время тренировок_1 (1)','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_1-1','','','2021-07-07 14:20:12','2021-07-07 11:20:12','',419,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png',0,'attachment','image/png',0),(896,1,'2021-07-07 14:20:12','2021-07-07 11:20:12','','Web_REO_T4 во время тренировок_1 (1)','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_1-1-2','','','2021-07-07 14:20:12','2021-07-07 11:20:12','',411,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png',0,'attachment','image/png',0),(897,1,'2021-07-07 14:20:26','2021-07-07 11:20:26','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter  wp-image-620\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg\" alt=\"\" width=\"774\" height=\"655\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter  wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter  wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"781\" height=\"476\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-07 14:20:26','2021-07-07 11:20:26','',419,'https://reo.ua/?p=897',0,'revision','',0),(898,1,'2021-07-07 14:25:22','2021-07-07 11:25:22','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter  wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-625\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"1038\" height=\"432\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter  wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-07 14:25:22','2021-07-07 11:25:22','',411,'https://reo.ua/?p=898',0,'revision','',0),(899,1,'2021-07-07 15:19:16','2021-07-07 12:19:16','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4','','','2021-07-07 15:19:16','2021-07-07 12:19:16','',411,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4.png',0,'attachment','image/png',0),(900,1,'2021-07-07 15:19:16','2021-07-07 12:19:16','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4-2','','','2021-07-07 15:19:16','2021-07-07 12:19:16','',419,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4.png',0,'attachment','image/png',0),(901,1,'2021-07-07 16:18:22','2021-07-07 13:18:22','','Web_REO_T7 Спека_2','','inherit','open','closed','','web_reo_t7-speka_2-2','','','2021-07-07 16:18:22','2021-07-07 13:18:22','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2-1.png',0,'attachment','image/png',0),(902,1,'2021-07-07 16:18:22','2021-07-07 13:18:22','','Web_REO_T7 Спека_2','','inherit','open','closed','','web_reo_t7-speka_2-2-2','','','2021-07-07 16:18:22','2021-07-07 13:18:22','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_2-1.png',0,'attachment','image/png',0),(903,1,'2021-07-07 16:18:45','2021-07-07 13:18:45','','Web_REO_T7 Спека_5','','inherit','open','closed','','web_reo_t7-speka_5','','','2021-07-07 16:18:45','2021-07-07 13:18:45','',557,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png',0,'attachment','image/png',0),(904,1,'2021-07-07 16:18:45','2021-07-07 13:18:45','','Web_REO_T7 Спека_5','','inherit','open','closed','','web_reo_t7-speka_5-2','','','2021-07-07 16:18:45','2021-07-07 13:18:45','',565,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png',0,'attachment','image/png',0),(905,1,'2021-07-07 16:18:56','2021-07-07 13:18:56','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змоги компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Уникайте перебування на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-07 16:18:56','2021-07-07 13:18:56','',557,'https://reo.ua/?p=905',0,'revision','',0),(907,1,'2021-07-07 16:23:54','2021-07-07 13:23:54','','Головна','','inherit','closed','closed','','8-revision-v1','','','2021-07-07 16:23:54','2021-07-07 13:23:54','',8,'https://reo.ua/?p=907',0,'revision','',0),(908,1,'2021-07-07 16:24:32','2021-07-07 13:24:32','','Головна','','inherit','closed','closed','','8-revision-v1','','','2021-07-07 16:24:32','2021-07-07 13:24:32','',8,'https://reo.ua/?p=908',0,'revision','',0),(909,1,'2021-07-07 16:25:18','2021-07-07 13:25:18','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1','','','2021-07-07 16:25:18','2021-07-07 13:25:18','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png',0,'attachment','image/png',0),(910,1,'2021-07-07 16:25:18','2021-07-07 13:25:18','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1-2','','','2021-07-07 16:25:18','2021-07-07 13:25:18','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png',0,'attachment','image/png',0),(911,1,'2021-07-07 16:26:06','2021-07-07 13:26:06','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png\"><img class=\"aligncenter size-large wp-image-909\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-497\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg\" alt=\"\" width=\"529\" height=\"603\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-07 16:26:06','2021-07-07 13:26:06','',489,'https://reo.ua/?p=911',0,'revision','',0),(912,1,'2021-07-07 16:26:47','2021-07-07 13:26:47','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4-2','','','2021-07-07 16:26:47','2021-07-07 13:26:47','',411,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png',0,'attachment','image/png',0),(913,1,'2021-07-07 16:26:47','2021-07-07 13:26:47','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4-2-2','','','2021-07-07 16:26:47','2021-07-07 13:26:47','',419,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png',0,'attachment','image/png',0),(914,1,'2021-07-07 16:27:37','2021-07-07 13:27:37','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується при носінні спеціальних костюмів для схуднення, дотриманні суворих дієт, застосуванні сечогінних засобів, вживанні кофеїновмісних напоїв (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter  wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном.</li>\r\n 	<li>500 мл (близько 2,5 чашки) при прокиданні.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) що 5-15 хвилин тренування.</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу, вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини при спортивних навантаженнях?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичайно, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження та температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-07 16:27:37','2021-07-07 13:27:37','',411,'https://reo.ua/?p=914',0,'revision','',0),(915,1,'2021-07-07 16:28:35','2021-07-07 13:28:35','','Web_REO_T4 во время тренировок_3','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_3','','','2021-07-07 16:28:35','2021-07-07 13:28:35','',419,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png',0,'attachment','image/png',0),(916,1,'2021-07-07 16:28:35','2021-07-07 13:28:35','','Web_REO_T4 во время тренировок_3','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_3-2','','','2021-07-07 16:28:35','2021-07-07 13:28:35','',411,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png',0,'attachment','image/png',0),(917,1,'2021-07-07 16:29:12','2021-07-07 13:29:12','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносдержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter  wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном.</li>\r\n 	<li>500 мл (около 2,5 чашек) во время пробуждения.</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки.</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки.</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения, что может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» - натрий, калий, кальций, хлор. Благодаря такому составу, вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать про обезвоживание;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-07 16:29:12','2021-07-07 13:29:12','',419,'https://reo.ua/?p=917',0,'revision','',0),(918,1,'2021-07-07 16:31:16','2021-07-07 13:31:16','','Про воду ReO','','inherit','closed','closed','','11-revision-v1','','','2021-07-07 16:31:16','2021-07-07 13:31:16','',11,'https://reo.ua/?p=918',0,'revision','',0),(919,1,'2021-07-07 16:33:24','2021-07-07 13:33:24','','Головна','','inherit','closed','closed','','8-revision-v1','','','2021-07-07 16:33:24','2021-07-07 13:33:24','',8,'https://reo.ua/?p=919',0,'revision','',0),(920,1,'2021-07-07 16:36:40','2021-07-07 13:36:40','','Про воду ReO','','inherit','closed','closed','','11-revision-v1','','','2021-07-07 16:36:40','2021-07-07 13:36:40','',11,'https://reo.ua/?p=920',0,'revision','',0),(921,1,'2021-07-08 00:47:59','2021-07-07 21:47:59','','Главная','','inherit','closed','closed','','176-revision-v1','','','2021-07-08 00:47:59','2021-07-07 21:47:59','',176,'https://reo.ua/?p=921',0,'revision','',0),(922,1,'2021-07-08 00:49:06','2021-07-07 21:49:06','','Про воду ReO','','inherit','closed','closed','','177-revision-v1','','','2021-07-08 00:49:06','2021-07-07 21:49:06','',177,'https://reo.ua/?p=922',0,'revision','',0),(923,1,'2021-07-08 00:50:37','2021-07-07 21:50:37','','Про воду ReO','','inherit','closed','closed','','177-revision-v1','','','2021-07-08 00:50:37','2021-07-07 21:50:37','',177,'https://reo.ua/?p=923',0,'revision','',0),(924,1,'2021-07-08 00:51:56','2021-07-07 21:51:56','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси мають вигляд «кавової гущі», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після прийому їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-08 00:51:56','2021-07-07 21:51:56','',586,'https://reo.ua/?p=924',0,'revision','',0),(925,1,'2021-07-08 00:56:45','2021-07-07 21:56:45','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. </strong>Підвищений ризик дегідратації в осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації є зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 3. </strong>Фактори ризику дегідратації в осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-08 00:56:45','2021-07-07 21:56:45','',506,'https://reo.ua/?p=925',0,'revision','',0),(926,1,'2021-07-08 00:57:17','2021-07-07 21:57:17','','Web_REO_T10 Регідрадація пожилого возраста_1','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_1','','','2021-07-08 00:57:17','2021-07-07 21:57:17','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png',0,'attachment','image/png',0),(927,1,'2021-07-08 00:57:17','2021-07-07 21:57:17','','Web_REO_T10 Регідрадація пожилого возраста_1','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-2','','','2021-07-08 00:57:17','2021-07-07 21:57:17','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png',0,'attachment','image/png',0),(928,1,'2021-07-08 00:57:45','2021-07-07 21:57:45','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-08 00:57:45','2021-07-07 21:57:45','',577,'https://reo.ua/?p=928',0,'revision','',0),(929,1,'2021-07-08 00:58:17','2021-07-07 21:58:17','','Web_REO_T10 Регідрадація пожилого возраста_2_1','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1','','','2021-07-08 00:58:17','2021-07-07 21:58:17','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png',0,'attachment','image/png',0),(930,1,'2021-07-08 00:58:17','2021-07-07 21:58:17','','Web_REO_T10 Регідрадація пожилого возраста_2_1','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-2','','','2021-07-08 00:58:17','2021-07-07 21:58:17','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png',0,'attachment','image/png',0),(931,1,'2021-07-08 00:58:54','2021-07-07 21:58:54','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<img class=\"aligncenter size-full wp-image-515\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-25.jpg\" alt=\"\" width=\"742\" height=\"427\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<img class=\"aligncenter size-full wp-image-517\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-26.jpg\" alt=\"\" width=\"865\" height=\"531\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-08 00:58:54','2021-07-07 21:58:54','',577,'https://reo.ua/?p=931',0,'revision','',0),(933,1,'2021-07-08 01:04:20','2021-07-07 22:04:20','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1-3','','','2021-07-08 01:04:20','2021-07-07 22:04:20','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-1.png',0,'attachment','image/png',0),(934,1,'2021-07-08 01:04:55','2021-07-07 22:04:55','','Web_REO_T9 Регідрадація у дорослих_2 (7)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-7','','','2021-07-08 01:04:55','2021-07-07 22:04:55','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-7.png',0,'attachment','image/png',0),(935,1,'2021-07-08 01:04:55','2021-07-07 22:04:55','','Web_REO_T9 Регідрадація у дорослих_2 (7)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-7-2','','','2021-07-08 01:04:55','2021-07-07 22:04:55','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-7.png',0,'attachment','image/png',0),(1048,1,'2021-07-09 13:38:36','2021-07-09 10:38:36','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter size-large wp-image-988\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-09 13:38:36','2021-07-09 10:38:36','',582,'https://reo.ua/?p=1048',0,'revision','',0),(936,1,'2021-07-08 01:05:45','2021-07-07 22:05:45','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-7.png\"><img class=\"aligncenter size-large wp-image-934\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-7-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-08 01:05:45','2021-07-07 22:05:45','',582,'https://reo.ua/?p=936',0,'revision','',0),(937,1,'2021-07-13 16:42:44','2021-07-13 13:42:44','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\n<ul>\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\n 	<li>термін придатності продукту минув.</li>\n</ul>\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\n<h2>Коли варто звернутися до лікаря?</h2>\nОзнаками небезпечного харчового отруєння є:\n<ul>\n 	<li>діарея тривалістю ≥3 днів;</li>\n 	<li>часте блювання;</li>\n 	<li>температура, більша за 38,5 °С;</li>\n 	<li>різке погіршення зору чи різке порушення мовлення;</li>\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\n 	<li>поява крові в сечі або калі.</li>\n</ul>\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\n&nbsp;\n<h2>Що робити при харчовому отруєнні?</h2>\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\n\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\n\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму, щоб позбавитися токсинів.\n\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються: солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости.\n<h2>Скільки потрібно пити?</h2>\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\n<h2>Що необхідно пити?</h2>\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\n<h2>Вода для медичних цілей РеО</h2>\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Складник</strong></th>\n<th width=\"50%\"><strong>Вміст</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбітол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Вуглекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\n<ul>\n 	<li>має збалансований склад;</li>\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\n 	<li>усуває симптоми зневоднення.</li>\n</ul>\n<h2>Як запобігти харчовому отруєнню?</h2>\nОсновний спосіб профілактики харчового отруєння – уникати вживання  їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\n\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це може спричинити поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\n&nbsp;\n<h2>Список літератури</h2>\n<ol>\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-autosave-v1','','','2021-07-13 16:42:44','2021-07-13 13:42:44','',384,'https://reo.ua/?p=937',0,'revision','',0),(938,1,'2021-07-08 01:10:26','2021-07-07 22:10:26','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура &gt;38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати закріплювальні та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочні рекомендації щодо необхідної кількості рідини при харчовому отруєнні відсутні. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, які містять багато цукру, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовим отруєнням?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникнення їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому при вживанні цих продуктів у сирому чи недостатньо приготованому вигляді ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед приготуванням або вживанням їжі. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до вживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчовим отруєнням</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-08 01:10:26','2021-07-07 22:10:26','',384,'https://reo.ua/?p=938',0,'revision','',0),(939,1,'2021-07-08 01:11:50','2021-07-07 22:11:50','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін в роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищення температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-08 01:11:50','2021-07-07 22:11:50','',396,'https://reo.ua/?p=939',0,'revision','',0),(940,1,'2021-07-08 11:13:31','2021-07-08 08:13:31','','Web_REO_T11 Регідрадація у дітей_укр','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_ukr','','','2021-07-08 11:13:31','2021-07-08 08:13:31','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png',0,'attachment','image/png',0),(941,1,'2021-07-08 11:13:31','2021-07-08 08:13:31','','Web_REO_T11 Регідрадація у дітей_укр','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_ukr-2','','','2021-07-08 11:13:31','2021-07-08 08:13:31','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png',0,'attachment','image/png',0),(978,1,'2021-07-08 13:06:26','2021-07-08 10:06:26','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їх дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западання очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки трапилася втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-08 13:06:26','2021-07-08 10:06:26','',478,'https://reo.ua/?p=978',0,'revision','',0),(1082,1,'2021-07-13 01:34:15','2021-07-12 22:34:15','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їхній дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Причини, що зумовлюють дегідратацію у дітей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западання очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Немає</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спраги немає</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки наявна втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком молодше 2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині старше 10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й немає ознак надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз в 1-2 години. Якщо покращення стану немає, пришвидшіть введення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що містив 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-13 01:34:15','2021-07-12 22:34:15','',478,'https://reo.ua/?p=1082',0,'revision','',0),(942,1,'2021-07-08 11:14:07','2021-07-08 08:14:07','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, виникає їх дефіцит [1]. Причинами дегідратації можуть виступати зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (рис.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби було припинено грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації (наприклад, бікарбонати значною мірою втрачаються при діареї, але не при блюванні).\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Своєю чергою, втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечними, оскільки можуть спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують втрату рідини. На ранніх стадіях ознак і симптомів зневоднення є компенсованим. Згодом компенсаторні можливості організму дитини виснажуються, виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западіння очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими, можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації відсутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-08 11:14:07','2021-07-08 08:14:07','',478,'https://reo.ua/?p=942',0,'revision','',0),(944,1,'2021-07-08 11:23:53','2021-07-08 08:23:53','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-2','','','2021-07-08 11:23:53','2021-07-08 08:23:53','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2.png',0,'attachment','image/png',0),(945,1,'2021-07-08 11:24:35','2021-07-08 08:24:35','Обезвоживание или дегидратация - это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, возникает их дефицит [1]. В качестве причин дегидратации могут выступать - уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2.png\"><img class=\"aligncenter size-large wp-image-943\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>ричины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * .В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\nДіти чутливіші до дегідратації, ніж дорослі, оскільки відношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, что имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, что имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в настоящее время;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точные количество и характер солевых(электролитных) потерь зависят от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей(электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку могут повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, какие характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживания является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический\r\n\r\nшок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим\r\n\r\nцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">нормальный</td>\r\n<td width=\"156\">увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong><strong>Дефицит жидкости в % массы тела</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойный, раздражительный</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">нормальные</td>\r\n<td width=\"154\">запавшие</td>\r\n<td width=\"152\">запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фрэш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет - 100-200 мл(1/2-1 большой чашки), ребенку &gt;10 лет - столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствующие признаки чрезмерной гидратации (прежде всего отек ввек), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5 Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течении</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течении</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регідратації. Оценивайте состояние пациента раз на 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев - 6 часов, у старших детей - 3 часа) оцените состояние пациента согласно таблицы 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациента, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация - назначатся в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, который является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установлены хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально - давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:24:35','2021-07-08 08:24:35','',571,'https://reo.ua/?p=945',0,'revision','',0),(946,1,'2021-07-08 11:25:35','2021-07-08 08:25:35','','Web_REO_T10 Регідрадація пожилого возраста_4','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4','','','2021-07-08 11:25:35','2021-07-08 08:25:35','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4.png',0,'attachment','image/png',0),(947,1,'2021-07-08 11:25:35','2021-07-08 08:25:35','','Web_REO_T10 Регідрадація пожилого возраста_4','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2','','','2021-07-08 11:25:35','2021-07-08 08:25:35','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4.png',0,'attachment','image/png',0),(948,1,'2021-07-08 11:26:13','2021-07-08 08:26:13','','Web_REO_T10 Регідрадація пожилого возраста_6','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_6','','','2021-07-08 11:26:13','2021-07-08 08:26:13','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png',0,'attachment','image/png',0),(949,1,'2021-07-08 11:26:13','2021-07-08 08:26:13','','Web_REO_T10 Регідрадація пожилого возраста_6','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-2','','','2021-07-08 11:26:13','2021-07-08 08:26:13','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png',0,'attachment','image/png',0),(950,1,'2021-07-08 11:26:48','2021-07-08 08:26:48','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4.png\"><img class=\"aligncenter size-large wp-image-946\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-08 11:26:48','2021-07-08 08:26:48','',577,'https://reo.ua/?p=950',0,'revision','',0),(952,1,'2021-07-08 11:28:04','2021-07-08 08:28:04','','Web_REO_T10 Регідрадація пожилого возраста__укр','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-2','','','2021-07-08 11:28:04','2021-07-08 08:28:04','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png',0,'attachment','image/png',0),(1023,1,'2021-07-09 10:04:45','2021-07-09 07:04:45','','Web_REO_T11 Регідрадація у дітей_2 (1)','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-1-2','','','2021-07-09 10:04:45','2021-07-09 07:04:45','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png',0,'attachment','image/png',0),(1024,1,'2021-07-09 10:05:06','2021-07-09 07:05:06','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-09 10:05:06','2021-07-09 07:05:06','',571,'https://reo.ua/?p=1024',0,'revision','',0),(953,1,'2021-07-08 11:29:21','2021-07-08 08:29:21','','Web_REO_T10 Регідрадація пожилого возраста_6','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_6','','','2021-07-08 11:29:21','2021-07-08 08:29:21','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1.png',0,'attachment','image/png',0),(954,1,'2021-07-08 11:29:21','2021-07-08 08:29:21','','Web_REO_T10 Регідрадація пожилого возраста_6','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-3','','','2021-07-08 11:29:21','2021-07-08 08:29:21','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1.png',0,'attachment','image/png',0),(955,1,'2021-07-08 11:29:45','2021-07-08 08:29:45','','Web_REO_T10 Регідрадація пожилого возраста_5','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_5','','','2021-07-08 11:29:45','2021-07-08 08:29:45','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5.png',0,'attachment','image/png',0),(956,1,'2021-07-08 11:29:45','2021-07-08 08:29:45','','Web_REO_T10 Регідрадація пожилого возраста_5','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-2','','','2021-07-08 11:29:45','2021-07-08 08:29:45','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5.png',0,'attachment','image/png',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (957,1,'2021-07-08 11:30:07','2021-07-08 08:30:07','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> Вікове зменшення вмісту води в організмі</p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менш як 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, деякі з яких порушують водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. </strong>Підвищений ризик дегідратації в осіб похилого віку [5]</p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливішими клінічними ознаками дегідратації є зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. </strong>Фактори ризику дегідратації в осіб похилого віку</p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз на 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5.png\"><img class=\"aligncenter size-large wp-image-955\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. </strong>Поради щодо збільшення вживання води</p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-08 11:30:07','2021-07-08 08:30:07','',506,'https://reo.ua/?p=957',0,'revision','',0),(958,1,'2021-07-08 11:37:38','2021-07-08 08:37:38','','Web_REO_T10 Регідрадація пожилого возраста_4','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2','','','2021-07-08 11:37:38','2021-07-08 08:37:38','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1.png',0,'attachment','image/png',0),(959,1,'2021-07-08 11:37:38','2021-07-08 08:37:38','','Web_REO_T10 Регідрадація пожилого возраста_4','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-2','','','2021-07-08 11:37:38','2021-07-08 08:37:38','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1.png',0,'attachment','image/png',0),(962,1,'2021-07-08 11:44:55','2021-07-08 08:44:55','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. В качестве причин дегидратации могут выступать: уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическимцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:44:55','2021-07-08 08:44:55','',571,'https://reo.ua/?p=962',0,'revision','',0),(1043,1,'2021-07-09 13:17:41','2021-07-09 10:17:41','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>используйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-09 13:17:41','2021-07-09 10:17:41','',577,'https://reo.ua/?p=1043',0,'revision','',0),(960,1,'2021-07-08 11:40:12','2021-07-08 08:40:12','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1.png\"><img class=\"aligncenter size-large wp-image-958\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1-1024x351.png\" alt=\"\" width=\"1024\" height=\"351\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-08 11:40:12','2021-07-08 08:40:12','',577,'https://reo.ua/?p=960',0,'revision','',0),(961,1,'2021-07-08 11:42:58','2021-07-08 08:42:58','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. В качестве причин дегидратации могут выступать: уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическимцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установлены хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально - давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:42:58','2021-07-08 08:42:58','',571,'https://reo.ua/?p=961',0,'revision','',0),(963,1,'2021-07-08 11:47:11','2021-07-08 08:47:11','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-2','','','2021-07-08 11:47:11','2021-07-08 08:47:11','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1.png',0,'attachment','image/png',0),(964,1,'2021-07-08 11:47:11','2021-07-08 08:47:11','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-2-2','','','2021-07-08 11:47:11','2021-07-08 08:47:11','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1.png',0,'attachment','image/png',0),(966,1,'2021-07-08 11:47:43','2021-07-08 08:47:43','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. В качестве причин дегидратации могут выступать: уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическимцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:47:43','2021-07-08 08:47:43','',571,'https://reo.ua/?p=966',0,'revision','',0),(965,1,'2021-07-08 11:47:30','2021-07-08 08:47:30','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. В качестве причин дегидратации могут выступать: уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1.png\"><img class=\"aligncenter size-large wp-image-963\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическимцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:47:30','2021-07-08 08:47:30','',571,'https://reo.ua/?p=965',0,'revision','',0),(967,1,'2021-07-08 11:49:45','2021-07-08 08:49:45','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-3','','','2021-07-08 11:49:45','2021-07-08 08:49:45','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png',0,'attachment','image/png',0),(968,1,'2021-07-08 11:49:45','2021-07-08 08:49:45','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-3-2','','','2021-07-08 11:49:45','2021-07-08 08:49:45','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png',0,'attachment','image/png',0),(970,1,'2021-07-08 11:57:23','2021-07-08 08:57:23','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:57:23','2021-07-08 08:57:23','',571,'https://reo.ua/?p=970',0,'revision','',0),(969,1,'2021-07-08 11:49:59','2021-07-08 08:49:59','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. В качестве причин дегидратации могут выступать: уменьшения употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png\"><img class=\"aligncenter size-large wp-image-967\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни было приостановлено грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации (например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте).\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, что обуславливает ухудшение самочувствия человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание является компенсированным. Впоследствии компенсаторные возможности организма ребенка истощаются, возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными, возможно даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическимцианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль (специальные солевые растворы для оральной регидратации, подсоленные напитки). Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации, немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. При отсутствии улучшения состояния ускорьте введения жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус, что является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 11:49:59','2021-07-08 08:49:59','',571,'https://reo.ua/?p=969',0,'revision','',0),(971,1,'2021-07-08 12:03:02','2021-07-08 09:03:02','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 12:03:02','2021-07-08 09:03:02','',571,'https://reo.ua/?p=971',0,'revision','',0),(972,1,'2021-07-08 12:08:19','2021-07-08 09:08:19','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<img class=\"aligncenter size-full wp-image-479\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg\" alt=\"\" width=\"922\" height=\"546\" />\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 12:08:19','2021-07-08 09:08:19','',571,'https://reo.ua/?p=972',0,'revision','',0),(976,1,'2021-07-08 12:58:38','2021-07-08 09:58:38','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їх дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1 </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним, оскільки це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-08 12:58:38','2021-07-08 09:58:38','',478,'https://reo.ua/?p=976',0,'revision','',0),(973,1,'2021-07-08 12:15:33','2021-07-08 09:15:33','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їх дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1 </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним, оскільки це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. У свою чергу, деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації на перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в повільнішому темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірна різниця між ефективністю оральної та внутрішньовенної регідратації відсутня. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися у разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей <strong>РеО </strong>є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. <strong>РeО </strong>не містить консервантів, барвників та має приємний смак, що є важливою умовою для засобів, які застосовуються у педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при відчутті нудоти;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-08 12:15:33','2021-07-08 09:15:33','',478,'https://reo.ua/?p=973',0,'revision','',0),(974,1,'2021-07-08 12:32:05','2021-07-08 09:32:05','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png\"><img class=\"aligncenter size-large wp-image-967\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 12:32:05','2021-07-08 09:32:05','',571,'https://reo.ua/?p=974',0,'revision','',0),(975,1,'2021-07-08 12:32:24','2021-07-08 09:32:24','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png\"><img class=\"aligncenter size-large wp-image-967\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 12:32:24','2021-07-08 09:32:24','',571,'https://reo.ua/?p=975',0,'revision','',0),(977,1,'2021-07-08 12:59:51','2021-07-08 09:59:51','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їх дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. </strong>Причини, що зумовлюють дегідратацію у дітей</p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним, оскільки це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6]. Це зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западіння очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Відсутні</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із наявними деякими ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спрага відсутня</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки мала місце втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком &lt;2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині &gt;10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й відсутні ознаки надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз на 1-2 години. За відсутності покращення стану пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що включав 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-08 12:59:51','2021-07-08 09:59:51','',478,'https://reo.ua/?p=977',0,'revision','',0),(979,1,'2021-07-08 13:13:34','2021-07-08 10:13:34','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-4','','','2021-07-08 13:13:34','2021-07-08 10:13:34','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3.png',0,'attachment','image/png',0),(980,1,'2021-07-08 13:13:34','2021-07-08 10:13:34','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-4-2','','','2021-07-08 13:13:34','2021-07-08 10:13:34','',478,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3.png',0,'attachment','image/png',0),(981,1,'2021-07-08 13:13:59','2021-07-08 10:13:59','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3.png\"><img class=\"aligncenter size-large wp-image-979\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 13:13:59','2021-07-08 10:13:59','',571,'https://reo.ua/?p=981',0,'revision','',0),(982,1,'2021-07-08 13:15:40','2021-07-08 10:15:40','','Web_REO_T10 Регідрадація пожилого возраста_4 (1)','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1','','','2021-07-08 13:15:40','2021-07-08 10:15:40','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1-1.png',0,'attachment','image/png',0),(983,1,'2021-07-08 13:15:40','2021-07-08 10:15:40','','Web_REO_T10 Регідрадація пожилого возраста_4 (1)','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1-2','','','2021-07-08 13:15:40','2021-07-08 10:15:40','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-1-1.png',0,'attachment','image/png',0),(984,1,'2021-07-14 10:15:32','2021-07-14 07:15:32','<h2>Оральная регидратация у лиц пожилого возраста</h2>\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\n\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\n<strong>Связанные с возрастом особенности дегидратации:</strong>\n<ul>\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\n 	<li>уменьшение интенсивности ощущения жажды;</li>\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\n 	<li>деменция;</li>\n 	<li>употребление диуретиков [2].</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\n\nРасстройства здоровья, ассоциируемые с дегидратацией:\n<ul>\n 	<li>падение и переломы;</li>\n 	<li>расстройства сознания и мышления;</li>\n 	<li>запоры;</li>\n 	<li>инфекции мочевыводящей системы;</li>\n 	<li>почечная недостаточность;</li>\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\n 	<li>замедление заживления ран;</li>\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\n 	<li>повышение температуры;</li>\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\n</ul>\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\n<table>\n<tbody>\n<tr>\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\n</tr>\n<tr>\n<td width=\"169\">Возраст</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     70+</td>\n<td width=\"53\">✓     85+</td>\n<td width=\"68\">✓        85+</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     85+</td>\n</tr>\n<tr>\n<td width=\"169\">Запор/недержание мочи</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Понос/рвота</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Пищевые ограничения</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n&nbsp;\n<table>\n<tbody>\n<tr>\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Затрудненное глотание</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Головокружение</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Ощущение жажды</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Плохое настроение</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Прием некоторых препаратов</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Множественные сопутствующие заболевания</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      3+</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      4+</td>\n</tr>\n<tr>\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Боль</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Недавнее стационарное лечение</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Расстройства зрения</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\n</tr>\n<tr>\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Артериальное давление/пульс</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Спутанность сознания</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Сонливость, летаргия</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Лихорадка</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Увеличение частоты дыхания</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Недостаточная упитанность</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Наличие открытых ран</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Потливость</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\n</tr>\n<tr>\n<td width=\"169\">Гипергликемия</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Темный цвет мочи</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Повышенная плотность мочи</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\n\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\n\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\n</tr>\n<tr>\n<th width=\"94\">Расчет</th>\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\n</tr>\n<tr>\n<td width=\"94\">Сутки</td>\n<td width=\"197\">Доля замещенного дефицита (%)</td>\n<td width=\"180\">Базовые ежедневные потребности</td>\n</tr>\n<tr>\n<td width=\"94\">1</td>\n<td width=\"197\">50</td>\n<td width=\"180\">Не менее 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">2</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Не менее 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">3</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Не менее 1500 мл</td>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\n</tr>\n</tbody>\n</table>\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\n<h2>Профилактика</h2>\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\n<ul>\n 	<li>более физиологичная, чем внутривенная;</li>\n 	<li>высокая эффективность;</li>\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\n 	<li>низкая стоимость.</li>\n</ul>\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\n<ul>\n 	<li>используйте яркие чашки;</li>\n 	<li>применяйте кулеры и баллоны с водой;</li>\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\n 	<li>ведите журнал учета питья и мочеотделения;</li>\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\n</tr>\n<tr>\n<th width=\"137\"><strong>Вес (кг)</strong></th>\n<td width=\"30\">≤30</td>\n<td width=\"30\">35</td>\n<td width=\"30\">40</td>\n<td width=\"30\">45</td>\n<td width=\"30\">50</td>\n<td width=\"30\">55</td>\n<td width=\"30\">60</td>\n<td width=\"30\">65</td>\n<td width=\"30\">70</td>\n<td width=\"30\">75</td>\n<td width=\"30\">80</td>\n<td width=\"30\">85</td>\n<td width=\"30\">90</td>\n<td width=\"30\">95</td>\n<td width=\"30\">100</td>\n<td width=\"30\">105</td>\n</tr>\n<tr>\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,8</td>\n<td width=\"30\">1,9</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,1</td>\n<td width=\"30\">2,2</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,4</td>\n<td width=\"30\">2,5</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,7</td>\n<td width=\"30\">2,8</td>\n</tr>\n</tbody>\n</table>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\n\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\">Компонент</th>\n<th width=\"151\">Содержание</th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-autosave-v1','','','2021-07-14 10:15:32','2021-07-14 07:15:32','',577,'https://reo.ua/?p=984',0,'revision','',0),(985,1,'2021-07-08 13:19:10','2021-07-08 10:19:10','','Web_REO_T9 Регідрадація у дорослих_3','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3','','','2021-07-08 13:19:10','2021-07-08 10:19:10','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png',0,'attachment','image/png',0),(986,1,'2021-07-08 13:19:10','2021-07-08 10:19:10','','Web_REO_T9 Регідрадація у дорослих_3','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3-2','','','2021-07-08 13:19:10','2021-07-08 10:19:10','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png',0,'attachment','image/png',0),(987,1,'2021-07-08 13:19:28','2021-07-08 10:19:28','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png\"><img class=\"aligncenter size-large wp-image-909\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>Алгоритм регідратації у дорослих [8]</p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Поради щодо належної гідратації [10]</p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-08 13:19:28','2021-07-08 10:19:28','',489,'https://reo.ua/?p=987',0,'revision','',0),(995,1,'2021-07-08 14:17:13','2021-07-08 11:17:13','Токсикоз вагітних – це комплекс патологічних змін в організмі вагітної, що зазвичай з’являються на 13–16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози на 34-40-й тижні. Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що охоплює не тільки надзвичайно сильну нудоту та блювання (&gt;4 разів на день), а й падіння артеріального тиску під час переходу у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричину надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався під час попередньої вагітності чи у близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО – це готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додаткова перевага – її приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти рідку їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-07-08 14:17:13','2021-07-08 11:17:13','',465,'https://reo.ua/?p=995',0,'revision','',0),(988,1,'2021-07-08 13:32:38','2021-07-08 10:32:38','','Web_REO_T9 Регідрадація у дорослих_2 (9)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-9','','','2021-07-08 13:32:38','2021-07-08 10:32:38','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png',0,'attachment','image/png',0),(989,1,'2021-07-08 13:32:38','2021-07-08 10:32:38','','Web_REO_T9 Регідрадація у дорослих_2 (9)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-9-2','','','2021-07-08 13:32:38','2021-07-08 10:32:38','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png',0,'attachment','image/png',0),(990,1,'2021-07-08 13:32:57','2021-07-08 10:32:57','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter size-large wp-image-988\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. </strong>1. Алгоритм регидратации у взрослых [8]</p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Советы по надлежащей гидратации (10)</p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-08 13:32:57','2021-07-08 10:32:57','',582,'https://reo.ua/?p=990',0,'revision','',0),(991,1,'2021-07-08 13:33:39','2021-07-08 10:33:39','','Web_REO_T10 Регідрадація пожилого возраста_4 (2)','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-2','','','2021-07-08 13:33:39','2021-07-08 10:33:39','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png',0,'attachment','image/png',0),(992,1,'2021-07-08 13:33:39','2021-07-08 10:33:39','','Web_REO_T10 Регідрадація пожилого возраста_4 (2)','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-2-2','','','2021-07-08 13:33:39','2021-07-08 10:33:39','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png',0,'attachment','image/png',0),(993,1,'2021-07-08 13:33:51','2021-07-08 10:33:51','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержимого воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1.</strong> Возрастное уменьшение содержания воды в организме</p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее как 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, некоторые из которых нарушают водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. </strong>Повышенный риск дегидратации у лиц пожилого возраста</p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшими клиническими признаками дегидратации выступают уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. </strong>Факторы риска дегидратации у лиц пожилого возраста</p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>применяйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятие душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. </strong>Советы по увеличению употребления воды</p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол, который является дополнительным источником энергии и усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-08 13:33:51','2021-07-08 10:33:51','',577,'https://reo.ua/?p=993',0,'revision','',0),(1012,1,'2021-07-08 23:50:03','2021-07-08 20:50:03','','Web_REO_T5 при повышении температуры тела_3','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_3','','','2021-07-08 23:50:03','2021-07-08 20:50:03','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png',0,'attachment','image/png',0),(997,1,'2021-07-08 15:11:31','2021-07-08 12:11:31','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному довкіллі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-08 15:11:31','2021-07-08 12:11:31','',422,'https://reo.ua/?p=997',0,'revision','',0),(998,1,'2021-07-08 15:21:13','2021-07-08 12:21:13','Температурний баланс людини підтримується досить суворо й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-08 15:21:13','2021-07-08 12:21:13','',422,'https://reo.ua/?p=998',0,'revision','',0),(999,1,'2021-07-08 15:21:48','2021-07-08 12:21:48','Температурный баланс человека поддерживается организмом достаточно точно, и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости, поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру &lt;38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью как правило используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты (натрий, калий, магний).\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-08 15:21:48','2021-07-08 12:21:48','',432,'https://reo.ua/?p=999',0,'revision','',0),(1000,1,'2021-07-08 15:22:08','2021-07-08 12:22:08','Температурний баланс людини підтримується досить суворо, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру &lt;38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-08 15:22:08','2021-07-08 12:22:08','',422,'https://reo.ua/?p=1000',0,'revision','',0),(1001,1,'2021-07-08 15:25:33','2021-07-08 12:25:33','Температурный баланс человека поддерживается организмом достаточно точно, и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-641\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-645\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-08 15:25:33','2021-07-08 12:25:33','',432,'https://reo.ua/?p=1001',0,'revision','',0),(1002,1,'2021-07-08 15:27:20','2021-07-08 12:27:20','Температурний баланс людини підтримується досить суворо, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\"><img class=\"aligncenter wp-image-642\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-31-ru.jpg\" alt=\"\" width=\"921\" height=\"516\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\"><img class=\"aligncenter wp-image-646\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-32-ru.jpg\" alt=\"\" width=\"615\" height=\"322\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-650\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-08 15:27:20','2021-07-08 12:27:20','',422,'https://reo.ua/?p=1002',0,'revision','',0),(1003,1,'2021-07-08 15:54:10','2021-07-08 12:54:10','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3.png\"><img class=\"aligncenter size-large wp-image-979\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. </strong>Причины, которые обуславливают дегидратацию у детей</p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">является</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота серцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом &lt;2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку &gt;10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол. Сорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-08 15:54:10','2021-07-08 12:54:10','',571,'https://reo.ua/?p=1003',0,'revision','',0),(1004,1,'2021-07-08 16:57:04','2021-07-08 13:57:04','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не меншу важливість мають і солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» - натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-08 16:57:04','2021-07-08 13:57:04','',411,'https://reo.ua/?p=1004',0,'revision','',0),(1005,1,'2021-07-08 17:03:26','2021-07-08 14:03:26','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення, що може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-08 17:03:26','2021-07-08 14:03:26','',411,'https://reo.ua/?p=1005',0,'revision','',0),(1006,1,'2021-07-08 17:07:40','2021-07-08 14:07:40','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце, потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-08 17:07:40','2021-07-08 14:07:40','',419,'https://reo.ua/?p=1006',0,'revision','',0),(1007,1,'2021-07-08 17:08:07','2021-07-08 14:08:07','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце, втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-08 17:08:07','2021-07-08 14:08:07','',411,'https://reo.ua/?p=1007',0,'revision','',0),(1064,1,'2021-07-09 15:06:51','2021-07-09 12:06:51','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, запор, утомлюваність, головний біль, запаморочення. У дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання; у немовлят – сухий підгузок протягом 3 годин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищеної температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-09 15:06:51','2021-07-09 12:06:51','',396,'https://reo.ua/?p=1064',0,'revision','',0),(1008,1,'2021-07-08 17:13:10','2021-07-08 14:13:10','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і швидким диханням може призвести до зневоднення. Симптомами останнього у дорослих виступають відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення, а у дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання (у немовлят – сухий підгузок протягом 3 годин).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищенної температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-08 17:13:10','2021-07-08 14:13:10','',396,'https://reo.ua/?p=1008',0,'revision','',0),(1009,1,'2021-07-08 17:17:03','2021-07-08 14:17:03','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-606 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ru-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-08 17:17:03','2021-07-08 14:17:03','',405,'https://reo.ua/?p=1009',0,'revision','',0),(1010,1,'2021-07-08 23:49:39','2021-07-08 20:49:39','','Web_REO_T5 при повышении температуры тела_1','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_1','','','2021-07-08 23:49:39','2021-07-08 20:49:39','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1.png',0,'attachment','image/png',0),(1011,1,'2021-07-08 23:49:39','2021-07-08 20:49:39','','Web_REO_T5 при повышении температуры тела_1','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_1-2','','','2021-07-08 23:49:39','2021-07-08 20:49:39','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1.png',0,'attachment','image/png',0),(1013,1,'2021-07-08 23:50:03','2021-07-08 20:50:03','','Web_REO_T5 при повышении температуры тела_3','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_3-2','','','2021-07-08 23:50:03','2021-07-08 20:50:03','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png',0,'attachment','image/png',0),(1014,1,'2021-07-08 23:50:33','2021-07-08 20:50:33','','Web_REO_T5 при повышении температуры тела_5','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_5','','','2021-07-08 23:50:33','2021-07-08 20:50:33','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png',0,'attachment','image/png',0),(1015,1,'2021-07-08 23:50:33','2021-07-08 20:50:33','','Web_REO_T5 при повышении температуры тела_5','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_5-2','','','2021-07-08 23:50:33','2021-07-08 20:50:33','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png',0,'attachment','image/png',0),(1016,1,'2021-07-08 23:50:54','2021-07-08 20:50:54','Температурний баланс людини підтримується досить суворо, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1.png\"><img class=\"aligncenter size-large wp-image-1010\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-08 23:50:54','2021-07-08 20:50:54','',422,'https://reo.ua/?p=1016',0,'revision','',0),(1017,1,'2021-07-08 23:51:46','2021-07-08 20:51:46','','Web_REO_T5 при повышении температуры тела_2','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_2','','','2021-07-08 23:51:46','2021-07-08 20:51:46','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2.png',0,'attachment','image/png',0),(1018,1,'2021-07-08 23:51:46','2021-07-08 20:51:46','','Web_REO_T5 при повышении температуры тела_2','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_2-2','','','2021-07-08 23:51:46','2021-07-08 20:51:46','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2.png',0,'attachment','image/png',0),(1019,1,'2021-07-08 23:52:06','2021-07-08 20:52:06','','Web_REO_T5 при повышении температуры тела_4','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_4','','','2021-07-08 23:52:06','2021-07-08 20:52:06','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png',0,'attachment','image/png',0),(1020,1,'2021-07-08 23:52:06','2021-07-08 20:52:06','','Web_REO_T5 при повышении температуры тела_4','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_4-2','','','2021-07-08 23:52:06','2021-07-08 20:52:06','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png',0,'attachment','image/png',0),(1021,1,'2021-07-08 23:52:31','2021-07-08 20:52:31','Температурный баланс человека поддерживается организмом достаточно точно, и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2.png\"><img class=\"aligncenter size-large wp-image-1017\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, сильное потовыделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-08 23:52:31','2021-07-08 20:52:31','',432,'https://reo.ua/?p=1021',0,'revision','',0),(1022,1,'2021-07-09 10:04:45','2021-07-09 07:04:45','','Web_REO_T11 Регідрадація у дітей_2 (1)','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-1','','','2021-07-09 10:04:45','2021-07-09 07:04:45','',571,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png',0,'attachment','image/png',0),(1025,1,'2021-07-09 10:09:13','2021-07-09 07:09:13','','Web_REO_T3 при повышенной температуре_1','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_1','','','2021-07-09 10:09:13','2021-07-09 07:09:13','',405,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png',0,'attachment','image/png',0),(1026,1,'2021-07-09 10:09:13','2021-07-09 07:09:13','','Web_REO_T3 при повышенной температуре_1','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_1-2','','','2021-07-09 10:09:13','2021-07-09 07:09:13','',396,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png',0,'attachment','image/png',0),(1027,1,'2021-07-09 10:09:31','2021-07-09 07:09:31','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение, а у детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания (у новорожденных – сухой подгузник в течение ≥3 часов).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-09 10:09:31','2021-07-09 07:09:31','',405,'https://reo.ua/?p=1027',0,'revision','',0),(1028,1,'2021-07-09 11:13:26','2021-07-09 08:13:26','Харчове отруєння є наслідком уживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти запору та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати їжу, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-09 11:13:26','2021-07-09 08:13:26','',384,'https://reo.ua/?p=1028',0,'revision','',0),(1029,1,'2021-07-13 16:38:23','2021-07-13 13:38:23','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\n<ul>\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\n 	<li>срок годности продукта закончился.</li>\n</ul>\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\n<h2>Когда следует обратиться к врачу?</h2>\nПризнаками опасного пищевого отравления являются:\n<ul>\n 	<li>диарея длительностью ≥3 дней;</li>\n 	<li>частая рвота;</li>\n 	<li>температура больше 38,5 °С;</li>\n 	<li>резкое ухудшение зрения или резкое нарушение речи;</li>\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\n 	<li>появление крови в моче или кале.</li>\n</ul>\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\n&nbsp;\n<h2>Что делать при пищевом отравлении?</h2>\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\n\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\n\nМожно использовать лекарства против диареи и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\n\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются: соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты.\n<h2>Сколько нужно пить?</h2>\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\n<h2>Что необходимо пить?</h2>\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Составляющая</strong></th>\n<th width=\"50%\"><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пить даже при тошноте;</li>\n 	<li>устраняет симптомы обезвоживания.</li>\n</ul>\n<h2>Как избежать пищевых отравлений?</h2>\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\n\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\n&nbsp;\n<h2>Список литературы</h2>\n<ol>\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-autosave-v1','','','2021-07-13 16:38:23','2021-07-13 13:38:23','',390,'https://reo.ua/?p=1029',0,'revision','',0),(1030,1,'2021-07-09 11:16:22','2021-07-09 08:16:22','Харчове отруєння є наслідком уживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються (солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости).\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати їжу, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-09 11:16:22','2021-07-09 08:16:22','',384,'https://reo.ua/?p=1030',0,'revision','',0),(1031,1,'2021-07-09 11:17:30','2021-07-09 08:17:30','Харчове отруєння є наслідком уживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються: солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости.\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати їжу, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це спричиняє поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-09 11:17:30','2021-07-09 08:17:30','',384,'https://reo.ua/?p=1031',0,'revision','',0),(1032,1,'2021-07-09 11:20:03','2021-07-09 08:20:03','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура больше 38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n&nbsp;\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать лекарства против диареи и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются: соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты.\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при тошноте;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n&nbsp;\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-07-09 11:20:03','2021-07-09 08:20:03','',390,'https://reo.ua/?p=1032',0,'revision','',0),(1033,1,'2021-07-09 11:34:18','2021-07-09 08:34:18','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричинені бактеріями, вірусами чи паразитами. У більшості випадків антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. Під час оцінювання ступеня зневоднення варто звернути увагу на об’єми спожитої рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїновмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява крапчастого червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих небезпечними симптомами є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів у дітей або довше 5 днів у дорослих.\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз на 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для регідратації фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при нудоті, яка досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед уживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-09 11:34:18','2021-07-09 08:34:18','',368,'https://reo.ua/?p=1033',0,'revision','',0),(1034,1,'2021-07-13 16:50:57','2021-07-13 13:50:57','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\n&nbsp;\n\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\n<h2>Что делать при кишечных инфекциях?</h2>\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\n\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\n\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\n<h2>Когда следует обратиться к врачу?</h2>\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\n<ul>\n 	<li>нарушение сознания;</li>\n 	<li>появление крови либо желчи в рвотных массах;</li>\n 	<li>посинение лица;</li>\n 	<li>непрерывный плач, сильная раздражительность;</li>\n 	<li>появление точечной красной сыпи;</li>\n 	<li>холодные конечности;</li>\n 	<li>частое дыхание;</li>\n 	<li>температура ≥40 °С.</li>\n</ul>\nУ взрослых опасными симптомами являются:\n<ul>\n 	<li>температура ≥40 °С;</li>\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\n 	<li>рвота длительностью &gt;48 часов;</li>\n 	<li>появление крови в рвотных массах или кале;</li>\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\n</ul>\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней у детей или дольше 5 дней у взрослых.\n<h2>Сколько нужно пить?</h2>\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\n<table>\n<thead>\n<tr>\n<th width=\"33%\"><strong>Вес</strong></th>\n<th width=\"33%\"><strong>Возраст</strong></th>\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>&lt;5 кг</td>\n<td>&lt;4 месяцев</td>\n<td>200-400 мл</td>\n</tr>\n<tr>\n<td>5-7,9 кг</td>\n<td>4-11 месяцев</td>\n<td>400-600 мл</td>\n</tr>\n<tr>\n<td>8-10,9 кг</td>\n<td>12-23 месяца</td>\n<td>600-800 мл</td>\n</tr>\n<tr>\n<td>11-15,9 кг</td>\n<td>2-4 года</td>\n<td>800-1200 мл</td>\n</tr>\n<tr>\n<td>16-29,9 кг</td>\n<td>5-14 лет</td>\n<td>1200-2200 мл</td>\n</tr>\n<tr>\n<td>≥30 кг</td>\n<td>≥15 лет</td>\n<td>2200-4000 мл</td>\n</tr>\n</tbody>\n</table>\nЕсли человек хочет выпить больше, можно дать больше.\n\nНоворожденным дают пить со шприца (без иглы), малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\n<h2>Что необходимо пить?</h2>\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для регидратации фруктовые соки, поскольку они не способны компенсировать потерю солей.\n\n&nbsp;\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\n&nbsp;\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\n<h2>Как предотвратить кишечные инфекции?</h2>\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\n<h2>Список литературы</h2>\n<ol>\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-autosave-v1','','','2021-07-13 16:50:57','2021-07-13 13:50:57','',377,'https://reo.ua/?p=1034',0,'revision','',0),(1035,1,'2021-07-09 11:38:43','2021-07-09 08:38:43','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых опасными симптомами являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней у детей или дольше 5 дней у взрослых.\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца, малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для регидратации фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-07-09 11:38:43','2021-07-09 08:38:43','',377,'https://reo.ua/?p=1035',0,'revision','',0),(1038,1,'2021-07-09 12:26:30','2021-07-09 09:26:30','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який виступає додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-09 12:26:30','2021-07-09 09:26:30','',586,'https://reo.ua/?p=1038',0,'revision','',0),(1039,1,'2021-07-09 12:27:10','2021-07-09 09:27:10','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби смокчіть лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-09 12:27:10','2021-07-09 09:27:10','',586,'https://reo.ua/?p=1039',0,'revision','',0),(1040,1,'2021-07-09 12:29:35','2021-07-09 09:29:35','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы выглядят как «кофейная гуща», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Пососите кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-09 12:29:35','2021-07-09 09:29:35','',592,'https://reo.ua/?p=1040',0,'revision','',0),(1041,1,'2021-07-09 12:35:02','2021-07-09 09:35:02','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом на пахви та пахову ділянку;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-09 12:35:02','2021-07-09 09:35:02','',557,'https://reo.ua/?p=1041',0,'revision','',0),(1042,1,'2021-07-09 12:38:36','2021-07-09 09:38:36','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли вы заметили хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО имеет высокую степень минерализации, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-09 12:38:36','2021-07-09 09:38:36','',565,'https://reo.ua/?p=1042',0,'revision','',0),(1044,1,'2021-07-09 13:27:20','2021-07-09 10:27:20','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років уживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>запори;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5.png\"><img class=\"aligncenter size-large wp-image-955\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-09 13:27:20','2021-07-09 10:27:20','',506,'https://reo.ua/?p=1044',0,'revision','',0),(1045,1,'2021-07-09 13:33:59','2021-07-09 10:33:59','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png\"><img class=\"aligncenter size-large wp-image-909\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-09 13:33:59','2021-07-09 10:33:59','',489,'https://reo.ua/?p=1045',0,'revision','',0),(1046,1,'2021-07-09 13:38:31','2021-07-09 10:38:31','','Web_REO_T10 Регідрадація пожилого возраста_5','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-2','','','2021-07-09 13:38:31','2021-07-09 10:38:31','',506,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png',0,'attachment','image/png',0),(1047,1,'2021-07-09 13:38:31','2021-07-09 10:38:31','','Web_REO_T10 Регідрадація пожилого возраста_5','','inherit','open','closed','','web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-2-2','','','2021-07-09 13:38:31','2021-07-09 10:38:31','',577,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png',0,'attachment','image/png',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (1049,1,'2021-07-09 13:38:47','2021-07-09 10:38:47','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років уживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>запори;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png\"><img class=\"aligncenter size-large wp-image-1046\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1-1024x360.png\" alt=\"\" width=\"1024\" height=\"360\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-09 13:38:47','2021-07-09 10:38:47','',506,'https://reo.ua/?p=1049',0,'revision','',0),(1050,1,'2021-07-13 01:38:44','2021-07-12 22:38:44','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\n\n<strong> Группы риска дегидратации</strong> [5]:\n<ul>\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\n 	<li>дети с низкой массой тела при рождении;</li>\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\n 	<li>дети, которые не могут пить в данный момент;</li>\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\n 	<li>дети с признаками недостаточной упитанности.</li>\n</ul>\n<h2>Патогенез дегидратации</h2>\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\n\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\n<h2>Клиническая картина и степени дегидратации</h2>\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\n\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\n</tr>\n<tr>\n<th width=\"156\"><strong>Критерий</strong></th>\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\n</tr>\n<tr>\n<td width=\"156\"><strong>Состояние сознания</strong></td>\n<td width=\"156\">Активный, способен к общению</td>\n<td width=\"156\">Летаргия, раздраженность</td>\n<td width=\"156\">Расстройства сознания</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\n<td width=\"156\">Нормальная</td>\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\n<td width=\"156\">Тахикардия</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Частота дыхания</strong></td>\n<td width=\"156\">Нормальная</td>\n<td width=\"156\">Повышена</td>\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Артериальное давление</strong></td>\n<td width=\"156\">Нормальное</td>\n<td width=\"156\">Нормальное</td>\n<td width=\"156\">Гипотензия</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Цвет кожи</strong></td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Бледная, появление пятен</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Конечности</strong></td>\n<td width=\"156\">Теплые</td>\n<td width=\"156\">Теплые</td>\n<td width=\"156\">Холодные</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Периферический пульс </strong></td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Ослаблен</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\n<td width=\"156\">Нормальные</td>\n<td width=\"156\">Запавшие</td>\n<td width=\"156\">Глубоко запавшие</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\n<td width=\"156\">Влажные</td>\n<td width=\"156\">Сухие</td>\n<td width=\"156\">Сухие</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Тургор кожи</strong></td>\n<td width=\"156\">Складка быстро разглаживается</td>\n<td width=\"156\">Умеренно снижен</td>\n<td width=\"156\">Снижен</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\n<td width=\"156\">Нормальное</td>\n<td width=\"156\">Увеличено</td>\n<td width=\"156\">Значительно увеличено</td>\n</tr>\n</tbody>\n</table>\n(7)\n\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\n<ul>\n 	<li>прогрессирование ухудшения состояния;</li>\n 	<li>расстройства сознания;</li>\n 	<li>западение глаз;</li>\n 	<li>тахикардия;</li>\n 	<li>тахипноэ;</li>\n 	<li>уменьшение тургора кожи.</li>\n</ul>\n<strong>Признаки дегидратации</strong>\n\n<strong>Дефицит жидкости в % массы тела\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\n</tr>\n<tr>\n<td width=\"208\">Отсутствуют</td>\n<td width=\"208\">&lt; 5</td>\n<td width=\"208\">&lt;50</td>\n</tr>\n<tr>\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\n<td width=\"208\">5-10</td>\n<td width=\"208\">50-100</td>\n</tr>\n<tr>\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\n<td width=\"208\">&gt;10</td>\n<td width=\"208\">&gt;100</td>\n</tr>\n</tbody>\n</table>\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\n</tr>\n<tr>\n<th width=\"164\"><strong>Критерии оценки</strong></th>\n<th width=\"152\"><strong>А</strong></th>\n<th width=\"154\"><strong>В</strong></th>\n<th width=\"152\"><strong>С</strong></th>\n</tr>\n<tr>\n<td width=\"164\"><strong>Общее состояние</strong></td>\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Глаза</strong></td>\n<td width=\"152\">Нормальные</td>\n<td width=\"154\">Запавшие</td>\n<td width=\"152\">Запавшие</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Жажда</strong></td>\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\n<td width=\"154\">Пьет жадно, жажда есть</td>\n<td width=\"152\">Не может пить или пьет совсем немного</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\n\n<strong> </strong></td>\n<td width=\"152\">Складка кожи разглаживается быстро</td>\n<td width=\"154\">Складка кожи разглаживается медленно</td>\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Вывод</strong></td>\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Тактика действий</strong></td>\n<td width=\"152\">План А</td>\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\n</tr>\n</tbody>\n</table>\n<h2>План А: оральная регидратация</h2>\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\n<h2>Сколько жидкости давать?</h2>\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\n\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\n\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\n<table>\n<tbody>\n<tr>\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\n</tr>\n<tr>\n<th width=\"89\"><strong>Возраст</strong></th>\n<th width=\"89\">До 4 мес</th>\n<th width=\"89\">4-11 мес</th>\n<th width=\"89\">12-23 мес</th>\n<th width=\"89\">2-4 года</th>\n<th width=\"89\">5-14 лет</th>\n<th width=\"89\">&gt;15 лет</th>\n</tr>\n<tr>\n<th width=\"89\"><strong>Вес</strong></th>\n<td width=\"89\">До 5 кг</td>\n<td width=\"89\">5-7,9 кг</td>\n<td width=\"89\">8-10,9 кг</td>\n<td width=\"89\">11-15,9 кг</td>\n<td width=\"89\">16-29,9 кг</td>\n<td width=\"89\">&gt;30 кг</td>\n</tr>\n<tr>\n<th width=\"89\"><strong>Мл</strong></th>\n<td width=\"89\">200-400</td>\n<td width=\"89\">400-600</td>\n<td width=\"89\">600-800</td>\n<td width=\"89\">800-1200</td>\n<td width=\"89\">1200-2200</td>\n<td width=\"89\">2200-4000</td>\n</tr>\n</tbody>\n</table>\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\n\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\n\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\n\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\n</tr>\n<tr>\n<th width=\"208\"><strong>Возраст</strong></th>\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\n</tr>\n<tr>\n<th width=\"208\"><strong>До 12 мес</strong></th>\n<td width=\"208\">1 часа*</td>\n<td width=\"208\">5 часов</td>\n</tr>\n<tr>\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\n<td width=\"208\">30 минут*</td>\n<td width=\"208\">2,5 часов</td>\n</tr>\n</tbody>\n</table>\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Компонент</strong></th>\n<th width=\"151\"><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>нормализует диурез, снижает интоксикацию.</li>\n</ul>\n<h2>Профилактика дегидратации</h2>\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\n\nПотребности ребенка в жидкости рассчитываются таким образом:\n<ul>\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\n</ul>\n<h2>Список литературы:</h2>\n<ol>\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-autosave-v1','','','2021-07-13 01:38:44','2021-07-12 22:38:44','',571,'https://reo.ua/?p=1050',0,'revision','',0),(1051,1,'2021-07-09 13:47:33','2021-07-09 10:47:33','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-09 13:47:33','2021-07-09 10:47:33','',571,'https://reo.ua/?p=1051',0,'revision','',0),(1052,1,'2021-07-09 13:57:39','2021-07-09 10:57:39','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їхній дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Причини, що зумовлюють дегідратацію у дітей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западання очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Немає</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спраги немає</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки наявна втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком молодше 2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині старше 10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й немає ознак надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз в 1-2 години. Якщо покращення стану немає, пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що містив 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-09 13:57:39','2021-07-09 10:57:39','',478,'https://reo.ua/?p=1052',0,'revision','',0),(1054,1,'2021-07-09 14:30:45','2021-07-09 11:30:45','','Web_REO_T9 Регідрадація у дорослих_1 (2)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-2','','','2021-07-09 14:30:45','2021-07-09 11:30:45','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png',0,'attachment','image/png',0),(1055,1,'2021-07-09 14:30:45','2021-07-09 11:30:45','','Web_REO_T9 Регідрадація у дорослих_1 (2)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-2-2','','','2021-07-09 14:30:45','2021-07-09 11:30:45','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png',0,'attachment','image/png',0),(1056,1,'2021-07-09 14:31:01','2021-07-09 11:31:01','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter size-large wp-image-1054\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2-536x1024.png\" alt=\"\" width=\"536\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-09 14:31:01','2021-07-09 11:31:01','',489,'https://reo.ua/?p=1056',0,'revision','',0),(1057,1,'2021-07-09 14:48:59','2021-07-09 11:48:59','','Головна','','inherit','closed','closed','','8-revision-v1','','','2021-07-09 14:48:59','2021-07-09 11:48:59','',8,'https://reo.ua/?p=1057',0,'revision','',0),(1058,1,'2021-07-09 14:55:30','2021-07-09 11:55:30','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при ротовому диханні. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце. Втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-09 14:55:30','2021-07-09 11:55:30','',411,'https://reo.ua/?p=1058',0,'revision','',0),(1059,1,'2021-07-09 14:58:06','2021-07-09 11:58:06','','Web_REO_T6 при беременности_2','','inherit','open','closed','','web_reo_t6-pri-beremennosti_2','','','2021-07-09 14:58:06','2021-07-09 11:58:06','',473,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png',0,'attachment','image/png',0),(1060,1,'2021-07-09 14:58:06','2021-07-09 11:58:06','','Web_REO_T6 при беременности_2','','inherit','open','closed','','web_reo_t6-pri-beremennosti_2-2','','','2021-07-09 14:58:06','2021-07-09 11:58:06','',465,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png',0,'attachment','image/png',0),(1061,1,'2021-07-09 14:58:32','2021-07-09 11:58:32','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанасливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-09 14:58:32','2021-07-09 11:58:32','',419,'https://reo.ua/?p=1061',0,'revision','',0),(1115,1,'2021-07-13 17:41:48','2021-07-13 14:41:48','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4','','','2021-07-13 17:41:48','2021-07-13 14:41:48','',405,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png',0,'attachment','image/png',0),(1062,1,'2021-07-09 14:59:46','2021-07-09 11:59:46','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутанности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-07-09 14:59:46','2021-07-09 11:59:46','',473,'https://reo.ua/?p=1062',0,'revision','',0),(1063,1,'2021-07-09 15:02:02','2021-07-09 12:02:02','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потовыделение. Потеря жидкости с потом и усиленным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение. У детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания; у новорожденных – сухой подгузник в течение ≥3 часов.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потовыделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-09 15:02:02','2021-07-09 12:02:02','',405,'https://reo.ua/?p=1063',0,'revision','',0),(1065,1,'2021-07-09 15:10:14','2021-07-09 12:10:14','Харчове отруєння є наслідком уживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму, щоб позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються: солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости.\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати їжу, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це може спричинити поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-09 15:10:14','2021-07-09 12:10:14','',384,'https://reo.ua/?p=1065',0,'revision','',0),(1067,1,'2021-07-09 15:32:36','2021-07-09 12:32:36','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>используйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-09 15:32:36','2021-07-09 12:32:36','',577,'https://reo.ua/?p=1067',0,'revision','',0),(1068,1,'2021-07-09 15:33:07','2021-07-09 12:33:07','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років уживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>запори;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість рота, очей і шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png\"><img class=\"aligncenter size-large wp-image-1046\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1-1024x360.png\" alt=\"\" width=\"1024\" height=\"360\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-09 15:33:07','2021-07-09 12:33:07','',506,'https://reo.ua/?p=1068',0,'revision','',0),(1069,1,'2021-07-09 15:34:02','2021-07-09 12:34:02','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Уживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, уживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, уживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>смокчіть заморожений сік або інші напої;</li>\r\n 	<li>смокчіть шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter size-large wp-image-1054\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2-536x1024.png\" alt=\"\" width=\"536\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-09 15:34:02','2021-07-09 12:34:02','',489,'https://reo.ua/?p=1069',0,'revision','',0),(1095,1,'2021-07-13 15:42:46','2021-07-13 12:42:46','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-13 15:42:46','2021-07-13 12:42:46','',582,'https://reo.ua/?p=1095',0,'revision','',0),(1070,1,'2021-07-09 15:34:16','2021-07-09 12:34:16','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter size-large wp-image-988\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9-537x1024.png\" alt=\"\" width=\"537\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-09 15:34:16','2021-07-09 12:34:16','',582,'https://reo.ua/?p=1070',0,'revision','',0),(1071,1,'2021-07-09 15:36:54','2021-07-09 12:36:54','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пьется даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-09 15:36:54','2021-07-09 12:36:54','',571,'https://reo.ua/?p=1071',0,'revision','',0),(1072,1,'2021-07-09 15:38:18','2021-07-09 12:38:18','<h2>Дегідратація: визначення, причини, патогенез</h2>\r\nЗневоднення, або дегідратація – це порушення водно-сольового балансу, яке супроводжується дефіцитом води в організмі. Дегідратація виникає тоді, коли втрати води й електролітів своєчасно не поповнюються, тобто виникає їхній дефіцит [1]. Причини дегідратації можуть бути такі: зменшення вживання рідини, посилене її виділення із сечею, калом, блювотними масами, крововтрата, дисбаланс рідин в організмі (асцит, плевральний випіт), капілярна втрата рідини (при опіках і сепсисі) (мал.) [адаптовано з 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png\"><img class=\"aligncenter size-large wp-image-940\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr-1024x359.png\" alt=\"\" width=\"1024\" height=\"359\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Причини, що зумовлюють дегідратацію у дітей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примітка. * У цих випадках біль обмежує оральне вживання рідини.</em></p>\r\nДіти більш чутливі до дегідратації, ніж дорослі, оскільки співвідношення поверхні тіла дитини до маси тіла є значно більшим, аніж у дорослих [2, 3]. Найчастішими причинами дегідратації в дитячому віці є пронос і блювання [4].\r\n\r\n<strong>Групи ризику дегідратації [5]:</strong>\r\n<ul>\r\n 	<li>діти до 1 року, передусім до 5 місяців;</li>\r\n 	<li>діти з низькою масою тіла при народженні;</li>\r\n 	<li>діти, що мали 6 або більше епізодів рідкого випорожнення за останні 24 години;</li>\r\n 	<li>діти, що мали 3 або більше епізодів блювання за останні 24 години;</li>\r\n 	<li>діти, які не можуть пити на даний час;</li>\r\n 	<li>діти, яким під час хвороби припинили грудне вигодовування;</li>\r\n 	<li>діти з ознаками недостатньої вгодованості.</li>\r\n</ul>\r\n<h2>Патогенез дегідратації</h2>\r\nРідина, яка втрачається з блюванням, проносом, посиленим потовиділенням чи іншим шляхом, містить певну концентрацію солей, тому втрата рідини завжди супроводжується втратою солей. Точні кількість і характер сольових (електролітних) втрат залежать від причини дегідратації. Наприклад, бікарбонати значною мірою втрачаються під час діареї, але не при блюванні.\r\n\r\nВтрата рідини перешкоджає повноцінному функціонуванню всіх органів та тканин, що зумовлює погіршення самопочуття людини. Так само втрата солей (електролітів) і, навпаки, зростання їх концентрації внаслідок втрати води є небезпечним. Це може спричинити такі ускладнення, як судоми, порушення ритму і навіть зупинку серця [6], що зумовлює потребу в проведенні своєчасної регідратації за допомогою збалансованого розчину.\r\n<h2>Клінічна картина та ступені дегідратації</h2>\r\nДегідратація поділяється на ступені залежно від вираженості ознак і симптомів, які характеризують утрату рідини. На ранніх стадіях ознак і симптомів зневоднення можна компенсувати. Згодом компенсаторні можливості організму дитини виснажуються. Виникають спрага, дратівливість та неспокій, зниження тургору шкіри, западання очей і тім’ячка (у немовлят). У разі тяжкої дегідратації ці ознаки стають іще більш вираженими. Можливий навіть гіповолемічний шок, який характеризується розладами свідомості, відсутністю виділення сечі, периферичним ціанозом. Спостерігаються холодні вологі кінцівки, пришвидшення пульсу (пульс на променевій артерії може взагалі не визначатися), падіння артеріального тиску. Відсутність належної регідратації може призвести до летального наслідку [1].\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Табл. 1. Оцінка тяжкості дегідратації [7]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"135\"><strong>Критерій</strong></th>\r\n<th width=\"171\"><strong>Незначна дегідратація (&lt;5%)</strong></th>\r\n<th width=\"166\"><strong>Помірна дегідратація (5-9%)</strong></th>\r\n<th width=\"151\"><strong>Тяжка дегідратація (≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Стан свідомості</strong></td>\r\n<td width=\"171\">Жвавий, здатен до спілкування</td>\r\n<td width=\"166\">Летаргія, дратівливість</td>\r\n<td width=\"151\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота серцебиття</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Нормальна чи незначна тахікардія</td>\r\n<td width=\"151\">Тахікардія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Частота дихання</strong></td>\r\n<td width=\"171\">Нормальна</td>\r\n<td width=\"166\">Підвищена</td>\r\n<td width=\"151\">Підвищена; глибоке дихання з формуванням ацидозу</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Артеріальний тиск</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Гіпотензія</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Колір шкіри</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Блідий, поява плям</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Кінцівки</strong></td>\r\n<td width=\"171\">Теплі</td>\r\n<td width=\"166\">Теплі</td>\r\n<td width=\"151\">Холодні</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Периферичний пульс</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Нормальний</td>\r\n<td width=\"151\">Ослаблений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Очі та тім’ячко</strong></td>\r\n<td width=\"171\">Нормальні</td>\r\n<td width=\"166\">Запалі</td>\r\n<td width=\"151\">Глибоко запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Слизові оболонки</strong></td>\r\n<td width=\"171\">Вологі</td>\r\n<td width=\"166\">Сухі</td>\r\n<td width=\"151\">Сухі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Тургор шкіри</strong></td>\r\n<td width=\"171\">Складка негайно розгладжується</td>\r\n<td width=\"166\">Помірно знижений</td>\r\n<td width=\"151\">Знижений</td>\r\n</tr>\r\n<tr>\r\n<td width=\"135\"><strong>Час відновлення наповнення капілярів</strong></td>\r\n<td width=\"171\">Нормальний</td>\r\n<td width=\"166\">Збільшений</td>\r\n<td width=\"151\">Значно збільшений</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Червоні прапорці дегідратації (ознаки прогресування та ризику виникнення шоку) [8]:</strong>\r\n<ul>\r\n 	<li>прогресування погіршення стану;</li>\r\n 	<li>розлади свідомості;</li>\r\n 	<li>западання очей;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>тахіпное;</li>\r\n 	<li>зменшення тургору шкіри.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Табл. 2. Клінічні ознаки дегідратації та приблизний дефіцит рідини [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"213\"><strong>Ознаки дегідратації</strong></th>\r\n<th width=\"206\"><strong>Дефіцит рідини у % маси тіла</strong></th>\r\n<th width=\"203\"><strong>Дефіцит рідини у мл/кг маси тіла</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Немає</td>\r\n<td width=\"206\">&lt;5</td>\r\n<td width=\"203\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні деякі ознаки дегідратації</td>\r\n<td width=\"206\">5-10</td>\r\n<td width=\"203\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"213\">Наявні ознаки тяжкої дегідратації</td>\r\n<td width=\"206\">&gt;10</td>\r\n<td width=\"203\">&gt;100</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"622\"><em>Примітка. Наприклад, у дитини вагою 5 кг із деякими наявними ознаками дегідратації дефіцит рідини становить 250-500 мл.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Табл. 3. Критерії оцінки дегідратації та вибір тактики дій [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"155\"><strong>Критерій оцінки</strong></th>\r\n<th width=\"155\"><strong>А</strong></th>\r\n<th width=\"155\"><strong>В</strong></th>\r\n<th width=\"155\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Загальний стан</strong></td>\r\n<td width=\"155\">Нормальний, жвавий</td>\r\n<td width=\"155\">Неспокійний, дратівливий</td>\r\n<td width=\"155\">Розлади свідомості</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Очі</strong></td>\r\n<td width=\"155\">Нормальні</td>\r\n<td width=\"155\">Запалі</td>\r\n<td width=\"155\">Запалі</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Спрага</strong></td>\r\n<td width=\"155\">П’є спокійно, спраги немає</td>\r\n<td width=\"155\">П’є жадібно, є спрага</td>\r\n<td width=\"155\">Не може пити чи ледь-ледь п’є</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Щипок шкіри передпліччя</strong></td>\r\n<td width=\"155\">Складка шкіри розгладжується швидко</td>\r\n<td width=\"155\">Складка шкіри розгладжується повільно</td>\r\n<td width=\"155\">Складка шкіри розгладжується дуже повільно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Висновок</strong></td>\r\n<td width=\"155\">Ознак дегідратації немає, проте необхідна профілактика дегідратації, оскільки наявна втрата води</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна незначна або помірна дегідратація</td>\r\n<td width=\"155\">Якщо є ≥2 ознак із цього списку, наявна тяжка дегідратація</td>\r\n</tr>\r\n<tr>\r\n<td width=\"155\"><strong>Тактика дій</strong></td>\r\n<td width=\"155\">План А</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину та застосовуйте план В</td>\r\n<td width=\"155\">Якщо можливо, зважте дитину й невідкладно розпочинайте план С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральна регідратація</h2>\r\nБажано давати дитині рідини, що містять сіль (спеціальні сольові розчини для оральної регідратації, підсолені напої). Якщо провести регідратацію лише простою водою (гіпотонічний розчин), існує ризик надмірного зниження рівня солей в плазмі крові й утворення набряків [9].\r\n\r\nМожливим є також застосування рисового відвару (води, в якій варився рис), слабкого непідсолодженого чаю, непідсолодженого свіжого фруктового соку (фрешу), питної води. Деякі напої є потенційно небезпечними. Наприклад, напої, які містять цукор, можуть спричиняти осмотичну діарею та гіпернатріємію, тому слід уникати вживання солодких газованих напоїв, готових соків, підсолодженого чаю. Небажано також давати дитині каву чи рослинні чаї, які можуть мати діуретичну або проносну дію.\r\n<h2>Скільки рідини давати?</h2>\r\nЗагалом стільки, скільки дитина хоче випити. У разі діареї після кожного рідкого випорожнення давайте дитині віком молодше 2 років 50-100 мл рідини (1/4-1/2 великої чашки), дитині віком 2-10 років – 100-200 мл (1/2-1 великої чашки), дитині старше 10 років – стільки, скільки дитина захоче випити [1]. Якщо причина дегідратації інша, при регідратації можна орієнтуватися на відчуття спраги.\r\n\r\nПлан В: оральна регідратація за допомогою спеціальних розчинів у медичному закладі.\r\n\r\nЯкщо вага дитини відома, для визначення необхідної кількості рідини слід помножити вагу на 75 мл. Якщо вага дитини невідома, послуговуються таблицями відповідно до віку. У разі, коли дитина хоче випити більше й немає ознак надмірної гідратації (передусім набряк повік), можна дати більше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Табл. 4. Приблизна кількість розчину для оральної регідратації в перші 4 години [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вік</strong></th>\r\n<td width=\"89\">До 4 міс.</td>\r\n<td width=\"89\">4-11 міс.</td>\r\n<td width=\"89\">12-23 міс.</td>\r\n<td width=\"89\">2-4 роки</td>\r\n<td width=\"89\">5-14 років</td>\r\n<td width=\"89\">&gt;15 років</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вага</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"7\" width=\"623\"><em>Примітка. Орієнтуйтеся на вік лише тоді, коли не знаєте ваги. Приблизну кількість розчину для оральної регідратації в мл можна також розрахувати, помноживши вагу дитини в кг на 75. Якщо дитина хоче випити більше розчину, ніж розраховано, дайте їй випити більше.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nРозчин потрібно давати ложкою або з чашки. Для немовлят можна користуватися піпеткою чи шприцом без голки. Нерідко при швидкому посиленому питті виникає блювання, проте зазвичай воно не перешкоджає регідратації, оскільки більша частина рідини все-таки встигає всмоктатися. За появи блювання зачекайте 5-10 хвилин і продовжуйте регідратацію в більш повільному темпі. Через 4 години оцініть ступінь дегідратації за таблицею 3. За появи ознак тяжкої дегідратації перейдіть до плану С. У разі відсутності ознак дегідратації регідратацію можна припинити. У таких випадках зникає спрага, відновлюється сечовипускання, шкіра після щипка швидко розгладжується, дитина заспокоюється й зазвичай засинає [1].\r\n\r\n<strong>План С: внутрішньовенна регідратація </strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Табл. 5. Схема внутрішньовенної регідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>Вік</strong></th>\r\n<td width=\"208\">Спершу призначте інфузію 30 мл/кг протягом</td>\r\n<td width=\"208\">Далі призначте інфузію 70 мл/кг протягом</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong><em> </em></strong><strong>До 12 міс.</strong></th>\r\n<td width=\"208\"><strong><em> </em></strong>1 години*</td>\r\n<td width=\"208\"><strong><em> </em></strong>5 годин</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Понад 12 міс.</strong></th>\r\n<td width=\"208\">30 хвилин*</td>\r\n<td width=\"208\">2,5 годин</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"624\"><em>Примітки. Після госпіталізації негайно розпочніть інфузію збалансованих розчинів. Якщо дитина може пити, слід паралельно з інфузією давати розчини солей для оральної регідратації. Оцінюйте стан пацієнта раз в 1-2 години. Якщо покращення стану немає, пришвидшіть уведення рідини. Після повного введення об’єму рідини (у немовлят – 6 годин, у старших дітей – 3 години) оцініть стан пацієнта за таблицею 3 та знову оберіть оптимальний план лікування (А, В чи С). * Якщо пульс на променевій артерії слабкий або не визначається, повторіть таке введення ще раз.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЗа даними Кокранівського огляду, що містив 17 досліджень за участю 1811 пацієнтів, достовірної різниці між ефективністю оральної та внутрішньовенної регідратації немає. Оральна регідратація має бути першою лінією лікування у дітей із незначною та помірною дегідратацією, а внутрішньовенна регідратація – призначатися в разі невдачі оральної [10].\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РеО не містить консервантів, барвників та має приємний смак. Це є важливою умовою для засобів, які застосовуються в педіатричній практиці.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко п’ється навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [12].</li>\r\n</ul>\r\n<h2>Профілактика дегідратації</h2>\r\nДо станів, які потенційно можуть супроводжуватися зневодненням, належать підвищена фізична активність (спортивні заняття, активні ігри, біг), перебування в опалюваних приміщеннях та приміщеннях із сухим повітрям, фототерапія, поліурія, гарячка, опіки, посилене потовиділення, підвищення частоти дихання та серцебиття, встановлені хірургічні дренажі [12]. У таких випадках слід ретельно стежити за об’ємами пиття дитини, оптимально – давати пити через регулярні проміжки часу незалежно від відчуття спраги.\r\n<h2>Потреби дитини в рідині розраховуються таким чином:</h2>\r\n<ul>\r\n 	<li>4 мл/кг/год на перші 10 кг маси тіла;</li>\r\n 	<li>+2 мл/кг/год на кожні наступні 10 кг маси тіла;</li>\r\n 	<li>+1 мл/кг/год на кожен кг за ваги &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральна регідратація у дітей','','inherit','closed','closed','','478-revision-v1','','','2021-07-09 15:38:18','2021-07-09 12:38:18','',478,'https://reo.ua/?p=1072',0,'revision','',0),(1074,1,'2021-07-13 00:22:47','2021-07-12 21:22:47','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму організму подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>необхідно виспатися;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та призвести до подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода і солодкі газовані напої містять електроліти в дуже низьких концентраціях, тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу в організмі. Високий ступінь мінералізації води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які здебільшого минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак, якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку води перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема банани й авокадо містять калій, горіхи – магній, квашені продукти – натрій.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-13 00:22:47','2021-07-12 21:22:47','',595,'https://reo.ua/?p=1074',0,'revision','',0),(1075,1,'2021-07-13 00:27:23','2021-07-12 21:27:23','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему организму преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>необходимо выспаться;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и вызвать раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода и сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Высокая степень минерализации воды РеО позволяет восполнить утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько способов избежать развития похмельного синдрома или облегчить его.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте еду, богатую на углеводы. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, бананы и авокадо содержат много калия, орехи – магния, квашенные продукты – натрия.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-13 00:27:23','2021-07-12 21:27:23','',601,'https://reo.ua/?p=1075',0,'revision','',0),(1076,1,'2021-07-13 00:32:38','2021-07-12 21:32:38','Блювання є симптомом багатьох хвороб і станів, спричинених внутрішніми (хвороби травної системи, вагітність, пухлини головного мозку) та зовнішніми (отруєння) факторами.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\"><img class=\"aligncenter wp-image-717 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg\" alt=\"\" width=\"1148\" height=\"442\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Поширені причини блювання</strong></p>\r\n&nbsp;\r\n\r\nБлювання – захисний механізм, який перешкоджає всмоктуванню токсичних або шкідливих речовин шляхом швидкого викидання їх зі шлунка. Проте під час блювання втрачається велика кількість рідини та солей, що може спричинити зневоднення і появу неприємних симптомів: головного болю, запаморочення, втомлюваності, сильної спраги. Ознакою дегідратації є також потемніння сечі.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg\"><img class=\"aligncenter wp-image-721\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЗверніться до лікаря, якщо:\r\n<ul>\r\n 	<li>нудота та блювання супроводжуються сильним головним болем, гарячкою, порушенням зору, розладами свідомості;</li>\r\n 	<li>блювання триває &gt;2 днів для дорослих і дітей віком понад 2 роки, ≥24 години для дітей до 2 років і ≥12 годин для дітей до 1 року;</li>\r\n 	<li>періодичні напади нудоти та блювання турбують упродовж 1 місяця або більше;</li>\r\n 	<li>нудота та блювання супроводжуються непояснюваним схудненням;</li>\r\n 	<li>блювотні маси виглядають як «кавова гуща», містять кров або мають зелений колір.</li>\r\n</ul>\r\n<h2><strong>Що робити під час блювання?</strong></h2>\r\nНамагайтеся більше пити, але маленькими порціями – це дасть змогу запобігти спричиненому блюванням зневодненню.\r\n\r\nДайте організму можливість відпочити. Надмірна активність може посилити нудоту.\r\n\r\nУникайте сильних запахів та інших можливих подразників: диму, надмірного перегрівання та вологості, поїздок в автотранспорті, перебування в задушливих приміщеннях.\r\n\r\nУникайте твердої їжі впродовж 6 годин після останнього епізоду блювання. При відновленні харчування споживайте просту їжу, яка легко перетравлюється: тости, крекери, злакові пластівці, рис, фрукти.\r\n\r\nЇжте маленькими порціями. Після приймання їжі не лягайте. Відпочиньте в такому положенні, щоб голова була вище ніг (сидячи, напівлежачи).\r\n<h2>Скільки потрібно пити?</h2>\r\nПийте кілька ковтків рідини аби розсмоктуйте лід кожні 15 хвилин протягом 6-8 годин після останнього епізоду блювання. Об’єм випитої рідини має не лише забезпечити нормальну добову потребу (наведена в таблиці), а й компенсувати втрати води з блювотними масами.\r\n\r\n<strong>Табл. Потреба дітей і дорослих різного віку у воді</strong>\r\n\r\n&nbsp;\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Вік</strong></th>\r\n<th><strong>Стать</strong></th>\r\n<th><strong>Кількість склянок води на день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 років</td>\r\n<td>Дівчата та хлопці</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 років</td>\r\n<td>Дівчата</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 років</td>\r\n<td>Дівчата</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Хлопці</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 років</td>\r\n<td>Жінки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Чоловіки</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примітка. Дані представлені відповідно до рекомендацій Інституту медицини США.</em>\r\n<h2>Що необхідно пити?</h2>\r\nПід час блювання втрачається велика кількість води та солей (електролітів), тому відновлення водно-сольового балансу є пріоритетним завданням. Доцільно вживати збалансовані розчини для регідратації, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії для організму. Вода РeО має високий ступінь мінералізації за рахунок вмісту іонів натрію, хлориду, калію, магнію, кальцію та гідрокарбонату. Приємний солонуватий смак дає змогу пити воду РеО навіть при нудоті.\r\n<h2>Як запобігти блюванню?</h2>\r\n<ul>\r\n 	<li>Присядьте чи ляжте. Глибоко дихайте.</li>\r\n 	<li>Уникайте фізичних навантажень, уживання алкоголю, кофеїновмісних напоїв, жирної та гострої їжі.</li>\r\n 	<li>Посмокчіть шматочок льоду чи випийте холодної води.</li>\r\n</ul>\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Блювання як причина зневоднення','','inherit','closed','closed','','586-revision-v1','','','2021-07-13 00:32:38','2021-07-12 21:32:38','',586,'https://reo.ua/?p=1076',0,'revision','',0),(1078,1,'2021-07-13 00:46:30','2021-07-12 21:46:30','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом піх пахви та на пахові ділянки;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-13 00:46:30','2021-07-12 21:46:30','',557,'https://reo.ua/?p=1078',0,'revision','',0),(1079,1,'2021-07-13 00:56:25','2021-07-12 21:56:25','<h2>Дегідратація як проблема геріатричних пацієнтів</h2>\r\nОсобами похилого віку вважаються люди віком понад 65 років. Так само поняття «геріатричний пацієнт» пов’язано передусім не з віком, а зі значною ослабленістю та множинними захворюваннями. Основна мета ведення геріатричних пацієнтів – покращення та підтримка їхнього функціонального стану з метою збереження здатності до самообслуговування та покращення якості життя [1].\r\n\r\nОднією з вагомих проблем у осіб похилого та старечого віку є дегідратація [1]. Для повноцінного функціонування лімфатичної, серцево-судинної, травної та сечової систем необхідна достатня кількість рідини, проте з віком відбувається зменшення загального вмісту води в організмі, що погіршує роботу перелічених систем [2]. Так, у молодої людини сумарний вміст води в організмі становить близько 60%, а у пацієнта віком 70 років – близько 40% [3].\r\n\r\n<img class=\"aligncenter size-full wp-image-511\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg\" alt=\"\" width=\"740\" height=\"385\" />\r\n<p style=\"text-align: center;\"><strong>Мал.</strong> <strong>1.</strong> <strong>Вікове зменшення вмісту води в організмі</strong></p>\r\nВсесвітня організація охорони здоров’я рекомендує жінкам похилого віку вживати 2,2 л рідини щодня, а чоловікам – 2,9 л. Натомість у реальному житті середньостатистична людина віком понад 70 років вживає менше 1,5 л [4]. Причинами недостатнього споживання води в цьому віці є фізичні обмеження, незадовільний доступ до питної води та труднощі у відвідуванні туалету, порушення мислення та психічного стану, приймання значної кількості медикаментів, які можуть порушувати водний баланс [2].\r\n<h2>Вікові особливості, клінічна картина й оцінка ризику дегідратації</h2>\r\n<strong>Пов’язані з віком особливості дегідратації:</strong>\r\n<ul>\r\n 	<li>менший резерв рідини у зв’язку з меншою часткою її в організмі;</li>\r\n 	<li>зменшення інтенсивності відчуття спраги;</li>\r\n 	<li>зниження співвідношення м’язової/жирової тканини (це важливо, оскільки в м’язах зберігається в 2-7 разів більше води, ніж у жировій тканині);</li>\r\n 	<li>труднощі у виявленні симптомів дегідратації (менша пружність шкіри та западання очей у зв’язку зі зменшенням вмісту колагену та підшкірного жиру, часте ротове дихання внаслідок хронічних хвороб легень і серця, що призводить до сухості слизової оболонки рота і утруднює своєчасну діагностику зневоднення);</li>\r\n 	<li>деменція;</li>\r\n 	<li>уживання діуретиків [2].</li>\r\n</ul>\r\n<img class=\"aligncenter size-full wp-image-513\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-24.jpg\" alt=\"\" width=\"615\" height=\"361\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Підвищений ризик дегідратації в осіб похилого віку [5]</strong></p>\r\nДегідратація небезпечна тим, що пов’язана з низкою потенційно тяжких патологічних станів.\r\n\r\n<strong>Розлади здоров’я, асоційовані з дегідратацією:</strong>\r\n<ul>\r\n 	<li>падіння та переломи;</li>\r\n 	<li>розлади свідомості та мислення;</li>\r\n 	<li>закрепи;</li>\r\n 	<li>інфекції сечовивідної системи;</li>\r\n 	<li>ниркова недостатність;</li>\r\n 	<li>інсульт;</li>\r\n 	<li>збільшення потенційної токсичності медикаментів;</li>\r\n 	<li>сповільнення загоєння ран;</li>\r\n 	<li>ортостатична гіпотензія (зниження артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>підвищення температури;</li>\r\n 	<li>погіршення контролю рівня глюкози при цукровому діабеті [6].</li>\r\n</ul>\r\nЗа даними різних досліджень, із ризиком дегідратації асоціюються різні чинники (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(початок)</em></th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Вік</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Закреп / нетримання сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пронос/блювання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Харчові обмеження</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Табл. 1. Оцінка ризику дегідратації в осіб похилого віку [7] <em>(продовження)</em></strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані анамнезу</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Утруднене ковтання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запаморочення</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Відчуття спраги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Поганий настрій</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Приймання певних ліків</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множинні супутні захворювання</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Обмежена рухомість / падіння / різка ослабленість</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Біль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нещодавнє стаціонарне лікування</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторні інфекції сечової системи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Розлади зору</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Дані огляду та спостереження</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Співвідношення вжитої та виділеної рідини за добу</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артеріальний тиск / пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сплутаність свідомості</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливість, летаргія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухість слизової оболонки ротової порожнини, очей і сухість шкіри</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гарячка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Збільшена частота дихання</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостатня вгодованість</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наявність відкритих ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пітливість</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Результати обстежень</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гіперглікемія</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темний колір сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Підвищена густина сечі</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Загалом усі фактори ризику дегідратації осіб похилого віку можна розподілити на 4 великі групи (мал. 3)</strong>\r\n\r\nНайважливіші клінічні ознаки дегідратації: зменшення потовиділення під пахвами, зниження пружності шкіри, сухість слизової оболонки рота, розлади свідомості, які виникли нещодавно, темний колір сечі [16]. Слід також звертати увагу на ознаки гіповолемічного шоку: холодну та липку шкіру, зменшення виділення сечі, сплощення шийних вен, розлади свідомості, низький серцевий викид.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr.png\"><img class=\"aligncenter size-large wp-image-951\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta__ukr-1024x394.png\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3.</strong> <strong>Фактори ризику дегідратації в осіб похилого віку</strong></p>\r\n\r\n<h2>Особливості регідратації в осіб похилого віку</h2>\r\nРегідратація в осіб похилого віку може бути утруднена когнітивними змінами пацієнта, його фізичними обмеженнями, а також нетриманням сечі та, як наслідок, небажанням уживати воду. Тактику регідратації слід обирати залежно від ступеня зневоднення. Так, при легкій дегідратації застосовується оральна регідратація, а при помірній – комбінація оральної та внутрішньовенної (за допомогою збалансованих розчинів кристалоїдів). У випадку тяжкої дегідратації, основними ознаками якої є гіпотензія і тахікардія, призначається внутрішньовенна регідратація, за можливості – у комбінації з оральною.\r\n\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Табл. 2. Розрахунок необхідної кількості рідини для корекції дегідратації</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Розрахунок</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Вага до дегідратації (кг) – вага наразі (кг) = дефіцит (л)</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика заміщення дефіциту</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Доба</td>\r\n<td width=\"197\">Частка заміщеного дефіциту (%)</td>\r\n<td width=\"180\">Базові щоденні потреби</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менш як 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Примітка. Добове споживання рідини має включати базові щоденні потреби + відповідну частку дефіциту.</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПацієнти похилого віку зазвичай характеризуються великою кількістю коморбідних захворювань та загальною ослабленістю. Тому цей контингент надає особливого значення безпечності тактики будь-якого лікування. Оральна регідратація дає можливість поступово поповнити дефіцит рідини та електролітів фізіологічним шляхом і має низку інших переваг.\r\n<h2>Профілактика</h2>\r\n<strong>Переваги оральної регідратації над внутрішньовенною [17]:</strong>\r\n<ul>\r\n 	<li>більш фізіологічна, ніж внутрішньовенна;</li>\r\n 	<li>висока ефективність;</li>\r\n 	<li>відмінний профіль безпеки (без ризику розвитку ускладнень, притаманних інфузіям);</li>\r\n 	<li>низька вартість.</li>\r\n</ul>\r\n<strong>Рекомендації з профілактики дегідратації в осіб похилого віку [16]:</strong>\r\n<ul>\r\n 	<li>застосовуйте яскраві чашки;</li>\r\n 	<li>застосовуйте кулери та балони з водою;</li>\r\n 	<li>пропонуйте воду раз у 1,5 години та після певних дій (приймання душу, відвідування туалету, приймання ліків);</li>\r\n 	<li>заохочуйте запивання їжі та вживання рідких страв (суп, желе, йогурт, пюре з фруктів, морозиво);</li>\r\n 	<li>ведіть журнал обліку пиття та сечовиділення;</li>\r\n 	<li>якщо спостерігається дегідратація із втратою &gt;4% маси тіла впродовж 7 днів, доцільно на 3 дні призначити активну оральну регідратацію;</li>\r\n 	<li>у разі тяжкої дегідратації необхідні госпіталізація та внутрішньовенна регідратація.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Табл. 3. Потреба в рідині залежно від маси тіла [16]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вага (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Потреба</strong> <strong>в</strong> <strong>рідині</strong> <strong>(л/добу)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png\"><img class=\"aligncenter size-large wp-image-1046\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1-1024x360.png\" alt=\"\" width=\"1024\" height=\"360\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Поради щодо збільшення споживання води</strong></p>\r\n\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [18].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація в осіб похилого та старечого віку','','inherit','closed','closed','','506-revision-v1','','','2021-07-13 00:56:25','2021-07-12 21:56:25','',506,'https://reo.ua/?p=1079',0,'revision','',0),(1080,1,'2021-07-13 01:04:25','2021-07-12 22:04:25','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>используйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-13 01:04:25','2021-07-12 22:04:25','',577,'https://reo.ua/?p=1080',0,'revision','',0),(1081,1,'2021-07-13 01:26:53','2021-07-12 22:26:53','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>розсмоктуйте заморожений сік або інші напої;</li>\r\n 	<li>розсмоктуйте шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter size-large wp-image-1054\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2-536x1024.png\" alt=\"\" width=\"536\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png\"><img class=\"aligncenter size-large wp-image-985\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-621x1024.png\" alt=\"\" width=\"621\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку води (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-13 01:26:53','2021-07-12 22:26:53','',489,'https://reo.ua/?p=1081',0,'revision','',0),(1083,1,'2021-07-13 01:39:22','2021-07-12 22:39:22','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-13 01:39:22','2021-07-12 22:39:22','',571,'https://reo.ua/?p=1083',0,'revision','',0),(1084,1,'2021-07-13 09:56:20','2021-07-13 06:56:20','Токсикоз беременных – это комплекс патологических изменений в организме беременной, которые обычно появляются на 13–16 неделе. Более типичными являются ранние токсикозы, которые наблюдаются в первом триместре беременности, однако могут развиваться и поздние токсикозы на 34-40-й неделе. Одно из наиболее распространенных проявлений токсикоза – тошнота и/или рвота, от которых страдают 8 из 10 беременных. В большинстве случаев ранние токсикозы прекращаются до 16-20-й недели, хотя у некоторых женщин могут продолжаться и дольше.\r\n\r\nВ медицине выделяют такое отдельное болезненное состояние, как чрезмерная рвота беременных, которое включает не только очень сильные тошноту и рвоту (&gt;4 раз в день), но и падение артериального давления при переходе в вертикальное положение, а также обезвоживание вследствие потери жидкости с рвотными массами. Симптомами обезвоживания являются жажда и сухость во рту, ощущение усталости или сонливости, головокружение, судороги в мышцах, уменьшение количества мочи и изменение ее характеристик (темный цвет, сильный запах). Причина чрезмерной рвоты у беременных точно не установлена, однако если такое состояние наблюдалось при предыдущей беременности или у близких родственниц (мать, сестра), то его вероятность возрастает. Риск тошноты и рвоты также считается более высоким у молодых женщин, у женщин с ожирением, при первой или многоплодной беременности.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Гидратация у беременных</strong></p>\r\n&nbsp;\r\n<h2>Чем опасно обезвоживание у беременных?</h2>\r\nДостаточное количество воды необходимо для правильного формирования плаценты, околоплодных оболочек и околоплодных вод. Дегидратация во втором и третьем триместрах беременности может вызвать преждевременные роды вследствие повышения уровня окситоцина, который вызывает сокращение матки.\r\n\r\nКроме того, при снижении артериального давления на фоне чрезмерной рвоты возможно внезапное падение с вероятностью травм женщины и плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Водный баланс небеременных и беременных женщин, а также женщин, кормящих грудью</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при обезвоживании беременной следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>При изменении обычных движений плода.</li>\r\n 	<li>При начале кровотечения или подтекания околоплодных вод.</li>\r\n 	<li>При рвоте или диарее продолжительностью &gt;12 часов.</li>\r\n 	<li>При очень маленьком или отсутствующем диурезе.</li>\r\n 	<li>При потере сознания, приступах судорог, спутанности сознания.</li>\r\n 	<li>При появлении сокращений матки, которые могут свидетельствовать о начале преждевременных родов.</li>\r\n</ul>\r\n<h2>Сколько необходимо пить?</h2>\r\nСогласно рекомендациям Американской коллегии акушеров и гинекологов, чтобы предотвратить обезвоживание, следует пить 8-12 стаканов (1,9-3,0 л) воды в день. Стоит избегать кофеиносодержащих напитков (кофе, энерготоники) и сладких газированных напитков.\r\n\r\nРекомендованное разными профессиональными организациями количество жидкости для взрослых женщин, беременных и женщин, кормящих грудью, представлено в таблице.\r\n\r\n<strong>Табл. 1. Суточная потребность в жидкости для разных групп женщин</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Группа женщин</strong></th>\r\n<th width=\"50%\"><strong>ВОЗ, 2003</strong></th>\r\n<th width=\"50%\"><strong>США и Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Взрослые женщины</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Беременные</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Женщины, кормящие грудью</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Что необходимо пить?</h2>\r\nПри дегидратации теряется не только вода, но и необходимые организму соли, поэтому, устраняя обезвоживание, следует пополнять и запас солей. Кроме того, обычная вода недолго задерживается в организме, поскольку поступление жидкости одновременно активирует процессы ее выведения с мочой. При этом соли удерживают жидкость в организме, позволяя полноценно наводнять все клетки и ткани. Поэтому при рвоте беременных следует отдавать предпочтение сбалансированным растворам, которые содержат соли (электролиты), то есть натрий, калий, магний и др.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО представляет собой готовый раствор для оральной регидратации. Важно, что вода РеО содержит все необходимые электролиты (натрий, калий, магний, кальций), а также сорбитол – дополнительный источник энергии, который усваивается клетками организма без участия инсулина. Вода РeО не содержит консервантов и красителей, а дополнительным ее преимуществом является приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для беременных:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\r\n<ul>\r\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\r\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\r\n 	<li>обращать внимание на ощущение жажды;</li>\r\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\r\n 	<li>всегда носить с собой бутылку воды.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: как вернуться к обычному течению беременности?','','inherit','closed','closed','','473-revision-v1','','','2021-07-13 09:56:20','2021-07-13 06:56:20','',473,'https://reo.ua/?p=1084',0,'revision','',0),(1085,1,'2021-07-13 10:11:37','2021-07-13 07:11:37','Токсикоз вагітних – це комплекс патологічних змін в організмі вагітної, що зазвичай з’являються на 13–16 тижні вагітності. Типовішими є ранні токсикози, що спостерігаються в першому триместрі вагітності, проте можуть розвиватися й пізні токсикози на 34-40-й тижні. Один із найпоширеніших проявів токсикозу – нудота та/або блювання, від яких страждають 8 із 10 вагітних. Здебільшого ранні токсикози припиняються до 16-20-го тижня вагітності, проте у деяких вагітних можуть тривати довше.\r\n\r\nУ медицині виокремлюють такий хворобливий стан, як надмірне блювання вагітних, що охоплює не тільки надзвичайно сильну нудоту та блювання (&gt;4 разів на день), а й падіння артеріального тиску під час переходу у вертикальне положення та зневоднення внаслідок втрати рідини з блювотними масами. Симптомами зневоднення є спрага та сухість у роті, відчуття втоми чи сонливості, запаморочення, судоми в м’язах, зменшення кількості сечі та зміни її характеристик (темний колір, сильний запах).\r\n\r\nПричину надмірного блювання вагітних точно не встановлено, але якщо такий стан спостерігався під час попередньої вагітності чи у близьких родичок (мати, сестра), то його ймовірність зростає. Ризик нудоти та блювання також є вищим у молодих жінок, у жінок з ожирінням, при першій або багатоплідній вагітності.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\"><img class=\"aligncenter wp-image-665 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg\" alt=\"\" width=\"1054\" height=\"628\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Гідратація у вагітних</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечне зневоднення у вагітних?</h2>\r\nДостатня кількість води необхідна для правильного формування плаценти, навколоплідних оболонок і навколоплідних вод. Дегідратація у другому та третьому триместрах вагітності може спричинити передчасні пологи внаслідок підвищення рівня окситоцину, який зумовлює скорочення матки.\r\n\r\nКрім того, при зниженні артеріального тиску на тлі надмірного блювання можливе раптове падіння з імовірністю травм жінки та плода.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\"><img class=\"aligncenter wp-image-669\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\"><img class=\"aligncenter wp-image-674\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Водний баланс невагітних і вагітних жінок, а також жінок, які годують грудьми</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках у разі зневоднення вагітній варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>При зміні звичних рухів плода.</li>\r\n 	<li>При початку кровотечі чи підтікання навколоплідних вод.</li>\r\n 	<li>При блюванні чи проносі тривалістю &gt;12 годин.</li>\r\n 	<li>При дуже малому чи відсутньому сечовиділенні.</li>\r\n 	<li>При зомлінні, нападі судом, сплутаності свідомості.</li>\r\n 	<li>У разі появи скорочень матки, які можуть свідчити про початок передчасних пологів.</li>\r\n</ul>\r\n<h2>Скільки необхідно пити?</h2>\r\nЗа рекомендаціями Американської колегії акушерів і гінекологів, щоб запобігти зневодненню, потрібно пити 8-12 склянок (1,9-3,0 л) води на день. Слід уникати кофеїновмісних напоїв (кава, енерготоніки) та солодких газованих напоїв.\r\n\r\nРекомендована різними фаховими організаціями кількість рідини для дорослих жінок, вагітних і жінок, які годують грудьми, представлена в таблиці.\r\n\r\n<strong>Табл. 1. Добова потреба в рідині для різних груп жінок</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"25%\"><strong>Група жінок</strong></th>\r\n<th width=\"25%\"><strong>ВООЗ, 2003</strong></th>\r\n<th width=\"25%\"><strong>США та Канада, 2004</strong></th>\r\n<th width=\"25%\"><strong>Європа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Дорослі жінки</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Вагітні</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Жінки, що годують грудьми</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Що необхідно пити?</h2>\r\nПри дегідратації втрачається не лише вода, а й необхідні організму солі, тому, усуваючи зневоднення, слід поповнювати й запас солей. Окрім того, звичайна вода недовго затримується в організмі, оскільки надходження рідини одночасно активує процеси її виведення із сечею. Натомість солі утримують рідину в організмі, даючи змогу повноцінно наводнити всі клітини та тканини. З цієї причини при блюванні вагітних варто віддавати перевагу збалансованим розчинам, які містять солі (електроліти), тобто натрій, калій, магній тощо.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО – це готовий до вживання розчин для оральної регідратації. Важливо, що вода РеО містить усі необхідні електроліти (натрій, калій, магній, кальцій), а також сорбітол – додаткове джерело енергії, що засвоюється клітинами організму без участі інсуліну. Вода РeО не містить жодних консервантів і барвників, а додаткова перевага – її приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. 2. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для вагітних:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню у вагітних?</h2>\r\n<ul>\r\n 	<li>пити більше рідини – 8-12 склянок (1,9-3,0 л) на день;</li>\r\n 	<li>їсти рідку їжу (супи, фрукти, овочі);</li>\r\n 	<li>звертати увагу на відчуття спраги;</li>\r\n 	<li>уникати спортивних занять на вулиці та прогулянок у спекотний час;</li>\r\n 	<li>завжди носити із собою пляшку води.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Американської колегії акушерів і гінекологів. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз: як повернутися до звичайного перебігу вагітності?','','inherit','closed','closed','','465-revision-v1','','','2021-07-13 10:11:37','2021-07-13 07:11:37','',465,'https://reo.ua/?p=1085',0,'revision','',0),(1109,1,'2021-07-13 17:07:14','2021-07-13 14:07:14','У людини температура підтримується на постійному рівні (температурний баланс), й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\"><img class=\"aligncenter size-full wp-image-1090\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\" alt=\"\" width=\"1007\" height=\"560\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-13 17:07:14','2021-07-13 14:07:14','',422,'https://reo.ua/?p=1109',0,'revision','',0),(1086,1,'2021-07-13 10:50:38','2021-07-13 07:50:38','У людини температура підтримується на постійному рівні, та званний - температурний баланс, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1.png\"><img class=\"aligncenter size-large wp-image-1010\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-13 10:50:38','2021-07-13 07:50:38','',422,'https://reo.ua/?p=1086',0,'revision','',0),(1087,1,'2021-07-13 13:17:59','2021-07-13 10:17:59','','Web_REO_T9 Регідрадація у дорослих_3 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3-1','','','2021-07-13 13:17:59','2021-07-13 10:17:59','',489,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png',0,'attachment','image/png',0),(1088,1,'2021-07-13 13:17:59','2021-07-13 10:17:59','','Web_REO_T9 Регідрадація у дорослих_3 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3-1-2','','','2021-07-13 13:17:59','2021-07-13 10:17:59','',582,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png',0,'attachment','image/png',0),(1094,1,'2021-07-13 15:42:15','2021-07-13 12:42:15','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>розсмоктуйте заморожений сік або інші напої;</li>\r\n 	<li>розсмоктуйте шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter wp-image-1054 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\" alt=\"\" width=\"1170\" height=\"2234\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png\"><img class=\"aligncenter size-large wp-image-1087\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1-726x1024.png\" alt=\"\" width=\"726\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку води (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-13 15:42:15','2021-07-13 12:42:15','',489,'https://reo.ua/?p=1094',0,'revision','',0),(1089,1,'2021-07-13 13:18:18','2021-07-13 10:18:18','<h2>Дегідратація: визначення та типи</h2>\r\nДегідратація – це патологічний стан, коли організм втрачає більше води, ніж отримує. За умови доступу до питної води у здорових дорослих дегідратація спостерігається рідко, проте вона може виникнути у будь-якої людини як ускладнення різноманітних захворювань і станів, зокрема гіперглікемії [1]. Вода може втрачатися через шкіру, легені, нирки та травну систему [2].\r\n<h2>При дегідратації організм втрачає не тільки воду, а й електроліти, передусім натрій.</h2>\r\n<strong>Залежно</strong> <strong>від</strong> <strong>співвідношення</strong> <strong>втрат</strong> <strong>рідини</strong> <strong>та</strong> <strong>натрію</strong> <strong>виділяють</strong> <strong>три</strong> <strong>форми</strong> <strong>дегідратації:</strong>\r\n<ul>\r\n 	<li>ізотонічна (втрата рідини = втрата натрію);</li>\r\n 	<li>гіпертонічна (втрата рідини &gt; втрата натрію);</li>\r\n 	<li>гіпотонічна (втрати рідини &lt; втрата натрію) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Табл. 1. Причини основних видів дегідратації [1]</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Ізотонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпертонічна дегідратація</strong></th>\r\n<th width=\"113\"><strong>Гіпотонічна дегідратація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Блювання\r\n\r\n• Пронос\r\n\r\n• Пітливість\r\n\r\n• Опіки\r\n\r\n• Хвороби нирок\r\n\r\n• Гіперглікемія\r\n\r\n•Гіпоальдостеронізм</td>\r\n<td width=\"113\">• Гарячка\r\n\r\n• Часте дихання\r\n\r\n• Нецукровий діабет</td>\r\n<td width=\"113\">• Вживання діуретиків</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Також дегідратацію можна класифікувати залежно від особливостей причинного фактора:</h2>\r\n<ul>\r\n 	<li>надмірні втрати рідини через травний тракт: блювання, пронос, вживання проносних засобів, промивання шлунка, наявність нориць;</li>\r\n 	<li>надмірні втрати рідини через шкіру: сильне потовиділення, фізичні навантаження, опіки, тяжкі дерматологічні захворювання;</li>\r\n 	<li>надмірні втрати рідини із сечею: вживання сечогінних препаратів, гострі та хронічні ниркові захворювання, посилене сечовиділення після усунутої обструкції сечовидільних шляхів, Аддісонова хвороба, гіпоальдостеронізм, гіперглікемія;</li>\r\n 	<li>внутрішньочеревні втрати рідини: панкреатит, асцит, перитоніт;</li>\r\n 	<li>неможливість поповнити запаси рідини: порушення мислення та психічного стану, іммобілізація, розлади формування відчуття спраги, передозування ліками із розвитком коми;</li>\r\n 	<li>інше: сепсис, гіпертиреоз, бронхіальна астма, хронічне обструктивне захворювання легень, вживання наркотиків [1].</li>\r\n</ul>\r\n<h2>Клінічна картина</h2>\r\n<strong>Незначній та помірній дегідратації властиві такі ознаки:</strong>\r\n<ul>\r\n 	<li>спрага;</li>\r\n 	<li>сухість у роті;</li>\r\n 	<li>втома, сонливість;</li>\r\n 	<li>зменшення кількості сечовипускань та об’єму сечі;</li>\r\n 	<li>темний колір сечі;</li>\r\n 	<li>головний біль;</li>\r\n 	<li>сухість шкіри;</li>\r\n 	<li>запаморочення;</li>\r\n 	<li>відсутність слізної рідини.</li>\r\n</ul>\r\n<strong>Для тяжкої дегідратації притаманним є:</strong>\r\n<ul>\r\n 	<li>різке зменшення кількості сечовипускань або повне їх припинення;</li>\r\n 	<li>запаморочення, що перешкоджає пересуванню;</li>\r\n 	<li>ортостатична гіпотензія (падіння артеріального тиску на &gt;20 мм рт. ст. під час переходу з горизонтального положення у вертикальне);</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>гарячка;</li>\r\n 	<li>зниження еластичності шкіри;</li>\r\n 	<li>летаргія, сонливість;</li>\r\n 	<li>сплутаність свідомості;</li>\r\n 	<li>кома;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХоча на перший погляд зневоднення видається не дуже небезпечним станом, його ускладнення можуть бути тяжкими й навіть загрожувати життю.\r\n\r\n<strong>Ускладнення дегідратації охоплюють:</strong>\r\n<ul>\r\n 	<li>зміни психічного стану;</li>\r\n 	<li>ниркову недостатність;</li>\r\n 	<li>розвиток \"шокової печінки\" та \"шокової нирки\" – некрозу цих органів унаслідок гіпоперфузії;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гіпотензію;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Червоними прапорцями, які свідчать про тяжку небезпечну дегідратацію, є:</strong>\r\n<ul>\r\n 	<li>дезорієнтація, сплутаність свідомості;</li>\r\n 	<li>сильне запаморочення;</li>\r\n 	<li>відсутність сечовипускання впродовж доби;</li>\r\n 	<li>тахікардія;</li>\r\n 	<li>судомні напади [4].</li>\r\n</ul>\r\n<h2>Діагностика</h2>\r\nЗолотого стандарту діагностики дегідратації немає, тому найчастіше діагноз встановлюють з огляду на клінічну картину. Нерідко використовується визначення осмолярності сечі та плазми крові, проте на цей показник значно впливають причина зневоднення та гострота перебігу процесу. Нормальні значення осмолярності плазми крові становлять 280-300 мОсм/л, а сечі – 600-1200 мОсм/л. При перевищенні цих показників можна запідозрити зневоднення.\r\n\r\nСлід пам’ятати, що зменшення об’єму сечі та висока її осмолярність можуть бути не лише при дегідратації, а й при серцевій недостатності, цирозі печінки, нефротичному синдромі та хронічних ниркових захворюваннях.\r\n\r\nІншими ознаками дегідратації є зниження маси тіла на ≥3% протягом 7 днів та зростання співвідношення азоту сечовини до креатиніну вище 10 [1].\r\n\r\nІнструментальним методом, який дає змогу встановити дегідратацію, є ультразвукове визначення здатності нижньої порожнистої вени до спадіння. Зміна діаметра вени при диханні &gt;50% свідчить про спадіння та зменшення внутрішньосудинного об’єму рідини [5]. На результат цього дослідження можуть впливати цироз печінки, хронічні серцево-судинні захворювання, штучна вентиляція легень [6].\r\n\r\nЩо стосується диференційної діагностики, то головним завданням є розрізнення втрати рідини та втрати крові. Це важливо, оскільки тактика інфузійної терапії й оптимальні препарати в цих випадках будуть різними [1].\r\n<h2>Лікування</h2>\r\nЛікування дегідратації спрямоване на заміщення втраченої рідини паралельно з виявленням причини її втрати. При легкій дегідратації з нормальними показниками артеріального тиску та частоти серцевих скорочень застосовується оральна регідратація, а при тяжкій дегідратації, яка супроводжується гіпотензією й тахікардією, – внутрішньовенна (збалансовані розчини кристалоїдів, Рінгер-лактатний розчин, 0,9% розчин натрію хлориду) [7]. Якщо пацієнт здатен пити, застосовується комбінована регідратація: поєднання внутрішньовенної та оральної. Слід зауважити, що надмірна регідратація (переважно внутрішньовенна) може спричиняти периферичні набряки та набряк легень [1].\r\n<h2>Рекомендації для пацієнтів із дегідратацією:</h2>\r\n<ul>\r\n 	<li>пийте воду маленькими ковтками;</li>\r\n 	<li>пийте напої, що містять електроліти (солі). Можна пити спеціальні спортивні напої чи розчини для корекції зневоднення;</li>\r\n 	<li>розсмоктуйте заморожений сік або інші напої;</li>\r\n 	<li>розсмоктуйте шматочки льоду;</li>\r\n 	<li>якщо дегідратація виникла через біль у роті при питті та прийманні їжі, пийте через соломинку.</li>\r\n</ul>\r\nДорослим рекомендовано вживати 2-3 л рідини на добу [9]. Слід заохочувати пацієнтів поповнювати запаси рідини відповідно до кількості фізичних навантажень.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png\"><img class=\"aligncenter size-large wp-image-1054\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2-536x1024.png\" alt=\"\" width=\"536\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Алгоритм регідратації у дорослих [8]</strong></p>\r\n<em>Примітка. Цей алгоритм призначений для застосування при дегідратації, спричиненій блюванням та/або діареєю, й може застосовуватися при незначній/помірній нудоті та блюванні вагітних. Не застосовуйте його в разі тяжкої дегідратації чи надмірного блювання вагітних.</em>\r\n<h2>Профілактика</h2>\r\n<strong>Рекомендації щодо профілактики дегідратації:</strong>\r\n<ul>\r\n 	<li>плануйте свій питний режим заздалегідь. Якщо ваш режим дня (робота чи відпочинок) передбачає підвищене потовиділення, фізичну активність або тепловий вплив, беріть із собою напої, що містять воду й електроліти (солі);</li>\r\n 	<li>уникайте фізичних навантажень і знаходження на вулиці в спекотні дні, особливо за високої вологості. Якщо це необхідно, плануйте вихід на вулицю рано-вранці та після заходу сонця;</li>\r\n 	<li>заохочуйте до пиття дітей та осіб похилого віку, що вас оточують. Перевагу варто віддавати напоям, які містять солі;</li>\r\n 	<li>уникайте споживання алкоголю, особливо в спекотні дні, оскільки алкоголь посилює втрати рідини та порушує здатність людини відчувати ранні ознаки дегідратації;</li>\r\n 	<li>віддавайте перевагу світлому та вільному одягу;</li>\r\n 	<li>користуйтеся особистим віялом або спреєм із водою;</li>\r\n 	<li>під час перебування на вулиці намагайтеся бути в тіні.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png\"><img class=\"aligncenter size-large wp-image-1087\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1-726x1024.png\" alt=\"\" width=\"726\" height=\"1024\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Поради щодо належної гідратації [10]</strong></p>\r\n<strong>Рекомендації щодо вживання рідини під час спортивних навантажень на вулиці в спекотну погоду [3]:</strong>\r\n<ul>\r\n 	<li>випийте 2 чашки води впродовж 2 годин до початку навантаження та 1-2 чашки води за 15 хвилин до початку навантаження;</li>\r\n 	<li>випивайте 0,5-1 чашку води (250 мл) кожні 15-20 хвилин навантаження (якщо п’єте з пляшки, робіть 4-8 середніх ковтків).</li>\r\n</ul>\r\n<h2>Вода для медичних цілей РеО («Юрія-Фарм»)</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол. Він є додатковим джерелом енергії, що засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників та має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників та вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>нормалізує діурез, знижує інтоксикацію [11].</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol class=\"post-sources\">\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральна регідратація у дорослих','','inherit','closed','closed','','489-revision-v1','','','2021-07-13 13:18:18','2021-07-13 10:18:18','',489,'https://reo.ua/?p=1089',0,'revision','',0),(1090,1,'2021-07-13 13:19:04','2021-07-13 10:19:04','','Web_REO_T5 при повышении температуры тела_1 (1)','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_1-1','','','2021-07-13 13:19:04','2021-07-13 10:19:04','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png',0,'attachment','image/png',0),(1091,1,'2021-07-13 13:19:04','2021-07-13 10:19:04','','Web_REO_T5 при повышении температуры тела_1 (1)','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_1-1-2','','','2021-07-13 13:19:04','2021-07-13 10:19:04','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png',0,'attachment','image/png',0),(1092,1,'2021-07-13 13:19:18','2021-07-13 10:19:18','У людини температура підтримується на постійному рівні, та званний - температурний баланс, й будь-яке зниження чи підвищення температури тіла може бути свідченням хвороби.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua.jpg\"><img class=\"aligncenter wp-image-640\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ua-1024x700.jpg\" alt=\"\" width=\"924\" height=\"632\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Підтримка температурного балансу в людини</strong></p>\r\n&nbsp;\r\n\r\nПідвищення температури (гарячка, лихоманка) може бути наслідком низки інфекційних і неінфекційних причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\"><img class=\"aligncenter size-full wp-image-1090\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png\" alt=\"\" width=\"1007\" height=\"560\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Причини лихоманки</strong></p>\r\n&nbsp;\r\n\r\nПідвищенням температури вважається перевищення показника в 37 °С, небезпечним підвищенням – у 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3.png\"><img class=\"aligncenter size-large wp-image-1012\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_3-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ступені підвищення температури</strong></p>\r\n&nbsp;\r\n\r\nВисоку температуру нерідко супроводжують біль у м’язах і суглобах, сильне потовиділення, пришвидшене серцебиття тощо.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5.png\"><img class=\"aligncenter size-large wp-image-1014\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_5-1024x907.png\" alt=\"\" width=\"1024\" height=\"907\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 4. Симптоми, що асоціюються з гарячкою</strong></p>\r\n&nbsp;\r\n<h2>В яких випадках при підвищенні температури варто звернутися до лікаря?</h2>\r\n<ul>\r\n 	<li>Висип, який посилюється.</li>\r\n 	<li>Запаморочення.</li>\r\n 	<li>Блювання.</li>\r\n 	<li>Задишка.</li>\r\n 	<li>Біль під час сечовипускання.</li>\r\n 	<li>Біль у животі.</li>\r\n 	<li>Неможливість притиснути підборіддя до грудей.</li>\r\n 	<li>Сильний головний біль.</li>\r\n 	<li>Напади судом.</li>\r\n</ul>\r\n<h2>Який зв’язок між водою та високою температурою?</h2>\r\nВода має великий показник теплоємності, завдяки чому сприяє підтримці стабільної температури тіла в холодному чи спекотному середовищі. Випаровування води з потом дає тілу змогу втрачати значну кількість тепла.\r\n\r\nПри підвищеній температурі тіла виділяється піт, а також зростає частота дихання, внаслідок чого непомітно втрачається велика кількість рідини, тому доцільно компенсувати цю втрату ще до розвитку зневоднення.\r\n<h2>Що робити при підвищенні температури тіла?</h2>\r\nТемпература є захисним механізмом організму, що пригнічує розмноження вірусів і бактерій. Тому температуру меншу за 38,5 °С знижувати не варто. Дієвим немедикаментозним методом зниження температури є застосування холодних компресів. Також необхідна належна гідратація, оскільки при зневодненні ймовірність швидкого зниження температури менша.\r\n\r\nЯкщо вплинути на причину значного підвищення температури тіла неможливо, можна зменшити неприємні симптоми (біль у голові та м’язах) за допомогою ліків. Із цією метою зазвичай використовують ібупрофен і парацетамол.\r\n<h2>Скільки необхідно пити?</h2>\r\nЩо вища температура, то більшою є втрата рідини. Оскільки зневоднення може посилити неприємні й небезпечні симптоми підвищення температури (наприклад, збільшення частоти серцебиття), потрібно вчасно компенсувати втрату рідини. Крім того, рясне пиття збільшує сечовиділення та виведення нирками токсинів і продуктів розпаду клітин. Тому за наявності підвищення температури слід пити не менш як 10 склянок води на день.\r\n<h2>Що необхідно пити?</h2>\r\nПри підвищеній температурі з потом втрачається не лише вода, а й солі. Тому доцільно компенсувати втрату рідини спеціальними напоями, які містять електроліти: натрій, калій, магній, кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації зі всіма необхідними електролітами. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>1. Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Що потрібно та не потрібно робити при підвищенні температури тіла?','','inherit','closed','closed','','422-revision-v1','','','2021-07-13 13:19:18','2021-07-13 10:19:18','',422,'https://reo.ua/?p=1092',0,'revision','',0),(1093,1,'2021-07-13 15:37:42','2021-07-13 12:37:42','У человека температура тела поддерживается на постоянном уровне (температурный баланс), и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2.png\"><img class=\"aligncenter size-large wp-image-1017\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, повышенное потоотделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-13 15:37:42','2021-07-13 12:37:42','',432,'https://reo.ua/?p=1093',0,'revision','',0),(1096,1,'2021-07-13 15:44:53','2021-07-13 12:44:53','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанавливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-13 15:44:53','2021-07-13 12:44:53','',419,'https://reo.ua/?p=1096',0,'revision','',0),(1097,1,'2021-07-13 15:53:07','2021-07-13 12:53:07','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при інтенсивному диханні ротом. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце. Втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має високий ступінь мінералізації та містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-13 15:53:07','2021-07-13 12:53:07','',411,'https://reo.ua/?p=1097',0,'revision','',0),(1098,1,'2021-07-13 16:19:18','2021-07-13 13:19:18','','Web_REO_T5 при повышении температуры тела_2 (1)','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_2-1','','','2021-07-13 16:19:18','2021-07-13 13:19:18','',432,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png',0,'attachment','image/png',0),(1099,1,'2021-07-13 16:19:18','2021-07-13 13:19:18','','Web_REO_T5 при повышении температуры тела_2 (1)','','inherit','open','closed','','web_reo_t5-pri-povyshenii-temperatury-tela_2-1-2','','','2021-07-13 16:19:18','2021-07-13 13:19:18','',422,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png',0,'attachment','image/png',0),(1100,1,'2021-07-13 16:19:31','2021-07-13 13:19:31','У человека температура тела поддерживается на постоянном уровне (температурный баланс), и любое снижение или повышение температуры тела может быть свидетельством заболевания.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Поддержка температурного баланса у человека</strong></p>\r\n&nbsp;\r\n\r\nПовышение температуры (лихорадка) может быть следствием целого ряда инфекционных и неинфекционных причин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png\"><img class=\"aligncenter size-large wp-image-1098\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1-1024x557.png\" alt=\"\" width=\"1024\" height=\"557\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Причины лихорадки</strong></p>\r\n&nbsp;\r\n\r\nПовышением температуры считается превышение показателя в 37 °С, опасным повышением – в 39,5 °С.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Степени повышения температуры</strong></p>\r\n&nbsp;\r\n\r\nВысокую температуру нередко сопровождают боль в мышцах и суставах, повышенное потоотделение, учащение сердцебиения и т. д.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Симптомы, ассоциирующиеся с лихорадкой</strong></p>\r\n&nbsp;\r\n<h2>В каких случаях при повышении температуры следует обратиться к врачу?</h2>\r\n<ul>\r\n 	<li>Сыпь, которая усиливается</li>\r\n 	<li>Головокружение</li>\r\n 	<li>Рвота</li>\r\n 	<li>Одышка</li>\r\n 	<li>Боль при мочеиспускании</li>\r\n 	<li>Боль в животе</li>\r\n 	<li>Невозможность прижать подбородок к груди</li>\r\n 	<li>Сильная головная боль</li>\r\n 	<li>Приступы судорог</li>\r\n</ul>\r\n<h2>Какая связь между водой и высокой температурой?</h2>\r\nВода имеет большой показатель теплоемкости, что способствует поддержанию стабильной температуры тела в холодной или жаркой окружающей среде. Испарение воды с потом позволяет телу терять значительное количество тепла.\r\n\r\nПри повышенной температуре тела выделяется пот, а также увеличивается частота дыхания, вследствие чего незаметно теряется большое количество жидкости. Поэтому целесообразно компенсировать эту потерю еще до развития обезвоживания.\r\n<h2>Что делать при повышении температуры тела?</h2>\r\nТемпература является защитным механизмом организма, который угнетает размножение вирусов и бактерий. Поэтому температуру меньше 38,5 °С снижать не стоит. Действенным немедикаментозным методом снижения температуры является использование холодных компрессов. Необходима также соответствующая гидратация, поскольку при обезвоживании вероятность быстрого снижения температуры меньше.\r\n\r\nЕсли повлиять на причину значительного повышения температуры тела невозможно, следует уменьшить неприятные симптомы (боль в голове и мышцах) с помощью лекарств. С этой целью, как правило, используются ибупрофен и парацетамол.\r\n<h2>Сколько необходимо пить?</h2>\r\nЧем выше температура, тем большей является потеря жидкости. Поскольку обезвоживание может усилить неприятные и опасные симптомы повышения температуры (например, увеличение частоты сердцебиения), следует вовремя компенсировать потерю жидкости. Кроме того, обильное питье увеличивает диурез и выведение почками токсинов и продуктов распада клеток. Поэтому при повышенной температуре следует пить не меньше 10 стаканов воды в день.\r\n<h2>Что необходимо пить?</h2>\r\nПри повышенной температуре с потом теряется не только вода, но и соли. Поэтому целесообразно компенсировать потерю жидкости специальными напитками, которые содержат электролиты: натрий, калий, магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации со всеми необходимыми электролитами. РeО не содержит консервантов, красителей, а также имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Что нужно и не нужно делать при повышении температуры тела?','','inherit','closed','closed','','432-revision-v1','','','2021-07-13 16:19:31','2021-07-13 13:19:31','',432,'https://reo.ua/?p=1100',0,'revision','',0),(1101,1,'2021-07-13 16:31:44','2021-07-13 13:31:44','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і частим диханням може призвести до зневоднення. Симптомами зневоднення у дорослих виступають - відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення. У дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання; у немовлят – сухий підгузок протягом 3 годин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<img class=\"aligncenter size-full wp-image-681\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg\" alt=\"\" width=\"1221\" height=\"752\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищеної температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-13 16:31:44','2021-07-13 13:31:44','',396,'https://reo.ua/?p=1101',0,'revision','',0),(1102,1,'2021-07-13 16:34:43','2021-07-13 13:34:43','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потоотделение. Потеря жидкости с потом и учащенным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение. У детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания; у новорожденных – сухой подгузник в течение ≥3 часов.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<img class=\"aligncenter wp-image-610 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-11-ru.jpg\" alt=\"\" width=\"1212\" height=\"742\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потоотделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-13 16:34:43','2021-07-13 13:34:43','',405,'https://reo.ua/?p=1102',0,'revision','',0),(1103,1,'2021-07-13 16:39:21','2021-07-13 13:39:21','Пищевое отравление является следствием употребления испорченной или загрязненной вредными бактериями еды. Чаще всего это происходит в таких случаях:\r\n<ul>\r\n 	<li>еда недостаточно приготовлена или недостаточно разогрета;</li>\r\n 	<li>еда неправильно сохраняется (не замороженная и не охлажденная);</li>\r\n 	<li>еда слишком долго находилась при комнатной температуре;</li>\r\n 	<li>еда приготовлена больным человеком или человеком, который не вымыл должным образом руки;</li>\r\n 	<li>срок годности продукта закончился.</li>\r\n</ul>\r\nПри пищевом отравлении, как правило, имеют место минимум три таких симптома, как боль в животе, диарея, рвота, потеря аппетита, умеренное повышение температуры, слабость, тошнота, головная боль.\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nПризнаками опасного пищевого отравления являются:\r\n<ul>\r\n 	<li>диарея длительностью ≥3 дней;</li>\r\n 	<li>частая рвота;</li>\r\n 	<li>температура больше 38,5 °С;</li>\r\n 	<li>резкое ухудшение зрения или резкое нарушение речи;</li>\r\n 	<li>признаки сильного обезвоживания (сухость во рту, уменьшение или отсутствие мочеиспусканий);</li>\r\n 	<li>появление крови в моче или кале.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки опасного пищевого отравления</strong></p>\r\n&nbsp;\r\n<h2>Что делать при пищевом отравлении?</h2>\r\nВ большинстве случаев пищевое отравление можно лечить в домашних условиях. Выздоровление, как правило, наступает через 3-5 дней.\r\n\r\nОдним из главных методов лечения является регидратация, поскольку с поносом и рвотой теряется большое количество жидкости, а потеря жидкости препятствует должному выведению токсинов.\r\n\r\nМожно использовать лекарства против диареи и противорвотные лекарства, однако перед их применением следует посоветоваться с врачом, поскольку понос и рвота являются природными способами организма избавиться от токсинов.\r\n\r\nПри восстановлении питания следует начинать с продуктов, которые легко перевариваются: соленые крекеры, бананы, рис, овсяная каша, куриный бульон, вареный картофель и другие овощи, тосты.\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при пищевом отравлении отсутствуют. Известно только то, что необходимо пить как можно больше, но маленькими порциями: столько, сколько вы можете перенести.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется и вода, и соли (электролиты). Поэтому для восстановления водно-солевого баланса целесообразно употреблять сбалансированные растворы, содержащие натрий, калий и магний. Избегайте напитков, которые содержат много сахара, поскольку это может усилить диарею, а также кофеинсодержащих напитков, способных усилить обезвоживание.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и дополнительный источник энергии – сорбитол. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО для регидратации при пищевом отравлении:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при тошноте;</li>\r\n 	<li>устраняет симптомы обезвоживания.</li>\r\n</ul>\r\n<h2>Как избежать пищевых отравлений?</h2>\r\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\r\n\r\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\r\n&nbsp;\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Обезвоживание при пищевых отравлениях','','inherit','closed','closed','','390-revision-v1','','','2021-07-13 16:39:21','2021-07-13 13:39:21','',390,'https://reo.ua/?p=1103',0,'revision','',0),(1104,1,'2021-07-13 16:43:09','2021-07-13 13:43:09','Харчове отруєння є наслідком вживання зіпсованої чи забрудненої шкідливими бактеріями їжі. Найчастіше це трапляється в таких випадках:\r\n<ul>\r\n 	<li>їжа недостатньо приготована чи недостатньо розігріта;</li>\r\n 	<li>їжа неправильно зберігається (не заморожена та не охолоджена);</li>\r\n 	<li>їжа занадто довго перебувала при кімнатній температурі;</li>\r\n 	<li>їжа приготована хворою людиною чи людиною, яка не помила руки належним чином;</li>\r\n 	<li>термін придатності продукту минув.</li>\r\n</ul>\r\nПри харчовому отруєнні зазвичай наявні щонайменше три з таких симптомів, як біль у животі, діарея, блювання, втрата апетиту, помірне підвищення температури, слабкість, нудота, головний біль.\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nОзнаками небезпечного харчового отруєння є:\r\n<ul>\r\n 	<li>діарея тривалістю ≥3 днів;</li>\r\n 	<li>часте блювання;</li>\r\n 	<li>температура, більша за 38,5 °С;</li>\r\n 	<li>різке погіршення зору чи різке порушення мовлення;</li>\r\n 	<li>ознаки сильного зневоднення (сухість у роті, зменшення чи відсутність сечовипускань);</li>\r\n 	<li>поява крові в сечі або калі.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-535\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg\" alt=\"\" width=\"994\" height=\"243\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки небезпечного харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Що робити при харчовому отруєнні?</h2>\r\nУ більшості випадків харчове отруєння можна лікувати в домашніх умовах. Одужання зазвичай настає через 3-5 днів.\r\n\r\nОдним із головних методів лікування є регідратація, оскільки з проносом і блюванням втрачається велика кількість рідини, а втрата рідини перешкоджає належному виведенню токсинів.\r\n\r\nМожна застосовувати ліки проти проносу та протиблювотні ліки, проте перед їх застосуванням варто порадитися з лікарем, оскільки діарея та блювання є природними способами організму, щоб позбавитися токсинів.\r\n\r\nПри відновленні харчування слід розпочинати з продуктів, які легко перетравлюються: солені крекери, банани, рис, вівсяна каша, курячий бульйон, варена картопля й інші овочі, тости.\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при харчовому отруєнні немає. Відомо лише те, що потрібно пити якомога більше, але маленькими порціями: стільки, скільки ви можете перенести.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачаються і вода, і солі (електроліти). Тому для відновлення водно-сольового балансу доцільно вживати збалансовані розчини, що містять натрій, калій і магній. Уникайте напоїв, багатих на цукор, оскільки це може посилити діарею, а також кофеїновмісних напоїв, які здатні поглибити зневоднення.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та додаткове джерело енергії – сорбітол. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Переваги води РеО для регідратації при харчовому отруєнні:</h2>\r\n<ul>\r\n 	<li>має збалансований склад;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>не містить консервантів, барвників і вуглеводів;</li>\r\n 	<li>має приємний смак і її легко пити навіть при нудоті;</li>\r\n 	<li>усуває симптоми зневоднення.</li>\r\n</ul>\r\n<h2>Як запобігти харчовому отруєнню?</h2>\r\nОсновний спосіб профілактики харчового отруєння – уникати вживання  їжі, яка може бути небезпечною. М’ясо, птиця, яйця та морепродукти можуть бути забруднені небезпечними бактеріями, які гинуть при тепловій обробці. Тому вживання цих продуктів у сирому чи недостатньо приготованому вигляді може бути небезпечним – ризик отруєння зростає. Іншими потенційно небезпечними продуктами є непастеризоване молоко та сир, а також сирі немиті фрукти й овочі.\r\n\r\nЗавжди мийте руки перед тим, як приготувати або вжити їжу. Переконайтеся, що ваша їжа зберігається належним чином. Ретельно мийте гарячою водою з мийним засобом усе кухонне приладдя, що контактує із сирими продуктами. Для нарізання сирого м’яса та риби користуйтеся окремими дошками. Зберігайте сире м’ясо окремо від їжі, готової до споживання, бажано – на нижній полиці холодильника, де воно не зможе протекти на інші продукти. Не мийте сире м’ясо перед приготуванням, оскільки це може спричинити поширення бактерій на кухні. Підтримуйте в холодильнику температуру нижче 5 °C. Уникайте переповнення холодильника – це перешкоджає циркуляції повітря та, відповідно, належному охолодженню. Охолоджуйте залишки їжі впродовж 90 хвилин після приготування. Не зберігайте готову їжу в холодильнику довше 2 днів і не розігрівайте її більш як 1 раз. Не вживайте продукти, термін придатності яких минув, навіть якщо вони виглядають і пахнуть нормально.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-539\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Заходи щодо запобігання харчового отруєння</strong></p>\r\n&nbsp;\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Матеріали Національної служби здоров’я Великої Британії [Електронний ресурс]. – Режим доступу: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контролю та профілактики хвороб США [Електронний ресурс]. – Режим доступу: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Зневоднення при харчових отруєннях','','inherit','closed','closed','','384-revision-v1','','','2021-07-13 16:43:09','2021-07-13 13:43:09','',384,'https://reo.ua/?p=1104',0,'revision','',0),(1105,1,'2021-07-13 16:48:21','2021-07-13 13:48:21','Гострі кишкові інфекції – це група інфекційних хвороб, яким притаманні раптовий початок і наявність діареї, а іноді – нудота та/або блювання, гарячка, біль у животі та м’язах, втрата апетиту.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-547\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg\" alt=\"\" width=\"968\" height=\"232\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми гастроентериту</strong></p>\r\n&nbsp;\r\n\r\nГострі кишкові інфекції зазвичай самостійно минають через кілька днів, хоча можуть тривати й до 2 тижнів. Кишкові інфекції можуть бути спричинені бактеріями, вірусами чи паразитами. Здебільшого антибіотики не потрібні й можуть лише погіршити стан хворого.\r\n<h2>Що робити при кишкових інфекціях?</h2>\r\nОсновне ускладнення та провідна небезпека гострих кишкових інфекцій – це зневоднення. Під час оцінювання ступеня зневоднення варто звернути увагу на об’єми спожитої рідини, сечовипускання, кількість епізодів діареї та блювання.\r\n\r\nПри незначному чи помірному зневодненні оральна регідратація є такою ж ефективною, як внутрішньовенна, і так само дієво попереджає госпіталізацію (Listernick R. і співавтори, 1986; Cohen M. і співавтори, 1995). Лише 1 дитина з 25 дітей, які отримували оральну регідратацію, потребує внутрішньовенного введення розчинів (Hartling L. і співавтори, 2006).\r\n\r\nЗа появи апетиту слід розпочинати харчування з таких продуктів, як відварений рис і картопля, тости, банани. Слід уникати кофеїновмісних напоїв, алкоголю, жирної та солодкої їжі, молочних продуктів (окрім кефіру та непідсолодженого йогурту).\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nПри гострій кишковій інфекції у дітей варто звернутися до лікаря за появи таких симптомів:\r\n<ul>\r\n 	<li>порушення свідомості;</li>\r\n 	<li>поява крові чи жовчі в блювотних масах;</li>\r\n 	<li>посиніння обличчя;</li>\r\n 	<li>безперервний плач, сильна дратівливість;</li>\r\n 	<li>поява \"крапчастого\" червоного висипу;</li>\r\n 	<li>холодні кінцівки;</li>\r\n 	<li>часте дихання;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ дорослих небезпечними симптомами є:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>безперервний пронос тривалістю &gt;24 годин;</li>\r\n 	<li>блювання тривалістю &gt;48 годин;</li>\r\n 	<li>поява крові в блювотних масах або калі;</li>\r\n 	<li>поява ознак сильного зневоднення (сильна спрага, різке зменшення або відсутність сечовипускання, різка слабкість, запаморочення).</li>\r\n</ul>\r\nДо лікаря також варто звернутися, якщо симптоми гострої кишкової інфекції тривають довше 2 днів у дітей або довше 5 днів у дорослих.\r\n<h2>Скільки потрібно пити?</h2>\r\nДля дітей об’єм рідини слід розраховувати відповідно до ваги за допомогою таблиці чи простої формули: вагу (кг) помножити на 75. Якщо вага точно не відома, можна використовувати оцінку за віком.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вага</strong></th>\r\n<th width=\"33%\"><strong>Вік</strong></th>\r\n<th width=\"33%\"><strong>Приблизна кількість розчину для оральної регідратації, яку потрібно дати в перші 4 години</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 місяців</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 місяців</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 місяці</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 роки</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 років</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 років</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЯкщо людина хоче випити більше, можна дати більше.\r\n\r\nНовонародженим дають пити зі шприца, немовлятам і старшим дітям – із ложки або чашки. Дітям віком менше 2 років варто давати 1 чайну ложку рідини раз в 1-2 хвилини, а старших дітей потрібно заохочувати самостійно робити часті невеликі ковтки з чашки. При блюванні слід зачекати 5-10 хвилин і продовжити регідратацію.\r\n<h2>Що необхідно пити?</h2>\r\nПри проносі та блюванні втрачається не лише вода, а й солі. Тому оптимальним напоєм для відновлення таких втрат є збалансовані за мінеральним складом розчини, що містять натрій, калій і магній. Не слід використовувати для регідратації фруктові соки, оскільки вони не здатні компенсувати втрату солей.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png\"><img class=\"aligncenter wp-image-831\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1-1024x655.png\" alt=\"\" width=\"769\" height=\"492\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Відновлення водно-сольового балансу</strong></p>\r\n&nbsp;\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО має збалансований склад і містить найважливіші електроліти для відновлення водно-сольового балансу. Приємний солонуватий смак дає змогу пити воду РеО невеликими порціями навіть при нудоті, яка досить часто супроводжує кишкові інфекції.\r\n<h2>Як запобігти кишковим інфекціям?</h2>\r\nОсновними заходами профілактики кишкових інфекцій є часте миття рук і хороша гігієна загалом. У маленьких дітей частоту інфекцій і госпіталізацій знижує грудне вигодовування. Слід ретельно мити овочі та фрукти перед вживанням; уникати вживання сирого м’яса, риби, морепродуктів. Окрім того, важливе значення має якісна питна вода.\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Зневоднення при кишкових інфекціях','','inherit','closed','closed','','368-revision-v1','','','2021-07-13 16:48:21','2021-07-13 13:48:21','',368,'https://reo.ua/?p=1105',0,'revision','',0),(1106,1,'2021-07-13 16:52:35','2021-07-13 13:52:35','Острые кишечные инфекции – это группа инфекционных заболеваний, для которых характерны внезапное начало, диарея, а иногда – тошнота и рвота, повышенная температура тела, боль в животе и мышцах, потеря аппетита.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы гастроэнтерита</strong></p>\r\n&nbsp;\r\n\r\nОстрые кишечные инфекции, как правило, самостоятельно проходят через несколько дней, хотя могут длиться и до 2 недель. Кишечные инфекции могут быть вызваны бактериями, вирусами либо паразитами. В большинстве случаев антибиотики не нужны и могут только ухудшить состояние больного.\r\n<h2>Что делать при кишечных инфекциях?</h2>\r\nОсновное осложнение и главная опасность острых кишечных инфекций – это обезвоживание. При оценке степени обезвоживания следует обратить внимание на объем употребления жидкости, объем мочеиспускания, количество эпизодов диареи и рвоты.\r\n\r\nПри незначительном или умеренном обезвоживании оральная регидратация является такой же эффективной, как внутривенная, и так же действенно предотвращает госпитализацию (Listernick R. и соавторы, 1986; Cohen M. и соавторы, 1995). Только 1 ребенок из 25 детей, которые получали оральную регидратацию, требует внутривенного введения растворов (Hartling L. и соавторы, 2006).\r\n\r\nПри появлении аппетита следует начинать питание с таких продуктов, как отваренный рис и картофель, тосты, бананы. Следует избегать кофеинсодержащих напитков, алкоголя, жирной и сладкой еды, молочных продуктов (кроме кефира и несладкого йогурта).\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nВ случае острой кишечной инфекции у детей следует обратиться к врачу при появлении таких симптомов:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>появление крови либо желчи в рвотных массах;</li>\r\n 	<li>посинение лица;</li>\r\n 	<li>непрерывный плач, сильная раздражительность;</li>\r\n 	<li>появление точечной красной сыпи;</li>\r\n 	<li>холодные конечности;</li>\r\n 	<li>частое дыхание;</li>\r\n 	<li>температура ≥40 °С.</li>\r\n</ul>\r\nУ взрослых опасными симптомами являются:\r\n<ul>\r\n 	<li>температура ≥40 °С;</li>\r\n 	<li>непрерывный понос длительностью &gt;24 часа;</li>\r\n 	<li>рвота длительностью &gt;48 часов;</li>\r\n 	<li>появление крови в рвотных массах или кале;</li>\r\n 	<li>появление признаков сильного обезвоживания (сильная жажда, резкое уменьшение или отсутствие мочеиспускания, резкая слабость, головокружение).</li>\r\n</ul>\r\nК врачу также следует обратиться, если симптомы острой кишечной инфекции длятся дольше 2 дней у детей или дольше 5 дней у взрослых.\r\n<h2>Сколько нужно пить?</h2>\r\nДля детей объем жидкости следует рассчитывать в соответствии с весом при помощи таблицы или простой формулы: вес (кг) умножить на 75. Если вес точно не известен, можно использовать возрастную оценку.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>Вес</strong></th>\r\n<th width=\"33%\"><strong>Возраст</strong></th>\r\n<th width=\"33%\"><strong>Приблизительное количество раствора для оральной регидратации, которое следует дать в первые 4 часа</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 месяцев</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 месяцев</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 месяца</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 года</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 лет</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 лет</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nЕсли человек хочет выпить больше, можно дать больше.\r\n\r\nНоворожденным дают пить со шприца (без иглы), малышам и старшим детям – с ложки или чашки. Детям в возрасте до 2 лет следует давать 1 чайную ложку жидкости раз в 1-2 минуты, а старших детей необходимо поощрять самостоятельно делать частые небольшие глотки из чашки. При рвоте следует подождать 5-10 минут и продолжить регидратацию.\r\n<h2>Что необходимо пить?</h2>\r\nПри диарее и рвоте теряется не только вода, но и соли. Поэтому оптимальным напитком являются сбалансированные по минеральному составу растворы, которые содержат натрий, калий и магний. Не стоит использовать для регидратации фруктовые соки, поскольку они не способны компенсировать потерю солей.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\r\n<strong>Рис. 2. Восстановление водно-солевого баланса</strong></p>\r\n&nbsp;\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО имеет сбалансированный состав и содержит самые важные электролиты для восстановления водно-солевого баланса. Приятный солоноватый вкус позволяет пить воду РеО небольшими порциями даже при ощущении тошноты, которое достаточно часто сопровождает кишечные инфекции.\r\n<h2>Как предотвратить кишечные инфекции?</h2>\r\nОсновными мерами профилактики кишечных инфекций является частое мытье рук и хорошая гигиена в целом. У маленьких детей частоту инфекций и госпитализаций снижает грудное вскармливание. Следует тщательно мыть овощи и фрукты перед употреблением; избегать употребления сырого мяса, рыбы, морепродуктов. Кроме того, важное значение имеет качественная питьевая вода.\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Обезвоживание при кишечных инфекциях','','inherit','closed','closed','','377-revision-v1','','','2021-07-13 16:52:35','2021-07-13 13:52:35','',377,'https://reo.ua/?p=1106',0,'revision','',0),(1107,1,'2021-07-13 16:55:54','2021-07-13 13:55:54','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы выглядят как «кофейная гуща», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО имеет высокую степень минерализации за счет содержания ионов натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Рассасывайте кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-13 16:55:54','2021-07-13 13:55:54','',592,'https://reo.ua/?p=1107',0,'revision','',0),(1108,1,'2021-07-13 16:59:21','2021-07-13 13:59:21','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при частом дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО имеет высокую степень минерализации и содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанавливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-13 16:59:21','2021-07-13 13:59:21','',419,'https://reo.ua/?p=1108',0,'revision','',0),(1110,1,'2021-07-13 17:07:43','2021-07-13 14:07:43','','Про воду ReO','','inherit','closed','closed','','11-revision-v1','','','2021-07-13 17:07:43','2021-07-13 14:07:43','',11,'https://reo.ua/?p=1110',0,'revision','',0),(1111,1,'2021-07-13 17:41:12','2021-07-13 14:41:12','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3','','','2021-07-13 17:41:12','2021-07-13 14:41:12','',405,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3.png',0,'attachment','image/png',0),(1112,1,'2021-07-13 17:41:12','2021-07-13 14:41:12','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3-2','','','2021-07-13 17:41:12','2021-07-13 14:41:12','',396,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3.png',0,'attachment','image/png',0),(1113,1,'2021-07-13 17:41:27','2021-07-13 14:41:27','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3-2','','','2021-07-13 17:41:27','2021-07-13 14:41:27','',405,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png',0,'attachment','image/png',0),(1114,1,'2021-07-13 17:41:27','2021-07-13 14:41:27','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3-2-2','','','2021-07-13 17:41:27','2021-07-13 14:41:27','',396,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png',0,'attachment','image/png',0),(1116,1,'2021-07-13 17:41:48','2021-07-13 14:41:48','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4-2','','','2021-07-13 17:41:48','2021-07-13 14:41:48','',396,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png',0,'attachment','image/png',0),(1117,1,'2021-07-13 17:42:03','2021-07-13 14:42:03','Лихорадка – это повышение температуры тела вследствие изменений в работе терморегуляторного центра. Как правило, лихорадка возникает под воздействием веществ, выделяющихся при развитии воспаления, и выступает защитным механизмом, поскольку повышение температуры усиливает собственную иммунную защиту и тормозит рост вредных бактерий.\r\n\r\nПри повышении температуры ускоряются дыхание и сердцебиение, усиливается потоотделение. Потеря жидкости с потом и учащенным дыханием может привести к обезвоживанию. Симптомами последнего у взрослых являются ощущение жажды, сухость во рту, сухость кожи, запор, утомляемость, головная боль, головокружение. У детей также капризность, отсутствие слез, уменьшение или отсутствие мочеиспускания; у новорожденных – сухой подгузник в течение ≥3 часов.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки обезвоживания у взрослых и детей</strong></p>\r\n&nbsp;\r\n\r\nОпасность обезвоживания обусловливает необходимость в обильном питье при высокой температуре. При вирусных заболеваниях, которые часто являются причиной температуры, питье также способствует увлажнению слизистых оболочек, уменьшая раздражение и боль в горле, а также облегчая отхождение мокроты при кашле.\r\n<h2>Что делать при повышенной температуре?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png\"><img class=\"aligncenter size-large wp-image-1115\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1024x661.png\" alt=\"\" width=\"1024\" height=\"661\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Особенности лечения повышенной температуры у детей</strong></p>\r\n&nbsp;\r\n<h2>Сколько нужно пить?</h2>\r\nПри повышении температуры возрастает потеря жидкости с потом. Эту потерю, а также потерю солей необходимо своевременно восполнять. Считается, что взрослым при наличии повышения температуры необходимо пить не менее 10 стаканов жидкости в день.\r\n<h2>Что необходимо пить?</h2>\r\nПоскольку при высокой температуре и сильном потоотделении теряется не только вода, но и соли (электролиты), необходимо компенсировать эти потери напитками, содержащими натрий, калий, магний и кальций.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Он является дополнительным источником энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th><strong>Составляющая</strong></th>\r\n<th><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при повышенной температуре:</h2>\r\n<ul>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>нормализует диурез и снижает общую интоксикацию.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Почему необходимо много пить при повышенной температуре?','','inherit','closed','closed','','405-revision-v1','','','2021-07-13 17:42:03','2021-07-13 14:42:03','',405,'https://reo.ua/?p=1117',0,'revision','',0),(1118,1,'2021-07-13 17:42:46','2021-07-13 14:42:46','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4','','','2021-07-13 17:42:46','2021-07-13 14:42:46','',396,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1.png',0,'attachment','image/png',0),(1119,1,'2021-07-13 17:42:46','2021-07-13 14:42:46','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4-3','','','2021-07-13 17:42:46','2021-07-13 14:42:46','',405,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1.png',0,'attachment','image/png',0),(1120,1,'2021-07-13 17:43:02','2021-07-13 14:43:02','Лихоманка, або гарячка – це підвищення температури тіла внаслідок змін у роботі терморегуляторного центру. Зазвичай лихоманка виникає під дією речовин, які виділяються при розвитку запалення, й виступає захисним механізмом, оскільки підвищення температури посилює власний імунний захист і гальмує ріст шкідливих бактерій.\r\n\r\nПри підвищенні температури пришвидшуються дихання та серцебиття, посилюється потовиділення. Втрата рідини з потом і частим диханням може призвести до зневоднення. Симптомами зневоднення у дорослих виступають - відчуття спраги, сухість у роті, сухість шкіри, закреп, втомлюваність, головний біль, запаморочення. У дітей також капризність, відсутність сліз, зменшення чи відсутність сечовипускання; у немовлят – сухий підгузок протягом 3 годин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-607 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-10-ua-1024x517.jpg\" alt=\"\" width=\"1024\" height=\"517\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки зневоднення у дорослих і дітей</strong></p>\r\n&nbsp;\r\n\r\nНебезпека зневоднення зумовлює потребу в рясному питті при високій температурі. У разі вірусних захворювань, які часто є причиною підвищеної температури, пиття також сприяє зволоженню слизових оболонок, зменшуючи подразнення та біль у горлі, а також полегшуючи відходження мокротиння при кашлі.\r\n<h2>Що робити при підвищеній температурі?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png\"><img class=\"aligncenter size-large wp-image-1114\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1-1024x663.png\" alt=\"\" width=\"1024\" height=\"663\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Особливості лікування підвищеної температури у дітей</strong></p>\r\n&nbsp;\r\n<h2>Скільки потрібно пити?</h2>\r\nПри підвищенні температури зростає втрата рідини з потом. Цю втрату, а також втрату солей необхідно своєчасно поповнювати. Вважається, що дорослим за наявності підвищеної температури слід пити не менш як 10 склянок рідини на день.\r\n<h2>Що необхідно пити?</h2>\r\nОскільки при високій температурі та сильному потовиділенні втрачається не лише вода, а й солі (електроліти), необхідно компенсувати ці втрати напоями, які містять натрій, калій, магній та кальцій.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для оральної регідратації, що містить усі необхідні електроліти та сорбітол, який є додатковим джерелом енергії. Він засвоюється клітинами організму без участі інсуліну. РeО не містить консервантів, барвників і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Вода РеО при підвищеній температурі:</h2>\r\n<ul>\r\n 	<li>усуває симптоми зневоднення;</li>\r\n 	<li>допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>нормалізує діурез і знижує загальну інтоксикацію.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ul>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ul>','Чому потрібно багато пити при підвищеній температурі?','','inherit','closed','closed','','396-revision-v1','','','2021-07-13 17:43:02','2021-07-13 14:43:02','',396,'https://reo.ua/?p=1120',0,'revision','',0),(1121,1,'2021-07-14 00:43:16','2021-07-13 21:43:16','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом під пахви та на пахові ділянки;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО має високий ступінь мінералізації, містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-14 00:43:16','2021-07-13 21:43:16','',557,'https://reo.ua/?p=1121',0,'revision','',0),(1123,1,'2021-07-14 02:27:01','2021-07-13 23:27:01','Рвота является симптомом многих заболеваний и состояний. Причинами могут быть как внутренние (беременность, опухоли головного мозга, заболевания пищеварительной системы), так и внешние (отравление) факторы.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Распространенные причины рвоты</strong></p>\r\n&nbsp;\r\n\r\nРвота – защитный механизм, который препятствует всасыванию токсических или вредных веществ путем быстрого выбрасывания их из желудка. Тем не менее при рвоте теряется большое количество жидкости и солей, что может вызвать обезвоживание и появление неприятных симптомов: головной боли и головокружения, утомляемости, сильной жажды. Признаком дегидратации также является потемнение мочи.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Обратитесь к врачу, если:</h2>\r\n<ul>\r\n 	<li>тошнота и рвота сопровождаются сильной головной болью, повышением температуры тела, нарушением зрения, расстройствами сознания;</li>\r\n 	<li>рвота длится &gt;2 дней для взрослых и детей старше 2 лет, ≥24 часов для детей до 2 лет и ≥12 часов для детей до 1 года;</li>\r\n 	<li>периодические приступы тошноты и рвоты беспокоят на протяжении 1 месяца или больше;</li>\r\n 	<li>тошнота и рвота сопровождаются неясным похудением;</li>\r\n 	<li>рвотные массы выглядят как «кофейная гуща», содержат кровь или имеют зеленый цвет.</li>\r\n</ul>\r\n<h2>Что делать при рвоте?</h2>\r\nСтарайтесь много пить, но маленькими порциями – это позволит предупредить вызванное рвотой обезвоживание.\r\n\r\nДайте организму возможность отдохнуть. Чрезмерная активность может усилить тошноту.\r\n\r\nИзбегайте сильных запахов и других возможных раздражителей: дыма, чрезмерного перегревания и влажности, поездок в автотранспорте, нахождения в душных помещениях.\r\n\r\nИзбегайте твердой еды в течение 6 часов после последнего эпизода рвоты. При возобновлении питания употребляйте простую еду, которая легко переваривается: тосты, крекеры, злаковые хлопья, рис, фрукты.\r\n\r\nЕшьте маленькими порциями. После еды не ложитесь. Отдохните в таком положении, чтобы голова была выше ног (сидя, полулежа).\r\n<h2>Сколько нужно пить?</h2>\r\nПейте несколько глотков жидкости либо рассасывайте лед каждые 15 минут на протяжении 6-8 часов после последнего эпизода рвоты. Объем выпитой жидкости должен не только обеспечить нормальную суточную потребность (приведена в таблице), но и компенсировать потерю воды с рвотными массами.\r\n\r\n<strong>Табл. Потребность детей и взрослых разного возраста в воде</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Возраст</strong></th>\r\n<th><strong>Пол</strong></th>\r\n<th><strong>Количество стаканов воды в день</strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 лет</td>\r\n<td>Девочки и мальчики</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 лет</td>\r\n<td>Девочки</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 лет</td>\r\n<td>Девочки</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Мальчики</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 лет</td>\r\n<td>Женщины</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Мужчины</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Примечание. Данные представлены согласно рекомендациям Института медицины США.</em>\r\n<h2>Что необходимо пить?</h2>\r\nПри рвоте теряется большое количество воды и солей (электролитов), поэтому восстановление водно-солевого баланса является приоритетной задачей. Целесообразно употреблять сбалансированные растворы для регидратации, которые содержат натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым раствором для оральной регидратации, который содержит все необходимые электролиты и сорбитол, выступающий дополнительным источником энергии для организма. Вода РeО - это маломинерализированная вода, которая содержит ионы натрия, хлорида, калия, магния, кальция и гидрокарбоната. Приятный солоноватый вкус позволяет пить воду РеО даже при тошноте.\r\n<h2>Как предупредить рвоту?</h2>\r\n<ul>\r\n 	<li>Присядьте или лягте. Глубоко дышите.</li>\r\n 	<li>Избегайте физических нагрузок, употребления алкоголя, кофеиносодержащих напитков, жирной и острой еды.</li>\r\n 	<li>Рассасывайте кусочек льда или выпейте холодной воды.</li>\r\n</ul>\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Рвота как причина обезвоживания','','inherit','closed','closed','','592-revision-v1','','','2021-07-14 02:27:01','2021-07-13 23:27:01','',592,'https://reo.ua/?p=1123',0,'revision','',0),(1124,1,'2021-07-14 02:29:23','2021-07-13 23:29:23','Внутренняя температура тела человека всегда стабильна, поэтому организм требует охлаждения, когда температура окружающей среды увеличивается. В первую очередь это реализуется за счет расширения кровеносных сосудов и повышения притока крови к поверхности кожи. Такие изменения позволяют излучаться лишнему теплу. Испарение пота также охлаждает кожу, однако чрезмерное потовыделение может привести к дегидратации.\r\n\r\nРиск обезвоживания больше, если вы работаете или занимаетесь спортом на свежем воздухе. Если своевременно не пополнять запасы жидкости, дегидратация и высокая температура окружающей среды могут привести к тепловому удару, который даже может угрожать жизни.\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Признаки и симптомы теплового поражения и теплового удара</strong></p>\r\n&nbsp;\r\n<h2>Что делать при тепловом поражении?</h2>\r\nЕсли продолжать находиться на жаре, тепловое поражение может перерасти в опасный для жизни и здоровья тепловой удар, поэтому необходимо действовать следующим образом:\r\n<ul>\r\n 	<li>перейдите в затененное место;</li>\r\n 	<li>оботрите тело прохладной водой и обмахните веером;</li>\r\n 	<li>наложите компрессы со льдом на подмышечные и паховые области;</li>\r\n 	<li>лягте в прохладном месте и приподнимите ноги;</li>\r\n 	<li>выпейте воды, чтобы предупредить обезвоживание.</li>\r\n</ul>\r\n<h2>Когда следует обратиться к врачу?</h2>\r\nЕсли вы заметили хотя бы один признак теплового удара (высокая температура тела больше 40 °С, красная горячая сухая кожа без пота, быстрый сильный пульс, пульсирующая головная боль, тошнота, спутанность сознания), необходимо сразу обратиться к врачу.\r\n<h2>Сколько нужно пить?</h2>\r\nПоддерживать нормальный баланс жидкости и солей-электролитов легче, чем восстанавливать его при нарушении. Поэтому необходимо пить, не дожидаясь ощущения жажды. По данным Института медицины США, женщины должны выпивать не менее 9 стаканов воды в день, а мужчины – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Что необходимо пить?</h2>\r\nПри физической нагрузке в жару теряется 1-2,5 литра пота в час, а содержание натрия на литр пота составляет 100-700 мг. Значительный дефицит натрия может существенно ухудшить самочувствие и даже вызвать судороги и нарушение сознания. Простая вода не позволяет компенсировать утраченные с потом и мочой электролиты, поэтому следует отдавать предпочтение сбалансированным напиткам, содержащим натрий, калий и магний.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для профилактики и устранения обезвоживания. Вода РеО - это маломинерализованная вода, которая, содержит все необходимые электролиты (натрий, калий, магний, кальций) и сорбитол – дополнительный источник энергии, который легко усваивается клетками. Благодаря приятному вкусу пить воду РeО можно даже при тошноте.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\">Табл. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Составляющие</strong></th>\r\n<th width=\"161\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Почему следует выбрать воду РеО при тепловом поражении?</h2>\r\n<ul>\r\n 	<li>РеО имеет сбалансированный водно-электролитный состав;</li>\r\n 	<li>РеО помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>РеО не содержит консервантов, углеводов и красителей;</li>\r\n 	<li>РеО имеет приятный вкус, ее легко пить даже при ощущении тошноты.</li>\r\n</ul>\r\n<h2>Как предупредить обезвоживание в жару?</h2>\r\n<ul>\r\n 	<li>Не ждите обезвоживания и жажды. Действуйте на опережение: пейте перед любой работой или другой физической активностью, а также перед пребыванием на открытом пространстве.</li>\r\n 	<li>Избегайте пребывания на солнце в самые жаркие часы. Если это все же необходимо, одевайте легкую закрытую одежду, солнцезащитные очки, головной убор и пользуйтесь солнцезащитными средствами.</li>\r\n 	<li>Запланируйте регулярные перерывы на питье и всегда имейте с собой бутылку воды.</li>\r\n 	<li>Отдавайте предпочтение сбалансированным напиткам, пополняющим запас не только воды, но и солей.</li>\r\n 	<li>Для перекусов выбирайте свежие фрукты и овощи, богатые водой (ягоды, арбуз, персики, нектарины, грейпфруты, огурцы, помидоры, сладкий перец).</li>\r\n 	<li>Обращайте внимание на цвет мочи. При ее потемнении следует увеличить объем питья.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Как предупредить тепловой удар?</strong></p>\r\n&nbsp;\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Как предупредить тепловой удар и обезвоживание в летнюю жару?','','inherit','closed','closed','','565-revision-v1','','','2021-07-14 02:29:23','2021-07-13 23:29:23','',565,'https://reo.ua/?p=1124',0,'revision','',0),(1125,1,'2021-07-14 02:30:42','2021-07-13 23:30:42','Внутрішня температура тіла людини завжди стабільна, тому організм потребує охолодження, коли температура навколишнього середовища збільшується. Насамперед це реалізується за рахунок розширення кровоносних судин і підвищення притоку крові до поверхні шкіри. Такі зміни дають змогу випромінюватися зайвому теплу. Випаровування поту також охолоджує шкіру, проте надмірне потовиділення може призвести до дегідратації.\r\n\r\nРизик зневоднення є більшим, коли ви працюєте чи займаєтеся спортом на свіжому повітрі. Якщо своєчасно не поповнювати запаси рідини, дегідратація та висока температура довкілля можуть призвести до теплового удару, який може навіть загрожувати життю.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3.png\"><img class=\"aligncenter size-large wp-image-868\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_3-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Ознаки та симптоми теплового ураження й теплового удару</strong></p>\r\n&nbsp;\r\n<h2>Що робити при тепловому ураженні?</h2>\r\nЯкщо продовжити перебування на сонці, теплове ураження може перерости в небезпечний для життя та здоров’я тепловий удар, тому необхідно діяти таким чином:\r\n<ul>\r\n 	<li>перейдіть у затінене місце;</li>\r\n 	<li>обітріть тіло прохолодною водою й обмахніть віялом;</li>\r\n 	<li>накладіть компреси з льодом під пахви та на пахові ділянки;</li>\r\n 	<li>ляжте в прохолодному місці та підніміть ноги;</li>\r\n 	<li>випийте води, щоб запобігти зневодненню.</li>\r\n</ul>\r\n<h2>Коли варто звернутися до лікаря?</h2>\r\nЯкщо у вас наявна хоча б одна ознака теплового удару (висока температура тіла більша за 40 °С, червона гаряча суха шкіра без поту, швидкий сильний пульс, пульсуючий головний біль, нудота, сплутаність свідомості), необхідно відразу звернутися до лікаря.\r\n<h2>Скільки потрібно пити?</h2>\r\nПідтримувати нормальний баланс рідини та солей-електролітів легше, ніж відновлювати його при порушенні. Тому слід пити, не очікуючи відчуття спраги. За даними Інституту медицини США, жінки повинні випивати щонайменше 9 склянок води на день, а чоловіки – 13.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\"><img class=\"aligncenter size-full wp-image-903\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_5.png\" alt=\"\" width=\"1005\" height=\"494\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Скільки необхідно пити?</strong></p>\r\n&nbsp;\r\n<h2>Що необхідно пити?</h2>\r\nПід час фізичного навантаження в спеку втрачається 1-2,5 літра поту на годину, а вміст натрію на літр поту становить 100-700 мг. Значний дефіцит натрію може суттєво погіршити самопочуття і навіть спричинити судоми та порушення свідомості. Проста вода не дає змогу компенсувати втрачені з потом і сечею електроліти, тому варто віддавати перевагу збалансованим напоям, які містять натрій, калій і магній.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО є готовим до вживання розчином для профілактики й усунення зневоднення. Вода РеО - це маломінералізована вода, що містить усі необхідні електроліти (натрій, калій, магній, кальцій) і сорбітол – додаткове джерело енергії, що легко засвоюється клітинами. Завдяки приємному смаку пити воду РеО можна навіть при нудоті. Важливо, що до складу РеО не входять консерванти та барвники.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Збалансований склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Складник</strong></th>\r\n<th width=\"151\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Чому варто обрати воду РеО при тепловому ураженні?</h2>\r\n<ul>\r\n 	<li>РеО має збалансований водно-електролітний склад;</li>\r\n 	<li>РеО допомагає відновити та підтримати водно-сольовий баланс;</li>\r\n 	<li>РеО не містить консервантів, вуглеводів та барвників;</li>\r\n 	<li>РеО приємна на смак, легко пити навіть при нудоті.</li>\r\n</ul>\r\n<h2>Як запобігти зневодненню в спеку?</h2>\r\n<ul>\r\n 	<li>Не чекайте зневоднення та спраги. Дійте на випередження: пийте перед будь-якою роботою чи іншою фізичною активністю, а також перед перебуванням на свіжому повітрі.</li>\r\n 	<li>Не знаходьтеся на сонці в найспекотніші години. Якщо це все ж необхідно, одягайте легкий закритий одяг, сонцезахисні окуляри, головний убір і користуйтеся захисними засобами від сонця.</li>\r\n 	<li>Заплануйте регулярні перерви на пиття та завжди майте із собою пляшку води.</li>\r\n 	<li>Віддавайте перевагу збалансованим напоям, які поповнюють запас не лише води, а й електролітів.</li>\r\n 	<li>Для перекусів обирайте свіжі та багаті на воду фрукти й овочі (ягоди, кавун, персики, нектарини, грейпфрути, огірки, помідори, солодкий перець).</li>\r\n 	<li>Звертайте увагу на колір сечі. При її потемнінні потрібно збільшити об’єм пиття.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1.png\"><img class=\"aligncenter size-large wp-image-872\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_1-1024x239.png\" alt=\"\" width=\"1024\" height=\"239\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Як запобігти тепловому удару?</strong></p>\r\n&nbsp;\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Як запобігти тепловому удару та зневодненню в літню спеку?','','inherit','closed','closed','','557-revision-v1','','','2021-07-14 02:30:42','2021-07-13 23:30:42','',557,'https://reo.ua/?p=1125',0,'revision','',0),(1126,1,'2021-07-14 02:32:40','2021-07-13 23:32:40','Будь-які фізичні навантаження та спортивні тренування супроводжуються значною втратою рідини з потом і при інтенсивному диханні ротом. Втрата рідини негативно впливає на результативність спортсмена та збільшує ризик теплового удару. Рівень дегідратації залежить від факторів з боку людини (генетичні особливості, вага, адаптація до клімату) та факторів з боку довкілля (температура та вологість, характеристики одягу, тривалість та інтенсивність навантаження). Крім того, ймовірність зневоднення підвищується, якщо носити спеціальні костюми для схуднення, дотримуватися суворих дієт, застосовувати сечогінні засоби, вживати кофеїновмісні напої (кава, енерготоніки).\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-623\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg\" alt=\"\" width=\"773\" height=\"653\" />\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Чинники, від яких залежить ризик дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Чим небезпечна втрата рідини?</h2>\r\nВтрата рідини в обсязі лише 1-2% маси тіла (це, наприклад, становить 700-1400 мл для людини вагою 70 кг) призводить до порушення нормального функціонування організму та збільшення навантаження на серце. Втрата 3% може навіть спричинити судоми, а втрата 4% ваги – смерть. Враховуючи те, що втрати рідини з потом становлять 0,5-2 л на годину, такого рівня дегідратації можна досягти вже через 1 годину інтенсивних тренувань або навіть швидше, якщо спортсмен розпочав заняття вже в стані зневоднення.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png\"><img class=\"aligncenter wp-image-912\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1-1024x451.png\" alt=\"\" width=\"772\" height=\"340\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Несприятливий вплив зневоднення</strong></p>\r\n&nbsp;\r\n\r\nОзнаками втрати рідини є запаморочення, сухість у роті, м’язові судоми, темна сеча, відчуття втоми, незважаючи на достатню кількість сну.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png\"><img class=\"aligncenter wp-image-894\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 3. Ознаки дегідратації</strong></p>\r\n&nbsp;\r\n<h2>Скільки необхідно пити?</h2>\r\nНе варто орієнтуватися виключно на відчуття спраги, оскільки воно виникає не відразу й може супроводжувати вже початкові стадії зневоднення.\r\n<ul>\r\n 	<li>500 мл (близько 2,5 чашки) перед сном;</li>\r\n 	<li>500 мл (близько 2,5 чашки) після прокидання;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 хвилин до тренування;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) кожні 5-15 хвилин тренування;</li>\r\n 	<li>800 мл (3 чашки) на кожні 500 г втрати ваги.</li>\r\n</ul>\r\nЗа тривалих тренувань потрібно контролювати належне надходження солей: необхідно вживати калій, магній і 300-600 мг натрію на годину.\r\n<h2>Що необхідно пити?</h2>\r\nПередусім за фізичних навантажень потрібна вода, але не менш важливі солі (електроліти). Спортсмени, які знають, що під час тренувань необхідно багато пити, часто п’ють звичайну воду, досягаючи різкого зниження вмісту натрію в крові внаслідок її розведення. Це може суттєво погіршити самопочуття, а в крайніх випадках призвести навіть до потенційно летальних наслідків, таких як набряк мозку.\r\n\r\nТакий стан іноді називають отруєнням водою. Крім того, пиття звичайної води без солей спричиняє здуття живота, пригнічує відчуття спраги, зменшуючи ймовірність належного поповнення запасів води надалі, а також збільшує сечовиділення, поглиблюючи втрату солей та рідини.\r\n\r\nТому оптимальним напоєм для спортсмена є водно-електролітні розчини, які дають змогу поповнити дефіцит і рідини, і солей.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода для медичних цілей РеО - це маломінералізованна вода, що містить «найважливіші електроліти» – натрій, калій, кальцій, хлор. Завдяки такому складу вода РеО дозволяє відновлювати та підтримувати водно-сольовий баланс під час та після тренувань. РeО не містить барвників та консервантів і має приємний смак.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Збалансований склад води РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Складник</strong></th>\r\n<th width=\"50%\"><strong>Вміст</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбітол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Вуглекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Як запобігти втраті рідини під час спортивних навантажень?</h2>\r\n<ul>\r\n 	<li>контролюйте вагу до та після тренування і пийте 800 мл рідини на кожні 500 г зменшення ваги;</li>\r\n 	<li>стежте за кольором сечі: якщо він темніший, аніж зазвичай, це може свідчити про зневоднення;</li>\r\n 	<li>дефіцит рідини також проявляється спрагою, втомлюваністю та зменшенням сечовипускання;</li>\r\n 	<li>пристосовуйте спортивний одяг до рівня навантаження, температури й вологості довкілля;</li>\r\n 	<li>пийте до, під час і після тренування.</li>\r\n</ul>\r\n<h2>Список літератури</h2>\r\n<ol>\r\n 	<li>Рекомендації Міжнародного товариства спортивного харчування (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Скільки потрібно пити під час тренувань?','','inherit','closed','closed','','411-revision-v1','','','2021-07-14 02:32:40','2021-07-13 23:32:40','',411,'https://reo.ua/?p=1126',0,'revision','',0),(1127,1,'2021-07-14 02:34:23','2021-07-13 23:34:23','Любые физические нагрузки и спортивные тренировки сопровождаются значительной потерей жидкости с потом и при частом дыхании ртом. Такая потеря жидкости оказывает негативное влияние на результативность спортсмена и увеличивает риск теплового удара. Уровень дегидратации зависит от факторов со стороны человека (генетические особенности, вес, адаптация к климату) и факторов со стороны окружающей среды (температура и влажность, характеристики одежды, длительность и интенсивность нагрузок). Кроме того, вероятность обезвоживания повышается при ношении специальных костюмов для похудения, соблюдении суровых диет, использовании мочегонных средств, употреблении кофеиносодержащих напитков (кофе, энерготоники).\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Факторы, от которых зависит риск дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Чем опасна потеря жидкости?</h2>\r\nПотеря жидкости в объеме всего 1-2% массы тела (это, например, составляет 700-1400 мл для человека весом 70 кг) приводит к нарушению нормального функционирования организма и увеличения нагрузки на сердце. Потеря 3% может даже вызывать судороги, а потеря 4% веса – смерть. Учитывая то, что потеря жидкости с потом составляет 0,5-2 л в час, такого уровня обезвоживания можно достичь уже через 1 час интенсивных тренировок или даже быстрее, если спортсмен начал занятия уже в состоянии дегидратации.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Неблагоприятное воздействие обезвоживания</strong></p>\r\n&nbsp;\r\n\r\nПризнаками потери жидкости являются головокружение, сухость во рту, мышечные судороги, темная моча, ощущение усталости, несмотря на достаточное количество сна.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Сколько необходимо пить?</h2>\r\nНе стоит ориентироваться только на ощущение жажды, поскольку оно возникает не сразу и может сопровождать уже начальные стадии обезвоживания.\r\n<ul>\r\n 	<li>500 мл (около 2,5 чашек) перед сном;</li>\r\n 	<li>500 мл (около 2,5 чашек) после пробуждения;</li>\r\n 	<li>400-600 мл (1,5-2,5 чашки) за 20-30 минут до тренировки;</li>\r\n 	<li>400-500 мл (1,5-2 чашки) каждые 5-15 минут тренировки;</li>\r\n 	<li>800 мл (3 чашки) на каждые 500 г потери веса.</li>\r\n</ul>\r\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\r\n<h2>Что необходимо пить?</h2>\r\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\r\n\r\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\r\n\r\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода для медицинских целей РеО - это маломинерализированная вода, которая содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанавливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Составляющая</strong></th>\r\n<th width=\"50%\"><strong>Содержимое</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\r\n<ul>\r\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\r\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\r\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\r\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\r\n 	<li>пейте до, во время и после тренировки.</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Сколько нужно пить во время тренировок?','','inherit','closed','closed','','419-revision-v1','','','2021-07-14 02:34:23','2021-07-13 23:34:23','',419,'https://reo.ua/?p=1127',0,'revision','',0),(1128,1,'2021-07-14 02:36:46','2021-07-13 23:36:46','Алкогольным напиткам присущ мочегонный эффект, что при злоупотреблении приводит к дегидратации. Рвота после чрезмерного употребления алкоголя также может привести к потере жидкости и солей. Именно обезвоживание является одной из основных причин появления симптомов похмелья – головной боли, головокружения и жажды.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Что делать при похмелье?</h2>\r\nК сожалению, быстро и действенно устранить похмелье невозможно, поскольку распад и выведение из организма токсических продуктов этилового спирта требует времени. Тем не менее можно помочь своему организму преодолеть похмельный синдром легче. Стоит попробовать такие меры:\r\n<ul>\r\n 	<li>пейте много жидкости на протяжении всего дня, желательно той, которая содержит электролиты (соли);</li>\r\n 	<li>необходимо выспаться;</li>\r\n 	<li>примите безрецептурный препарат от головной боли;</li>\r\n 	<li>не злоупотребляйте кофеиносодержащими напитками, поскольку они способны усилить обезвоживание и вызвать раздражение слизистой оболочки желудка;</li>\r\n 	<li>избегайте чрезмерного солнечного света;</li>\r\n 	<li>ешьте простую еду (тосты, крекеры), чтобы поднять уровень сахара в крови без раздражения слизистой оболочки желудка.</li>\r\n</ul>\r\n<h2>Сколько нужно пить?</h2>\r\nТочные рекомендации относительно необходимого количества жидкости при похмелье отсутствуют. В целом это зависит от количества и крепости выпитого накануне алкоголя. При наличии признаков похмелья следует каждые несколько минут делать 1-2 глотка воды на протяжении всего следующего дня после злоупотребления алкоголем.\r\n<h2>Что необходимо пить?</h2>\r\nАлкогольные напитки нарушают водно-солевой баланс в организме, вследствие чего возникают головная боль, слабость и раздражительность. Для восстановления этого баланса целесообразно употреблять напитки, содержащие электролиты – натрий, калий, магний, кальций. Это ускорит устранение перечисленных выше симптомов. Обычная вода и сладкие газированные напитки содержат электролиты в очень низких концентрациях, и поэтому не способны полноценно восстановить водно-солевой баланс.\r\n<h2>Вода для медицинских целей РеО</h2>\r\nВода РеО была разработана корпорацией «Юрия-Фарм» специально для медицинских целей, а именно восстановления и поддержания водно-солевого баланса организма. Сбалансированный состав воды РеО позволяет восполнить утраченные организмом электролиты, а сорбитол дает клеткам дополнительную энергию. Благодаря приятному солоноватому вкусу пить воду РеО можно небольшими порциями даже при тошноте.\r\n<h2>Когда следует обратиться к врачу при похмелье?</h2>\r\nПохмелье – это всего лишь совокупность неприятных симптомов, в большинстве случаев проходящих самостоятельно на протяжении суток. Другое дело – алкогольное отравление, которое может даже угрожать жизни. Обратитесь к врачу, если у вас или других людей появились такие признаки:\r\n<ul>\r\n 	<li>нарушение сознания;</li>\r\n 	<li>судороги;</li>\r\n 	<li>снижение температуры тела;</li>\r\n 	<li>замедленное или нерегулярное дыхание.</li>\r\n</ul>\r\n<h2>Как предотвратить похмелье?</h2>\r\nСамый лучший способ профилактики похмелья – избегать употребления алкоголя. Однако если вы все же решили выпить, имеется несколько способов избежать развития похмельного синдрома или облегчить его.\r\n<ul>\r\n 	<li>Пейте достаточно воды. Возьмите за правило выпивать стакан воды после каждой порции алкоголя (25 мл крепких напитков, 100 мл вина, 250 мл пива) и дополнительный стакан перед сном.</li>\r\n 	<li>Ешьте еду, богатую на углеводы. Коричневый рис или макароны могут замедлить усвоение алкоголя.</li>\r\n 	<li>Старайтесь пополнить дефицит электролитов. Например, бананы и авокадо содержат много калия, орехи – магния, квашенные продукты – натрия.</li>\r\n 	<li>Выбирайте светлые по цвету напитки, поскольку они содержат меньше продуктов ферментации, усиливающих похмелье.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Избегайте курения, поскольку оно способствует обезвоживанию и ухудшает качество сна.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Профилактика похмелья</strong></p>\r\n\r\n<h2>Источники</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Как преодолеть похмелье и обезвоживание, которое его сопровождает?','','inherit','closed','closed','','601-revision-v1','','','2021-07-14 02:36:46','2021-07-13 23:36:46','',601,'https://reo.ua/?p=1128',0,'revision','',0),(1129,1,'2021-07-14 02:37:44','2021-07-13 23:37:44','Алкогольним напоям притаманний сечогінний ефект, який при зловживанні призводить до дегідратації. Блювання після надмірного споживання алкоголю також може призвести до втрати рідини і солей. Саме зневоднення є однією з основних причин появи симптомів похмілля – головного болю, запаморочення та спраги.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png\"><img class=\"wp-image-821 aligncenter\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1-1024x656.png\" alt=\"\" width=\"667\" height=\"428\" /></a>\r\n<p style=\"text-align: center;\"><strong>Мал. 1. Симптоми похмілля</strong></p>\r\n\r\n<h2>Що робити при похміллі?</h2>\r\nНа жаль, швидко та дієво усунути похмілля неможливо, оскільки розпад та виведення з організму токсичних продуктів етилового спирту потребує часу. Проте можна допомогти своєму організму подолати похмільний синдром легше. Варто спробувати такі заходи:\r\n<ul>\r\n 	<li>пийте багато рідини протягом усього дня, бажано тієї, що містить електроліти (солі);</li>\r\n 	<li>необхідно виспатися;</li>\r\n 	<li>прийміть безрецептурний препарат від головного болю;</li>\r\n 	<li>не зловживайте кофеїновмісними напоями, оскільки вони можуть посилити зневоднення та призвести до подразнення слизової оболонки шлунка;</li>\r\n 	<li>уникайте надмірного сонячного світла;</li>\r\n 	<li>споживайте просту їжу (тости, крекери), щоб підняти рівень цукру в крові без подразнення слизової оболонки шлунка.</li>\r\n</ul>\r\n<h2>Скільки потрібно пити?</h2>\r\nТочних рекомендацій щодо необхідної кількості рідини при похміллі бракує. Загалом це залежить від кількості та міцності випитого напередодні алкоголю. За наявності ознак похмілля слід щокілька хвилин робити 1-2 ковтка води протягом усього наступного дня після зловживання алкоголем.\r\n<h2>Що необхідно пити?</h2>\r\nАлкогольні напої порушують водно-сольовий баланс в організмі, внаслідок чого виникають головний біль, слабкість і дратівливість. Для відновлення цього балансу доцільно вживати напої, які містять електроліти – натрій, калій, магній, кальцій. Це пришвидшить усунення перелічених вище симптомів. Звичайна вода і солодкі газовані напої містять електроліти в дуже низьких концентраціях, тому не здатні повноцінно відновити водно-сольовий баланс.\r\n<h2>Вода для медичних цілей РеО</h2>\r\nВода РеО була розроблена корпорацією «Юрія-Фарм» спеціально для медичних цілей, а саме відновлення та підтримки водно-сольового балансу в організмі. Збалансованний склад води РеО дає змогу поповнювати втрачені організмом електроліти, а сорбітол надає клітинам додаткову енергію. Завдяки приємному солонуватому смаку пити воду РеО можна невеликими порціями навіть під час нудоти.\r\n<h2>Коли варто звернутися до лікаря при похміллі?</h2>\r\nПохмілля – це лише сукупність неприємних симптомів, які здебільшого минають самостійно впродовж доби. Інша справа – алкогольне отруєння, що може навіть загрожувати життю. Зверніться до лікаря, якщо у вас або інших людей наявні такі ознаки:\r\n<ul>\r\n 	<li>затьмарення свідомості;</li>\r\n 	<li>напади судом;</li>\r\n 	<li>зниження температури тіла;</li>\r\n 	<li>сповільнене чи нерегулярне дихання.</li>\r\n</ul>\r\n<h2>Як запобігти похміллю?</h2>\r\nНайкращий спосіб профілактики похмілля – уникати вживання алкоголю. Однак, якщо ви все ж вирішили випити, є кілька можливостей запобігти розвитку похмільного синдрому чи полегшити його перебіг.\r\n<ul>\r\n 	<li>Пийте достатньо води. Візьміть за правило випивати склянку води після кожної порції алкоголю (25 мл міцних напоїв, 100 мл вина, 250 мл пива) та додаткову склянку води перед сном.</li>\r\n 	<li>Їжте багату на вуглеводи їжу. Коричневий рис або макарони можуть сповільнити всмоктування алкоголю.</li>\r\n 	<li>Намагайтеся поповнити дефіцит електролітів. Зокрема банани й авокадо містять калій, горіхи – магній, квашені продукти – натрій.</li>\r\n 	<li>Обирайте світлі за кольором напої, оскільки вони містять менше продуктів ферментації, які підсилюють похмілля.</li>\r\n 	<li>Уникайте газованих напоїв, тому що вони пришвидшують всмоктування алкоголю.</li>\r\n 	<li>Уникайте куріння, оскільки воно посилює зневоднення та погіршує якість сну.</li>\r\n</ul>\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png\"><img class=\"aligncenter size-large wp-image-819\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a></p>\r\n<p style=\"text-align: center;\"><strong>Мал. 2. Профілактика похмілля</strong></p>\r\n\r\n<h2>Джерела</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Як подолати похмілля та зневоднення, що його супроводжує?','','inherit','closed','closed','','595-revision-v1','','','2021-07-14 02:37:44','2021-07-13 23:37:44','',595,'https://reo.ua/?p=1129',0,'revision','',0),(1131,1,'2021-07-14 10:16:44','2021-07-14 07:16:44','','Оральная регидратация у взрослых','','inherit','open','closed','','oralnaya-regidratacziya-u-vzroslyh-2','','','2021-07-14 10:16:44','2021-07-14 07:16:44','',478,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-vzroslyh.pdf',0,'attachment','application/pdf',0),(1132,1,'2021-07-14 10:16:50','2021-07-14 07:16:50','','Оральная регидратация у детей','','inherit','open','closed','','oralnaya-regidratacziya-u-detej','','','2021-07-14 10:16:50','2021-07-14 07:16:50','',571,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-detej.pdf',0,'attachment','application/pdf',0),(1133,1,'2021-07-14 10:16:50','2021-07-14 07:16:50','','Оральная регидратация у детей','','inherit','open','closed','','oralnaya-regidratacziya-u-detej-2','','','2021-07-14 10:16:50','2021-07-14 07:16:50','',478,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-detej.pdf',0,'attachment','application/pdf',0),(1134,1,'2021-07-14 10:16:56','2021-07-14 07:16:56','','Оральная регидратация у лиц пожилого возраста','','inherit','open','closed','','oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta','','','2021-07-14 10:16:56','2021-07-14 07:16:56','',571,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta.pdf',0,'attachment','application/pdf',0),(1135,1,'2021-07-14 10:16:56','2021-07-14 07:16:56','','Оральная регидратация у лиц пожилого возраста','','inherit','open','closed','','oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta-2','','','2021-07-14 10:16:56','2021-07-14 07:16:56','',478,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta.pdf',0,'attachment','application/pdf',0),(1136,1,'2021-07-14 10:17:03','2021-07-14 07:17:03','Обезвоживание, или дегидратация – это нарушение водно-солевого баланса, которое сопровождается дефицитом воды в организме. Дегидратация возникает тогда, когда потери воды и электролитов своевременно не пополняются, то есть возникает их дефицит [1]. Причины дегидратации могут быть такие: уменьшение употребления жидкости, усиленное ее выделение с мочой, калом, рвотными массами, кровопотеря, дисбаланс жидкостей в организме (асцит, плевральный выпот), капиллярная потеря жидкости (при ожогах и сепсисе) (рис.) [адаптировано с 2].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис 1. Причины, которые обуславливают дегидратацию у детей</strong></p>\r\n<p style=\"text-align: center;\"><em>Примечание. * В этих случаях боль ограничивает оральное потребление жидкости.</em></p>\r\n<span class=\"VIiyi\" lang=\"ru\"><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"0\">Дети</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"1\">чувствительнее к</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"2\">дегидратации,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"3\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"4\">взрослые</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"5\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"6\">поскольку</span> со<span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"7\">отношение поверхности</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"8\">тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"9\">ребенка</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"10\">с массой тела</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"11\">значительно больше</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"12\">,</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"13\">чем</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"14\">у взрослых</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"15\">[2</span><span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"16\">, 3].</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"17\">Частыми</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"18\">причинами</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"19\">дегидратации</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"20\">в</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"21\">детском</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"22\">возрасте</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"23\">являются</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"24\">понос и</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"25\">рвота</span> <span class=\"JLqJ4b ChMk0b\" data-language-for-alternatives=\"ru\" data-language-to-translate-into=\"uk\" data-phrase-index=\"26\">[4].</span></span>\r\n\r\n<strong> Группы риска дегидратации</strong> [5]:\r\n<ul>\r\n 	<li>дети до 1 года, прежде всего до 5 месяцев;</li>\r\n 	<li>дети с низкой массой тела при рождении;</li>\r\n 	<li>дети, которые имели 6 или больше эпизодов жидкого стула за последние 24 часа;</li>\r\n 	<li>дети, которые имели 3 или больше эпизодов рвоты за последние 24 часа;</li>\r\n 	<li>дети, которые не могут пить в данный момент;</li>\r\n 	<li>дети, которым во время болезни приостановили грудное вскармливание;</li>\r\n 	<li>дети с признаками недостаточной упитанности.</li>\r\n</ul>\r\n<h2>Патогенез дегидратации</h2>\r\nЖидкость, которая теряется со рвотой, поносом, усиленным потоотделением или другим путем, содержит определенную концентрацию солей, поэтому потеря жидкости всегда сопровождается потерей солей. Точное количество и характер солевых (электролитных) потерь зависит от причины дегидратации. Например, бикарбонаты в значительной степени теряются при диарее, но не при рвоте.\r\n\r\nПотеря жидкости препятствует полноценному функционированию всех органов и тканей, из-за чего ухудшается самочувствие человека. В свою очередь, потеря солей (электролитов) и, наоборот, рост их концентрации в результате потери воды является опасной, поскольку может повлечь такие осложнения, как судороги, нарушение ритма и даже остановку сердца [6]. Это предопределяет потребность в проведении своевременной регидратации с помощью сбалансированного раствора.\r\n<h2>Клиническая картина и степени дегидратации</h2>\r\nДегидратация разделяется на степени в зависимости от выраженности признаков и симптомов, которые характеризуют потерю жидкости. На ранних стадиях признаков и симптомов обезвоживание можно компенсировать. Впоследствии компенсаторные возможности организма ребенка истощаются; возникают жажда, раздраженность и беспокойство, снижение тургора кожи, западение глаз и родничка (у младенцев). В случае тяжелой дегидратации эти признаки становятся еще более выраженными. Возможным становится даже гиповолемический шок, который характеризуется расстройствами сознания, отсутствием выделения мочи, периферическим цианозом. Наблюдаются холодные влажные конечности, учащение пульса (пульс на лучевой артерии может вообще не определяться), падение артериального давления.\r\n\r\nОтсутствие надлежащей регидратации может привести к летальному исходу [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">Таблица 1. Оценка тяжести дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Критерий</strong></th>\r\n<th width=\"156\"><strong>Незначительная дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Умеренная дегидратация (5-9%)</strong></th>\r\n<th width=\"156\"><strong>Тяжелая дегидратация (</strong><strong>≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Состояние сознания</strong></td>\r\n<td width=\"156\">Активный, способен к общению</td>\r\n<td width=\"156\">Летаргия, раздраженность</td>\r\n<td width=\"156\">Расстройства сознания</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота сердцебиения</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Нормальная, или незначительная тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Частота дыхания</strong></td>\r\n<td width=\"156\">Нормальная</td>\r\n<td width=\"156\">Повышена</td>\r\n<td width=\"156\">Повышена, глубокое дыхание с формированием ацидоза</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериальное давление</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Цвет кожи</strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Бледная, появление пятен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Конечности</strong></td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Теплые</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Ослаблен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Глаза и родничок</strong></td>\r\n<td width=\"156\">Нормальные</td>\r\n<td width=\"156\">Запавшие</td>\r\n<td width=\"156\">Глубоко запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Слизистые оболочки</strong></td>\r\n<td width=\"156\">Влажные</td>\r\n<td width=\"156\">Сухие</td>\r\n<td width=\"156\">Сухие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тургор кожи</strong></td>\r\n<td width=\"156\">Складка быстро разглаживается</td>\r\n<td width=\"156\">Умеренно снижен</td>\r\n<td width=\"156\">Снижен</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Время возобновления наполнения капилляров</strong></td>\r\n<td width=\"156\">Нормальное</td>\r\n<td width=\"156\">Увеличено</td>\r\n<td width=\"156\">Значительно увеличено</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nКрасные флажки дегидратации (признаки прогресса и риска возникновения шока) [8]:\r\n<ul>\r\n 	<li>прогрессирование ухудшения состояния;</li>\r\n 	<li>расстройства сознания;</li>\r\n 	<li>западение глаз;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>уменьшение тургора кожи.</li>\r\n</ul>\r\n<strong>Признаки дегидратации</strong>\r\n\r\n<strong>Дефицит жидкости в % массы тела\r\n</strong><strong>Дефицит жидкости в мл/кг массы тела</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\">Таблица 2. Клинические признаки дегидратации и приблизительный дефицит жидкости (1)</th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Отсутствуют</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть некоторые признаки дегидратации</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Есть признаки тяжелой дегидратации</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Например, у ребенка весом 5 кг с некоторыми признаками дегидратации дефицит жидкости составляет 250-500 мл.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\">Таблица 3. Критерии оценки дегидратации и выбор тактики действия (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Критерии оценки</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Общее состояние</strong></td>\r\n<td width=\"152\"><strong>Нормальное, активное</strong></td>\r\n<td width=\"154\"><strong>Неспокойное, раздражительное</strong></td>\r\n<td width=\"152\"><strong>Расстройство сознания</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Глаза</strong></td>\r\n<td width=\"152\">Нормальные</td>\r\n<td width=\"154\">Запавшие</td>\r\n<td width=\"152\">Запавшие</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Жажда</strong></td>\r\n<td width=\"152\">Пьет спокойно, жажда отсутствует</td>\r\n<td width=\"154\">Пьет жадно, жажда есть</td>\r\n<td width=\"152\">Не может пить или пьет совсем немного</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Щипок кожи </strong><strong>предплечья</strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Складка кожи разглаживается быстро</td>\r\n<td width=\"154\">Складка кожи разглаживается медленно</td>\r\n<td width=\"152\">Складка кожи разглаживается очень медленно</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Вывод</strong></td>\r\n<td width=\"152\">Признаков дегидратации нет, но нужна профилактика дегидратации, поскольку имеет место потеря воды</td>\r\n<td width=\"154\">Если есть ≥ 2 признака из этого списка, имеется незначительная или умеренная дегидратация</td>\r\n<td width=\"152\">Если есть ≥ 2 признака из этого списка, имеется тяжелая дегидратация</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Тактика действий</strong></td>\r\n<td width=\"152\">План А</td>\r\n<td width=\"154\">Если возможно, взвесьте ребенка и переходите к плану В</td>\r\n<td width=\"152\">Если возможно, взвесьте ребенка и  немедленно переходите к плану С</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>План А: оральная регидратация</h2>\r\nЖелательно давать ребенку жидкости, которые содержат соль: специальные солевые растворы для оральной регидратации, подсоленные напитки. Если провести регидратацию лишь простой водой (гипотонический раствор), существует риск чрезмерного снижения уровня солей в плазме крови и образования отеков [9]. Возможным является также применение рисового отвара (воды, в которой варился рис), слабого неподслащенного чая, неподслащенного свежего фруктового сока (фреш), питьевой воды. В свою очередь, некоторые напитки являются потенциально опасными. Например, напитки, которые содержат сахар, могут вызывать осмотическую диарею и гипернатриемию, потому следует избегать употребления сладких газированных напитков, готовых соков, подслащенного чая. Нежелательно также давать ребенку кофе или растительные чаи, которые могут иметь диуретическое или слабительное действие.\r\n<h2>Сколько жидкости давать?</h2>\r\nВ целом столько, сколько ребенок хочет выпить. В случае диареи после каждого жидкого стула давайте ребенку возрастом младше 2 лет 50-100 мл жидкости (1/4-1/2 большой чашки), ребенку возрастом 2-10 лет – 100-200 мл (1/2-1 большая чашка), ребенку старше 10 лет – столько, сколько ребенок захочет выпить [1]. Если причина дегидратации другая, при регидратации можно ориентироваться на ощущение жажды.\r\n\r\nПлан В: оральная регидратация с помощью специальных растворов в медицинском учреждении.\r\n\r\nЕсли вес ребенка известен, для определения необходимого количества жидкости следует умножить вес на 75 мл. Если вес ребенка неизвестен, пользуются таблицами в соответствии с возрастом. В случае, когда ребенок хочет выпить больше и отсутствуют признаки чрезмерной гидратации (прежде всего, отек век), можно дать больше.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\">Таблица 4. Приблизительное количество раствора для оральной регидратации  в первые 4 часа (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Возраст</strong></th>\r\n<th width=\"89\">До 4 мес</th>\r\n<th width=\"89\">4-11 мес</th>\r\n<th width=\"89\">12-23 мес</th>\r\n<th width=\"89\">2-4 года</th>\r\n<th width=\"89\">5-14 лет</th>\r\n<th width=\"89\">&gt;15 лет</th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вес</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. Ориентируйтесь на возраст лишь тогда, когда не знаете вес.\r\n\r\nПриблизительное количество жидкости для оральной регидратации в мл можно также рассчитать, умножив вес ребенка в кг на 75.\r\n\r\nЕсли ребенок хочет выпить больше жидкости, чем рассчитано, дайте выпить больше.\r\n\r\nРаствор нужно давать ложкой или из чашки. Для младенцев можно пользоваться пипеткой или шприцем без иглы. Нередко при быстром усиленном питье возникает рвота, однако обычно это не препятствует регидратации, поскольку большая часть жидкости все-таки успевает усвоится. При появлении рвоты подождите 5-10 минут и продолжайте регидратацию в более медленном темпе. Через 4 часа оцените степень дегидратации за таблицей 3. При появлении признаков тяжелой дегидратации перейдите к плану С. В случае отсутствия признаков дегидратации регидратацию можно прекратить. В таких случаях исчезает жажда, возобновляется мочеиспускание, кожа после щипка быстро разглаживается, ребенок успокаивается и обычно засыпает [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\">Таблица 5. Схема внутривенной дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Возраст</strong></th>\r\n<td width=\"208\">Сначала назначьте инфузию 30 мл/кг в течение</td>\r\n<td width=\"208\">Далее назначьте инфузию 70 мл/кг в течение</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>До 12 мес</strong></th>\r\n<td width=\"208\">1 часа*</td>\r\n<td width=\"208\">5 часов</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Старше 12 мес</strong></th>\r\n<td width=\"208\">30 минут*</td>\r\n<td width=\"208\">2,5 часов</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПримечание. После госпитализации немедленно начните инфузию сбалансированных растворов. Если ребенок может пить, необходимо параллельно с инфузией давать растворы солей для оральной регидратации. Оценивайте состояние пациента раз в 1-2 часа. Если улучшение состояния отсутствует, ускорьте введение жидкости. После полного введения объема жидкости (у младенцев – 6 часов, у старших детей – 3 часа) оцените состояние пациента согласно таблице 3 и опять выберите оптимальный план лечения (А, В или С). * Если пульс на лучевой артерии слаб или не определяется, повторите такое введение еще раз.\r\n<h2>Оральная регидратация – метод выбора при незначительной и умеренной дегидратации</h2>\r\nПо данным Кокрановского обзора, который включал 17 исследований при участии 1811 пациентов, достоверная разница между эффективностью оральной и внутривенной регидратации отсутствует. Оральная регидратация должна быть первой линией лечения у детей с незначительной и умеренной дегидратацией, а внутривенная регидратация назначается в случае неудачи оральной [10].\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, которая содержит все необходимые электролиты и сорбитол. Сорбитол – дополнительный источник энергии, которая усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус. Это является важным условием для средств, которые применяются в педиатрической практике.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Оральная регидратация у детей','','inherit','closed','closed','','571-revision-v1','','','2021-07-14 10:17:03','2021-07-14 07:17:03','',571,'https://reo.ua/?p=1136',0,'revision','',0),(1137,1,'2021-07-14 10:17:13','2021-07-14 07:17:13','<h2>Дегидратация: определение и типы</h2>\r\nДегидратация – это патологическое состояние, при котором организм теряет воды больше, чем её получает.\r\n\r\nПри условии доступности питьевой воды у здоровых взрослых дегидратация наблюдается редко, но она может возникнуть у любого человека как осложнение разнообразных заболеваний и состояний, например, при гипергликемии (1). Потери воды могут происходить через кожу, легкие, почки и пищеварительную систему (2).\r\n<h2>При дегидратации организм теряет не только воду, но и электролиты, прежде всего натрий.</h2>\r\n<strong>В зависимости от соотношения потерь жидкости и натрия выделяют три формы дегидратации:</strong>\r\n<ul>\r\n 	<li>изотоническая (потеря жидкости = потеря натрия);</li>\r\n 	<li>гипертоническая (потеря жидкости &gt; потеря натрия);</li>\r\n 	<li>гипотоническая (потери жидкости &lt; потеря натрия) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">Таблица 1. Причины основных видов дегидратации (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотоническая дегидратация </strong></th>\r\n<th width=\"113\"><strong>Гипертоническая дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотоническая дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Рвота\r\n\r\n• Понос\r\n\r\n• Потливость\r\n\r\n• Ожоги\r\n\r\n• Болезни почек\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Лихорадка\r\n\r\n• Частое дыхание\r\n\r\n• Несахарный диабет</td>\r\n<td width=\"113\">• Прием диуретиков</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Также дегидратацию можно классифицировать в зависимости от особенностей причинного фактора:</h2>\r\n<ul>\r\n 	<li>чрезмерные потери жидкости через пищеварительный тракт: рвота, понос, употребление слабительных средств, промывание желудка, наличие свищей;</li>\r\n 	<li>чрезмерные потери жидкости через кожу: сильное потоотделение, физические нагрузки, ожоги, тяжелые дерматологические заболевания;</li>\r\n 	<li>чрезмерные потери жидкости с мочой: употребление мочегонных препаратов, острые и хронические почечные заболевания, усиленное мочеотделение после устраненной обструкции мочевыводящих путей, Аддисоновая болезнь, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>внутрибрюшные потери жидкости: панкреатит, асцит, перитонит;</li>\r\n 	<li>невозможность пополнить потерю жидкости: нарушение мышления и психического состояния, иммобилизация, расстройства формирования ощущения жажды, передозировка лекарственными препаратами с развитием комы;</li>\r\n 	<li>другое: сепсис, гипертиреоз, бронхиальная астма, хронические обструктивные заболевания легких, употребление наркотиков [1].</li>\r\n</ul>\r\n<h2>Клиническая картина</h2>\r\n<strong>Незначительной и умеренной дегидратации свойственны такие признаки: </strong>\r\n<ul>\r\n 	<li>жажда;</li>\r\n 	<li>сухость во рту;</li>\r\n 	<li>утомляемость, сонливость;</li>\r\n 	<li>уменьшение количества мочеиспусканий и объема мочи;</li>\r\n 	<li>темный цвет мочи;</li>\r\n 	<li>головная боль;</li>\r\n 	<li>сухость кожи;</li>\r\n 	<li>головокружение;</li>\r\n 	<li>отсутствие слезной жидкости.</li>\r\n</ul>\r\n<strong>Для тяжелой дегидратации присущим является: </strong>\r\n<ul>\r\n 	<li>резкое уменьшение количества мочеиспусканий или полное их прекращение;</li>\r\n 	<li>головокружение, которое препятствует передвижению;</li>\r\n 	<li>ортостатическая гипотензия (падение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>лихорадка;</li>\r\n 	<li>снижение эластичности кожи;</li>\r\n 	<li>летаргия, сонливость;</li>\r\n 	<li>спутанное сознание;</li>\r\n 	<li>кома;</li>\r\n 	<li>приступы судорог;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nХотя на первый взгляд обезвоживание кажется не очень опасным состоянием, его осложнения могут быть тяжелыми и даже угрожать жизни.\r\n\r\n<strong>Осложнения дегидратации включают: </strong>\r\n<ul>\r\n 	<li>изменения психического состояния;</li>\r\n 	<li>почечную недостаточность;</li>\r\n 	<li>развитие «шоковой печени» и «шоковой почки» – некроз этих органов вследствие гипоперфузии;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензию;</li>\r\n 	<li>смерть [1].</li>\r\n</ul>\r\n<strong>Красными флажками, которые свидетельствуют о тяжелой опасной дегидратации, являются:</strong>\r\n<ul>\r\n 	<li>дезориентация, спутанное сознание;</li>\r\n 	<li>сильное головокружение;</li>\r\n 	<li>отсутствие мочеиспусканий в течение суток;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>судороги (4).</li>\r\n</ul>\r\n<h2>Диагностика</h2>\r\nЗолотой стандарт диагностики дегидратации отсутствует, поэтому чаще всего установить диагноз помогает клиническая картина. Нередко используется определение осмолярности мочи и плазмы крови, однако на этот показатель значительно влияют причина обезвоживания и острота течения процесса. Нормальные значения осмолярности плазмы крови представляют 280-300 мОсм/л, а мочи - 600-1200 мОсм/л. При превышении этих показателей можно заподозрить обезвоживание<strong>.</strong>\r\n\r\nСледует помнить, что уменьшение объема мочи и высокая ее осмолярность могут иметь место не только при дегидратации, но и при сердечной недостаточности, циррозе печени, нефротическом синдроме и хронических почечных заболеваниях.\r\n\r\nДругими признаками дегидратации являются снижение массы тела на ≥3% в течение 7 дней и рост соотношения азота мочевины к креатинину выше 10 [1].\r\n\r\nИнструментальным методом, который дает возможность установить дегидратацию, является ультразвуковое исследование способности нижней полой вены к спаданию. Изменения диаметра вены при дыхании &gt;50% свидетельствуют о спадании и уменьшении внутрисосудистого объема жидкости [5]. На результат этого исследования могут влиять цирроз печени, хронические сердечно-сосудистые заболевания, искусственная вентиляция легких [6]. Что касается дифференциальной диагностики, то главным заданием является различить потери жидкости и потери крови. Это важно, поскольку тактика инфузионной терапии и оптимальные препараты в этих случаях будут разными [1].\r\n<h2>Лечение</h2>\r\nЛечение дегидратации направлено на замещение потерянной жидкости параллельно с выявлением причины ее потери.\r\n\r\nПри легкой дегидратации с нормальными показателями артериального давления и частоты сердечных сокращений применяется оральная регидратация, а при тяжелой дегидратации, которая сопровождается гипотензией и тахикардией, – внутривенная (сбалансированые растворы кристаллоидов, раствор Рингер-лактат, 0,9% раствор натрия хлорида) [7]. Если пациент способен пить, применяется комбинированная регидратация: сочетание внутривенной и оральной. Следует заметить, что чрезмерная регидратация (преимущественно внутривенная) может вызывать периферические отеки и отек легких [1].\r\n<h2>Рекомендации для пациентов с дегидратацией:</h2>\r\n<ul>\r\n 	<li>пейте воду маленькими глотками;</li>\r\n 	<li>пейте напитки, которые содержат электролиты (соли). Можно пить специальные спортивные напитки или растворы для коррекции обезвоживания;</li>\r\n 	<li>рассасывайте замороженный сок или другие напитки;</li>\r\n 	<li>рассасывайте кусочки льда;</li>\r\n 	<li>если дегидратация возникла через боль во рту при питье и приеме еды, пейте через трубочку.</li>\r\n</ul>\r\nВзрослым рекомендуется употреблять 2-3 л жидкости в сутки [9]. Следует поощрять пациентов пополнять запасы жидкости в соответствии с количеством физических нагрузок.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Алгоритм регидратации у взрослых [8]</strong></p>\r\n<em>Примечание. Этот алгоритм предназначен для применения при дегидратации, вызванной рвотой и / или диареей, и может применяться при незначительной / умеренной тошноте и рвоте беременных. Не используйте его в случае тяжелой дегидратации или чрезмерной рвоте беременных.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Рекомендации относительно профилактики дегидратации:</strong>\r\n<ul>\r\n 	<li>планируйте свой питьевой режим заранее. Если ваш режим дня (работа или отдых) предполагает повышенное потоотделение, физическую активность или тепловое влияние, берите с собой напитки, которые содержат воду и электролиты (соли);</li>\r\n 	<li>избегайте физических нагрузок и пребывания на улице в жаркие дни, особенно при высокой влажности. Если это необходимо, планируйте выход на улицу рано утром и после заката солнца;</li>\r\n 	<li>поощряйте к питью детей и лиц преклонных лет, что вас окружают. Преимущества стоит отдавать напиткам, которые содержат соли;</li>\r\n 	<li>избегайте потребления алкоголя, особенно в жаркие дни, поскольку алкоголь усиливает потери жидкости и нарушает способность человека чувствовать ранние признаки дегидратации;</li>\r\n 	<li>отдавайте преимущество светлой и свободной одежде;</li>\r\n 	<li>пользуйтесь личным веером или спреем с водой;</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Советы по надлежащей гидратации (10)</strong></p>\r\n<strong>Рекомендации по применению жидкости при спортивных нагрузках на улице в жаркую погоду [3]:</strong>\r\n<ul>\r\n 	<li>выпейте 2 чашки воды в течение 2 часов до начала нагрузки и 1-2 чашки воды за 15 минут до начала нагрузки;</li>\r\n 	<li>выпивайте 0,5-1 чашку каждые 15-20 минут нагрузки (если пьете из бутылки, делайте 4-8 средних глотков).</li>\r\n</ul>\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\r\n\r\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\r\n\r\nРeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Составляющая</th>\r\n<th width=\"151\">Содержимое</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\r\n</ul>\r\n<h3>Список литературы</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Оральная регидратация у взрослых','','inherit','closed','closed','','582-revision-v1','','','2021-07-14 10:17:13','2021-07-14 07:17:13','',582,'https://reo.ua/?p=1137',0,'revision','',0),(1138,1,'2021-07-14 10:17:31','2021-07-14 07:17:31','<h2>Оральная регидратация у лиц пожилого возраста</h2>\r\nЛицами преклонных лет считаются люди возрастом свыше 65 лет. В свою очередь, понятие \"гериатрический пациент\" связано прежде всего не с возрастом, а со значительной ослабленностью и множественными заболеваниями. Основная цель ведения гериатрических пациентов – улучшение и поддержка их функционального состояния с целью сохранения способности к самообслуживанию и улучшению качества жизни [1].\r\n\r\nОдной из весомых проблем у лиц преклонного и старческого возраста является дегидратация [1]. Для полноценного функционирования лимфатической, сердечно-сосудистой, пищеварительной и мочевой систем необходимо достаточное количество жидкости. Однако с возрастом происходит уменьшение общего содержания воды в организме, которое ухудшает работу перечисленных систем [2]. Так, у молодого человека суммарное содержание воды в организме представляет приблизительно 60%, а у пациента возрастом 70 лет – приблизительно 40% [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис.</strong> <strong>1. Возрастное уменьшение содержания воды в организме</strong></p>\r\nВсемирная организация здравоохранения рекомендует женщинам преклонных лет употреблять 2,2 л жидкости ежедневно, а мужчинам – 2,9 л. Но в реальной жизни среднестатистический человек возрастом свыше 70 лет употребляет менее 1,5 л [4]. Причинами недостаточного потребления воды в этом возрасте являются физические ограничения, неудовлетворительный доступ к питьевой воде и трудности в посещении туалета, нарушения мышления и психического состояния, прием значительного количества медикаментов, которые могут нарушать водный баланс [2].\r\n<h2><strong>Возрастные особенности, клиническая картина и оценка риска дегидратации</strong></h2>\r\n<strong>Связанные с возрастом особенности дегидратации:</strong>\r\n<ul>\r\n 	<li>меньший резерв жидкости в связи с меньшим процентом содержания ее в организме;</li>\r\n 	<li>уменьшение интенсивности ощущения жажды;</li>\r\n 	<li>снижение соотношения мышечной/жировой ткани (это важно, поскольку в мышцах сохраняется в 2-7 раз больше воды, чем в жировой ткани);</li>\r\n 	<li>трудности в выявлении симптомов дегидратации (меньшая упругость кожи и западение глаз в связи с уменьшением содержащегося коллагена и подкожного жира, частое дыхание в результате хронических болезней легких и сердца, которое приводит к сухости слизистой оболочки рта и утруждает своевременную диагностику обезвоживания);</li>\r\n 	<li>деменция;</li>\r\n 	<li>употребление диуретиков [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Повышенный риск дегидратации у лиц пожилого возраста</strong></p>\r\nДегидратация опасна тем, что связана с рядом потенциально тяжелых патологических состояний.\r\n\r\nРасстройства здоровья, ассоциируемые с дегидратацией:\r\n<ul>\r\n 	<li>падение и переломы;</li>\r\n 	<li>расстройства сознания и мышления;</li>\r\n 	<li>запоры;</li>\r\n 	<li>инфекции мочевыводящей системы;</li>\r\n 	<li>почечная недостаточность;</li>\r\n 	<li>увеличение потенциальной токсичности медикаментов;</li>\r\n 	<li>замедление заживления ран;</li>\r\n 	<li>ортостатическая гипотензия (снижение артериального давления на &gt;20 мм рт. ст. при переходе из горизонтального положения в вертикальное);</li>\r\n 	<li>повышение температуры;</li>\r\n 	<li>ухудшение контроля уровня глюкозы при сахарном диабете [6].</li>\r\n</ul>\r\nПо данным разных исследований, с риском дегидратации ассоциируются разные факторы (табл. 1).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Возраст</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Запор/недержание мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Понос/рвота</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Пищевые ограничения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>Таблица 1. Оценка риска дегидратации у лиц пожилого возраста (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Затрудненное глотание</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Головокружение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ощущение жажды</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Плохое настроение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Прием некоторых препаратов</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Множественные сопутствующие заболевания</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ограниченная подвижность/падения/резкая ослабленность</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Боль</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недавнее стационарное лечение</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повторные инфекции мочевыводящей системы</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Расстройства зрения</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Данные осмотра и наблюдения</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Соотношение принятой и выделенной жидкости за сутки</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериальное давление/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Спутанность сознания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сонливость, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сухость во рту, сухость глаз, сухость кожи</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Лихорадка</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Увеличение частоты дыхания</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Недостаточная упитанность</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Наличие открытых ран</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Потливость</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">Результаты обследований</th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Темный цвет мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Повышенная плотность мочи</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>В общем, все факторы риска дегидратации пожилых людей можно разделить на 4 большие группы (рис. 3)</strong>\r\n\r\nВажнейшие клинические признаки дегидратации: уменьшение потоотделения под мышками, снижение упругости кожи, сухость слизистой оболочки рта, расстройства сознания, которые возникли недавно, темный цвет мочи [16]. Следует также обращать внимание на признаки гиповолемического шока: холодную и липкую кожу, уменьшение выделения мочи, уплощение шейных вен, расстройства сознания, низкий сердечный выброс.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Факторы риска дегидратации у лиц пожилого возраста</strong></p>\r\n\r\n<h2>Особенности регидратации у лиц пожилого возраста</h2>\r\nРегидратация у лиц преклонных лет может быть затруднена когнитивными изменениями пациента, его физическими ограничениями, а также недержанием мочи и, вследствие,  нежеланием употреблять воду. Тактику регидратации следует избирать в зависимости от степени обезвоживания. Так, при легкой дегидратации применяется оральная регидратация, а при умеренной – комбинация оральной и внутривенной (с помощью сбалансированных растворов кристаллоидов). В случае тяжелой дегидратации, основными признаками которой являются гипотензия и тахикардия, назначается внутривенная регидратация, при возможности – в комбинации с оральной.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">Таблица 2. Расчет необходимого количества жидкости для коррекции дегидратации</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\">Расчет</th>\r\n<th colspan=\"2\" width=\"378\">Вес до дегидратации (кг) – вес на данный момент (кг) =дефицит (л)</th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Тактика замещения дефицита</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутки</td>\r\n<td width=\"197\">Доля замещенного дефицита (%)</td>\r\n<td width=\"180\">Базовые ежедневные потребности</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Не менее 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em> Примечание. Суточное употребление жидкости должно включать базовые ежедневные потребности + соответствующую долю дефицита</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПациенты преклонных лет обычно характеризуются большим количеством коморбидных заболеваний и общей ослабленностью. Поэтому у этого контингента особенное значение имеет безопасность тактики любого лечения. Оральная регидратация дает возможность постепенно восполнить дефицит жидкости и электролитов физиологичным путем и имеет ряд других преимуществ.\r\n<h2>Профилактика</h2>\r\n<strong>Преимущества оральной регидратации над внутривенной [17]:</strong>\r\n<ul>\r\n 	<li>более физиологичная, чем внутривенная;</li>\r\n 	<li>высокая эффективность;</li>\r\n 	<li>отличный профиль безопасности (без риска развития осложнений, присущих инфузиям);</li>\r\n 	<li>низкая стоимость.</li>\r\n</ul>\r\n<strong> Рекомендации по профилактике дегидратации у лиц преклонных лет [16]:</strong>\r\n<ul>\r\n 	<li>используйте яркие чашки;</li>\r\n 	<li>применяйте кулеры и баллоны с водой;</li>\r\n 	<li>предлагайте воду раз в 1,5 часа и после определенных действий (принятия душа, посещения туалета, приема лекарств);</li>\r\n 	<li>поощряйте запивание еды и употребление жидкой еды (суп, желе, йогурт, пюре из фруктов, мороженое);</li>\r\n 	<li>ведите журнал учета питья и мочеотделения;</li>\r\n 	<li>если наблюдается дегидратация с потерей &gt;4% массы тела на протяжении 7 дней, целесообразно на 3 дня назначить активную оральную регидратацию;</li>\r\n 	<li>в случае тяжелой дегидратации необходимы госпитализация и внутривенная регидратация.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">Таблица 3. Потребность в жидкости зависимо от массы тела (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вес (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\">Потребность в жидкости (л/сутки)</th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 4. Советы по увеличению употребления воды</strong></p>\r\n\r\n<h2>Вода для медицинских целей РеО («Юрия-Фарм»)</h2>\r\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, содержащим все необходимые электролиты и сорбитол. Сорбитол – это дополнительный источник энергии, который усваивается клетками организма без участия инсулина. РeО не содержит консервантов, красителей и имеет приятный вкус.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 4. Сбалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Компонент</th>\r\n<th width=\"151\">Содержание</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\r\n</ul>\r\n<h2>Список литературы</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Оральная регидратация у лиц пожилого возраста','','inherit','closed','closed','','577-revision-v1','','','2021-07-14 10:17:31','2021-07-14 07:17:31','',577,'https://reo.ua/?p=1138',0,'revision','',0),(1139,1,'2021-07-14 10:23:33','2021-07-14 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11:11:08','',1165,'https://reo.ua/?p=1187',0,'revision','',0),(1188,1,'2021-07-14 17:31:29','2021-07-14 14:31:29','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\"><img class=\"aligncenter size-full wp-image-1192\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\" alt=\"\" width=\"952\" height=\"1141\" /></a>\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','publish','open','open','','aptechna-pitna-voda-shho-poraditi','','','2021-07-14 17:37:52','2021-07-14 14:37:52','',0,'https://reo.ua/?p=1188',9,'post','',0),(1189,1,'2021-07-14 17:29:08','2021-07-14 14:29:08','','3. Вибір аптечної води. Що порадити відвідувачу аптеки_укр_ИСХОДНИК','','inherit','open','closed','','3-vibir-aptechno%d1%97-vodi-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik','','','2021-07-14 17:29:08','2021-07-14 14:29:08','',1188,'https://reo.ua/wp-content/uploads/2021/07/3.-vibir-aptechnoї-vodi.-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik.pdf',0,'attachment','application/pdf',0),(1190,1,'2021-07-14 17:29:08','2021-07-14 14:29:08','','3. Вибір аптечної води. Що порадити відвідувачу аптеки_укр_ИСХОДНИК','','inherit','open','closed','','3-vibir-aptechno%d1%97-vodi-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik-2','','','2021-07-14 17:29:08','2021-07-14 14:29:08','',1197,'https://reo.ua/wp-content/uploads/2021/07/3.-vibir-aptechnoї-vodi.-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik.pdf',0,'attachment','application/pdf',0),(1191,1,'2021-07-14 17:31:29','2021-07-14 14:31:29','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<strong>Ситуація №1.</strong>\r\n\r\nВідвідувач: Порадьте щось для дитини! Вона щось не те з’їла і тепер має пронос.\r\n\r\nПровізор: Вам необхідно звернутися до лікаря! Тим часом можете розпочати питну регідратацію – відпоювання, оскільки втрата води та солей при проносі може бути небезпечною для дитини. Для комфортного та фізіологічного усунення зневоднення підійде спеціальна вода ReO, якій властивий оптимальний склад мікроелементів та низька мінералізація. Вживання води ReO допоможе швидко та безпечно усунути симптоми зневоднення.\r\n\r\n<strong>Ситуація №2.</strong>\r\n\r\nВідвідувачка: У мене сильний токсикоз, часто блюю. Порадьте щось від нудоти, будь ласка!\r\n\r\nПровізор: Блювання при токсикозі – це втрата не лише води, а й важливих мікроелементів, потреба в яких у вагітних є вищою. Для уникнення і вашого зневоднення, і зневоднення плоду, пийте спеціальну воду для регідратації ReO. У цій воді містяться натрій та калій у фізіологічних концентраціях, а також необхідні речовини. Вода ReO швидко знижує вміст токсинів і ліквідує ознаки дегідратації, тому після пиття цієї води майже одразу настає полегшення.\r\n\r\n<strong>Ситуація №3.</strong>\r\n\r\nВідвідувач: Будь ласка, дайте щось від похмілля.\r\n\r\nПровізор: Можу запропонувати спеціальну воду для регідратації та дезінтоксикації ReO. Ця вода ефективно тамує спрагу, поповнює запаси електролітів, допомагає знешкодити і вивести токсини, внаслідок чого швидко покращується самопочуття. Вона приємна на смак, і тому її легко пити навіть на тлі нудоти.\r\n\r\n<strong>Ситуація №4.</strong>\r\n\r\nВідвідувачка: Маю вірусну інфекцію з високою температурою і весь час хочу пити. Підкажіть, будь ласка, чим можна цьому зарадити?\r\n\r\nПровізор: Висока температура при вірусних інфекціях завжди спричиняє зневоднення, що сповільнює одужання. Для відновлення запасів рідини та електролітів і швидшого відновлення нормального самопочуття варто пити воду для медичних цілей ReO.\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','inherit','closed','closed','','1188-revision-v1','','','2021-07-14 17:31:29','2021-07-14 14:31:29','',1188,'https://reo.ua/?p=1191',0,'revision','',0),(1192,1,'2021-07-14 17:31:52','2021-07-14 14:31:52','','schem-81-ua','','inherit','open','closed','','schem-81-ua','','','2021-07-14 17:31:52','2021-07-14 14:31:52','',1188,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg',0,'attachment','image/jpeg',0),(1193,1,'2021-07-14 17:31:52','2021-07-14 14:31:52','','schem-81-ua','','inherit','open','closed','','schem-81-ua-2','','','2021-07-14 17:31:52','2021-07-14 14:31:52','',1197,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg',0,'attachment','image/jpeg',0),(1195,1,'2021-07-14 17:33:04','2021-07-14 14:33:04','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n\r\n&nbsp;\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\"><img class=\"aligncenter size-full wp-image-1192\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\" alt=\"\" width=\"952\" height=\"1141\" /></a>\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','inherit','closed','closed','','1188-revision-v1','','','2021-07-14 17:33:04','2021-07-14 14:33:04','',1188,'https://reo.ua/?p=1195',0,'revision','',0),(1194,1,'2021-07-14 17:31:59','2021-07-14 14:31:59','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\"><img class=\"aligncenter size-full wp-image-1192\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\" alt=\"\" width=\"952\" height=\"1141\" /></a>\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<strong>Ситуація №1.</strong>\r\n\r\nВідвідувач: Порадьте щось для дитини! Вона щось не те з’їла і тепер має пронос.\r\n\r\nПровізор: Вам необхідно звернутися до лікаря! Тим часом можете розпочати питну регідратацію – відпоювання, оскільки втрата води та солей при проносі може бути небезпечною для дитини. Для комфортного та фізіологічного усунення зневоднення підійде спеціальна вода ReO, якій властивий оптимальний склад мікроелементів та низька мінералізація. Вживання води ReO допоможе швидко та безпечно усунути симптоми зневоднення.\r\n\r\n<strong>Ситуація №2.</strong>\r\n\r\nВідвідувачка: У мене сильний токсикоз, часто блюю. Порадьте щось від нудоти, будь ласка!\r\n\r\nПровізор: Блювання при токсикозі – це втрата не лише води, а й важливих мікроелементів, потреба в яких у вагітних є вищою. Для уникнення і вашого зневоднення, і зневоднення плоду, пийте спеціальну воду для регідратації ReO. У цій воді містяться натрій та калій у фізіологічних концентраціях, а також необхідні речовини. Вода ReO швидко знижує вміст токсинів і ліквідує ознаки дегідратації, тому після пиття цієї води майже одразу настає полегшення.\r\n\r\n<strong>Ситуація №3.</strong>\r\n\r\nВідвідувач: Будь ласка, дайте щось від похмілля.\r\n\r\nПровізор: Можу запропонувати спеціальну воду для регідратації та дезінтоксикації ReO. Ця вода ефективно тамує спрагу, поповнює запаси електролітів, допомагає знешкодити і вивести токсини, внаслідок чого швидко покращується самопочуття. Вона приємна на смак, і тому її легко пити навіть на тлі нудоти.\r\n\r\n<strong>Ситуація №4.</strong>\r\n\r\nВідвідувачка: Маю вірусну інфекцію з високою температурою і весь час хочу пити. Підкажіть, будь ласка, чим можна цьому зарадити?\r\n\r\nПровізор: Висока температура при вірусних інфекціях завжди спричиняє зневоднення, що сповільнює одужання. Для відновлення запасів рідини та електролітів і швидшого відновлення нормального самопочуття варто пити воду для медичних цілей ReO.\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','inherit','closed','closed','','1188-revision-v1','','','2021-07-14 17:31:59','2021-07-14 14:31:59','',1188,'https://reo.ua/?p=1194',0,'revision','',0),(1196,1,'2021-07-14 17:33:18','2021-07-14 14:33:18','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\"><img class=\"aligncenter size-full wp-image-1192\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\" alt=\"\" width=\"952\" height=\"1141\" /></a>\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','inherit','closed','closed','','1188-revision-v1','','','2021-07-14 17:33:18','2021-07-14 14:33:18','',1188,'https://reo.ua/?p=1196',0,'revision','',0),(1197,1,'2021-07-14 17:31:29','2021-07-14 14:31:29','Во многих странах минеральную воду можно приобрести лишь в аптеках. Таким образом подчеркивают ее лечебные свойства, о которых думали великие врачи Архигинес, Гиппократ, Гален еще с древних времен. И сейчас её целительные свойства не уменьшились – наоборот, исследования показывают новые преимущества в результате правильного употребления нужной воды, в правильное время и при верных показания.\r\nНо возникает вопрос: в каких случаях можно рекомендовать аптечную воду посетителям?\r\nНа примере специальной воды РеО для регидратации и дезинтоксикации организма от ведущей Международной специализированной фармацевтической корпорации «Юрия-Фарм» посмотрим, когда данный продукт является целесообразным для употребления.\r\n<h2>Матрица жизни</h2>\r\nВода – самое распространенное соединение водорода и кислорода в природе. Это универсальный растворитель многих веществ, поэтому химически чистой воды в природе не существует.\r\n\r\nПричем вода, которая содержится в организме, качественно отличается от обычной, поскольку она структурирована.\r\n\r\nТакие кристаллические структуры воды – матрица жизни. Их присутствие дает возможность протекания важных биофизических процессов и биохимических реакций. Недостаточное поступление воды в организм или чрезмерная ее потеря приводят к обезвоживанию.\r\n\r\nПричинами обезвоживания могут быть диарея и рвота – не только при отравлениях, но и при токсикозе беременных; интенсивные физические нагрузки; алкогольная интоксикация; лихорадка; острые кишечные инфекции.\r\n\r\nВ любом случае дефицит воды и солей приводит к негативным последствиям для организма.\r\n\r\nВ частности, обезвоживание при длительной рвоте или диарее, за данными экспертов ВООЗ, является частой причиной детской заболеваемости и смертности, а также важной причиной истощения, вследствие недостаточного поступления в организм питательных веществ.\r\n\r\nУ взрослых дегидратация нередко приводит к сгущению крови, повышению риска тромбообразования; сопровождается нарушением сердечного ритма и снижением артериального давления, поэтому очень важно вовремя и правильно пополнять дефицит жидкости и электролитов в организме.\r\n\r\nКстати говоря, каждый второй украинец в той или иной мере страдает от обезвоживания. Поэтому проблема является весьма актуальной.\r\n\r\nНо необходимо помнить: в границах фармацевтической помощи мы можем давать совет лишь в неосложненных случаях.\r\n\r\nЕсли имеют место угрожающие симптомы сильного обезвоживания (ухудшение общего самочувствия, отсутствие слюны, бледность, запавшие глаза, аномальное дыхание, плач без слез), необходимо срочно вызвать скорую помощь.\r\n<h2>Сбалансированный состав</h2>\r\nОбращаем ваше внимание на то, что питье должно не только восстанавливать уровень жидкости, но и компенсировать потерю солей, а также покрывать энергетические потребности организма.\r\n\r\nНе стоит забывать о том, что потеря жидкости и электролитов приводит к нарушению рН крови в кислую сторону и в результате к нарушению работы важнейших органов и систем.\r\nВот почему «просто пить» во время интоксикации – это не выход. Вода поможет. Но не любая.\r\n\r\nХорошая рекомендация для устранения обезвоживания – специальная вода РеО, которая имеет хорошо сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n\r\nВ составе воды для медицинских целей РеО содержится оптимальный состав микроэлементов, в первую очередь натрия и калия, которые интенсивно теряет организм во время обезвоживания. Также в этой воде есть необходимые организму порции кальция, магния, гидрокарбонатов и хлоридов. Таким образом, вода помогает быстро возобновить кислотно-щелочной баланс.\r\n<h2>Качество и вкусовые свойства</h2>\r\nКстати говоря, слабогазированная вода РеО – это первая вода для медицинских целей, которую разработали для максимально быстрого всасывания воды и электролитов.\r\nВода снижает концентрацию токсических продуктов и устраняет признаки дегидратации. Важное значение в этом процессе имеет уровень ее минерализации – 2500-3000 мг/дм 3, что делает ее водой малой минерализации. Дело в том, что маломинерализованная лечебная вода оказывает более сложное действие, чем вода с высокой минерализацией. Работает правило: чем более сложным является раствор, тем большее количество солей распадается на ионы, а именно они влияют на организм. Маломинерализованные воды на более длительное время задерживаются в желудке, чем воды средней или высокой минерализации, всасываются практически полностью в тонкой кишке, не требуют дополнительных затрат энергии или времени для распада минеральной воды на ионы, получая их уже готовыми для процесса всасывания.\r\n\r\nИменно поэтому вода для медицинских целей РеО так быстро устраняет признаки обезвоживания и помогает улучшить самочувствие человека.\r\n\r\nВода рекомендована при состояниях, которые сопровождаются дегидратацией и интоксикацией организма, среди которых – токсикоз у беременных, физические нагрузки, острые кишечные инфекции у детей, алкогольная интоксикация, отравления, диарея, лихорадка.\r\n\r\nВода РеО имеет приятный солоноватый вкус, ее легко пить и можно принимать даже при тошноте.\r\n\r\nОтличные вкусовые качества воды обеспечивают более комфортное отпаивание не только у взрослых, но и у детей.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав воды для медицинских целей РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\">Концентрация</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому стоит посоветовать воду для медицинских целей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\r\n\r\nReO - больше, чем вода!','Выбор аптечной воды','','publish','open','open','','aptechna-pitna-voda-shho-poraditi','','','2021-07-14 17:49:00','2021-07-14 14:49:00','',0,'https://reo.ua/bez-kategorii/aptechna-pitna-voda-shho-poraditi/',10,'post','',0),(1198,1,'2021-07-14 17:34:33','2021-07-14 14:34:33','У деяких країнах світу продаж мінеральної води є прерогативою аптек. Це підкреслює лікувальні властивості мінеральних вод, які були помічені ще славетними медиками давнини: Архігінесом, Гіппократом та Галеном. У наш час клінічні дослідження підтверджують лікувальні якості мінеральних вод і виявляють переваги їх належного споживання. Фармацевт може не знати, у яких випадках варто порадити відвідувачам придбати аптечну воду. У цьому матеріалі ми розглянемо доцільність придбання питної води для медичних цілей на прикладі спеціальної води для регідратації та дезінтоксикації організму ReO від «Юрія-Фарм», Україна.\r\n<h2>Вода як основа життя</h2>\r\nВода – це найбільш поширена на нашій планеті сполука кисню та водню. Оскільки вода є універсальним розчинником для багатьох сполук, абсолютно хімічно чистої води в природі немає. Вода біологічних рідин організму є структурованою, чим і відрізняється від звичайної води. Саме наявність кристалічних структур води дає можливість відбуватися каскадам біохімічних реакцій та біофізичних перетворень.\r\n\r\nЗневоднення є небезпечним для життя та здоров’я людини станом, який може бути наслідком недостатнього надходження води або, навпаки, надмірної її втрати. Серед найпоширеніших причин зневоднення – пронос та гострі кишкові інфекції, блювання при отруєнні чи токсикозі вагітних, високий рівень фізичної активності, гарячка, алкогольна інтоксикація тощо.\r\n\r\nНезалежно від того, чим обумовлене зневоднення, дефіцит води та мінеральних солей супроводжується несприятливими наслідками для організму людини. За статистикою Всесвітньої організації охорони здоров’я, зневоднення внаслідок тривалого блювання чи проносу є частою причиною захворюваності та смертності дітей. Таке зневоднення є також однією із причин виснаження, оскільки при нестачі води порушується надходження в організм поживних речовин. Своєю чергою у дорослих дегідратація підвищує ризик тромбоутворення внаслідок згущення крові, а також нерідко супроводжується падінням артеріального тиску та порушеннями серцевого ритму.\r\n\r\nНаведені наслідки дегідратації обумовлюють важливість вчасної корекції дефіциту води та солей. Актуальність проблеми важко переоцінити, оскільки, за даними статистики, половина українців тою чи іншою мірою страждає від зневоднення.\r\n\r\nСлід пам’ятати, що фармацевт може надавати поради лише в легких та неускладнених ситуаціях. За наявності так званих «червоних прапорців» – ознак дегідратації, що загрожують життю, до яких належать погіршення самопочуття, відсутність виділення слини та сліз, блідість, запалі очі та розлади дихання, необхідно негайно звернутися до лікаря.\r\n<h2>Оптимальний склад напою для регідратації</h2>\r\nДля належного відновлення водно-сольового балансу напій повинен не лише поповнювати втрати рідини, але й відновлювати вміст солей та сприяти забезпеченню енергетичних потреб організму. Тому звичайна вода не завжди може допомогти.\r\n\r\nВдалим вибором для ліквідації зневоднення є спеціальна вода для регідратації та дезінтоксикації ReO від «Юрія-Фарм», Україна, якій властивий ретельно продуманий збалансований водно-сольовий склад. Перевагою води ReO є також відсутність консервантів, барвників і вуглеводів.\r\n\r\nВода для медичних цілей ReO містить базовий набір необхідних мікроелементів, передусім, натрію та калію, які переважно втрачаються при зневодненні. Іншими складниками води ReO є кальцій, магній, гідрокарбонати та хлориди у фізіологічних пропорціях. Слід зазначити, що втрата рідини та електролітів зсуває pH крові у кислий бік, призводячи до дисфункції багатьох органів і систем. За рахунок гідрокарбонатів вода ReO дає можливість вирівняти не лише водно-сольову, а й кислотно-лужну рівновагу.\r\n<h2>Значення мінералізації</h2>\r\nСлабогазована питна вода ReO є першою на фармацевтичному ринку України водою для медичних цілей, розробленою для максимально швидкого всмоктування води та іонів. Ця вода не лише усуває симптоми дегідратації, а й зменшує концентрацію токсинів у крові.\r\n\r\nОднією з передумов високої ефективності води ReO є низький рівень мінералізації — 2500-3000 мг/дм3. Відомо, що мінеральні води низької мінералізації здатні чинити складнішу лікувальну дію, ніж води великої мінералізації. Це пояснюється тим, що чим слабкішим є розчин, тим більша кількість солей у ньому розпадається на іони – активні складники мінеральної води. Крім того, води низької мінералізації довше затримуються в шлунку, ніж середньо- та високомінералізовані, а також майже повністю всмоктуються в тонкому кишківнику, не вимагаючи додаткових витрат енергії та часу для розпаду мінеральної води на іони.\r\n\r\nЗавдяки цьому низькомінералізована вода ReO дозволяє швидко покращити самопочуття людини за рахунок усунення неприємних симптомів зневоднення.\r\n\r\nВживання даної води рекомендовано при різного роду дегідратації та інтоксикації, зокрема при токсикозі вагітних, високоінтенсивних фізичних навантаженнях, гострих кишкових інфекціях, алкогольній чи іншій інтоксикації, отруєнні, проносі, гарячці.\r\n\r\nЛегкий солонуватий присмак води ReO дає змогу застосовувати її і для дорослих, і для дітей навіть при нудоті.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому варто порадити воду для медичних цілей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\"><img class=\"aligncenter size-full wp-image-1192\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg\" alt=\"\" width=\"952\" height=\"1141\" /></a>\r\n\r\nReO – більше, ніж вода!','Аптечна питна вода: що порадити?','','inherit','closed','closed','','1197-revision-v1','','','2021-07-14 17:34:33','2021-07-14 14:34:33','',1197,'https://reo.ua/?p=1198',0,'revision','',0),(1199,1,'2021-07-14 17:37:49','2021-07-14 14:37:49','','prev','','inherit','open','closed','','prev','','','2021-07-14 17:37:49','2021-07-14 14:37:49','',1188,'https://reo.ua/wp-content/uploads/2021/07/prev.png',0,'attachment','image/png',0),(1200,1,'2021-07-14 17:37:49','2021-07-14 14:37:49','','prev','','inherit','open','closed','','prev-2','','','2021-07-14 17:37:49','2021-07-14 14:37:49','',1197,'https://reo.ua/wp-content/uploads/2021/07/prev.png',0,'attachment','image/png',0),(1201,1,'2021-07-14 17:46:40','2021-07-14 14:46:40','Во многих странах минеральную воду можно приобрести лишь в аптеках. Таким образом подчеркивают ее лечебные свойства, о которых думали великие врачи Архигинес, Гиппократ, Гален еще с древних времен. И сейчас её целительные свойства не уменьшились – наоборот, исследования показывают новые преимущества в результате правильного употребления нужной воды, в правильное время и при верных показания.\nНо возникает вопрос: в каких случаях можно рекомендовать аптечную воду посетителям?\nНа примере специальной воды РеО для регидратации и дезинтоксикации организма от ведущей Международной специализированной фармацевтической корпорации «Юрия-Фарм» посмотрим, когда данный продукт является целесообразным для употребления.\n<h2>Матрица жизни</h2>\nВода – самое распространенное соединение водорода и кислорода в природе. Это универсальный растворитель многих веществ, поэтому химически чистой воды в природе не существует.\n\nПричем вода, которая содержится в организме, качественно отличается от обычной, поскольку она структурирована.\n\nТакие кристаллические структуры воды – матрица жизни. Их присутствие дает возможность протекания важных биофизических процессов и биохимических реакций. Недостаточное поступление воды в организм или чрезмерная ее потеря приводят к обезвоживанию.\n\nПричинами обезвоживания могут быть диарея и рвота – не только при отравлениях, но и при токсикозе беременных; интенсивные физические нагрузки; алкогольная интоксикация; лихорадка; острые кишечные инфекции.\n\nВ любом случае дефицит воды и солей приводит к негативным последствиям для организма.\n\nВ частности, обезвоживание при длительной рвоте или диарее, за данными экспертов ВООЗ, является частой причиной детской заболеваемости и смертности, а также важной причиной истощения, вследствие недостаточного поступления в организм питательных веществ.\n\nУ взрослых дегидратация нередко приводит к сгущению крови, повышению риска тромбообразования; сопровождается нарушением сердечного ритма и снижением артериального давления, поэтому очень важно вовремя и правильно пополнять дефицит жидкости и электролитов в организме.\n\nКстати говоря, каждый второй украинец в той или иной мере страдает от обезвоживания. Поэтому проблема является весьма актуальной.\n\nНо необходимо помнить: в границах фармацевтической помощи мы можем давать совет лишь в неосложненных случаях.\n\nЕсли имеют место угрожающие симптомы сильного обезвоживания (ухудшение общего самочувствия, отсутствие слюны, бледность, запавшие глаза, аномальное дыхание, плач без слез), необходимо срочно вызвать скорую помощь.\n<h2>Сбалансированный состав</h2>\nОбращаем ваше внимание на то, что питье должно не только восстанавливать уровень жидкости, но и компенсировать потерю солей, а также покрывать энергетические потребности организма.\n\nНе стоит забывать о том, что потеря жидкости и электролитов приводит к нарушению рН крови в кислую сторону и в результате к нарушению работы важнейших органов и систем.\nВот почему «просто пить» во время интоксикации – это не выход. Вода поможет. Но не любая.\n\nХорошая рекомендация для устранения обезвоживания – специальная вода РеО, которая имеет хорошо сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\n\nВ составе воды для медицинских целей РеО содержится оптимальный состав микроэлементов, в первую очередь натрия и калия, которые интенсивно теряет организм во время обезвоживания. Также в этой воде есть необходимые организму порции кальция, магния, гидрокарбонатов и хлоридов. Таким образом, вода помогает быстро возобновить кислотно-щелочной баланс.\n<h2>Качество и вкусовые свойства</h2>\nКстати говоря, слабогазированная вода РеО – это первая вода для медицинских целей, которую разработали для максимально быстрого всасывания воды и электролитов.\nВода снижает концентрацию токсических продуктов и устраняет признаки дегидратации. Важное значение в этом процессе имеет уровень ее минерализации – 2500-3000 мг/дм 3, что делает ее водой малой минерализации. Дело в том, что маломинерализованная лечебная вода оказывает более сложное действие, чем вода с высокой минерализацией. Работает правило: чем более сложным является раствор, тем большее количество солей распадается на ионы, а именно они влияют на организм. Маломинерализованные воды на более длительное время задерживаются в желудке, чем воды средней или высокой минерализации, всасываются практически полностью в тонкой кишке, не требуют дополнительных затрат энергии или времени для распада минеральной воды на ионы, получая их уже готовыми для процесса всасывания.\n\nИменно поэтому вода для медицинских целей РеО так быстро устраняет признаки обезвоживания и помогает улучшить самочувствие человека. Вода рекомендована при состояниях, которые сопровождаются дегидратацией и интоксикацией организма, среди которых – токсикоз у беременных, физические нагрузки, острые кишечные инфекции у детей, алкогольная интоксикация, отравления, диарея, лихорадка.\n\nВода РеО имеет приятный солоноватый вкус, ее легко пить и можно принимать даже при тошноте.\n\nОтличные вкусовые качества воды обеспечивают более комфортное отпаивание не только у взрослых, но и у детей.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. Состав воды для медицинских целей РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Компонент</strong></th>\n<th width=\"151\">Концентрация</th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n&nbsp;\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\n\nСостав воды для медицинских целей РеО\n\nБлиц рекомендация воды для медицинских целей РеО','Выбор аптечной воды','','inherit','closed','closed','','1197-autosave-v1','','','2021-07-14 17:46:40','2021-07-14 14:46:40','',1197,'https://reo.ua/?p=1201',0,'revision','',0),(1202,1,'2021-07-14 17:43:54','2021-07-14 14:43:54','','schem-81-ru','','inherit','open','closed','','schem-81-ru','','','2021-07-14 17:43:54','2021-07-14 14:43:54','',1197,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg',0,'attachment','image/jpeg',0),(1203,1,'2021-07-14 17:43:54','2021-07-14 14:43:54','','schem-81-ru','','inherit','open','closed','','schem-81-ru','','','2021-07-14 17:43:54','2021-07-14 14:43:54','',1188,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg',0,'attachment','image/jpeg',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (1204,1,'2021-07-14 17:48:26','2021-07-14 14:48:26','Во многих странах минеральную воду можно приобрести лишь в аптеках. Таким образом подчеркивают ее лечебные свойства, о которых думали великие врачи Архигинес, Гиппократ, Гален еще с древних времен. И сейчас её целительные свойства не уменьшились – наоборот, исследования показывают новые преимущества в результате правильного употребления нужной воды, в правильное время и при верных показания.\r\nНо возникает вопрос: в каких случаях можно рекомендовать аптечную воду посетителям?\r\nНа примере специальной воды РеО для регидратации и дезинтоксикации организма от ведущей Международной специализированной фармацевтической корпорации «Юрия-Фарм» посмотрим, когда данный продукт является целесообразным для употребления.\r\n<h2>Матрица жизни</h2>\r\nВода – самое распространенное соединение водорода и кислорода в природе. Это универсальный растворитель многих веществ, поэтому химически чистой воды в природе не существует.\r\n\r\nПричем вода, которая содержится в организме, качественно отличается от обычной, поскольку она структурирована.\r\n\r\nТакие кристаллические структуры воды – матрица жизни. Их присутствие дает возможность протекания важных биофизических процессов и биохимических реакций. Недостаточное поступление воды в организм или чрезмерная ее потеря приводят к обезвоживанию.\r\n\r\nПричинами обезвоживания могут быть диарея и рвота – не только при отравлениях, но и при токсикозе беременных; интенсивные физические нагрузки; алкогольная интоксикация; лихорадка; острые кишечные инфекции.\r\n\r\nВ любом случае дефицит воды и солей приводит к негативным последствиям для организма.\r\n\r\nВ частности, обезвоживание при длительной рвоте или диарее, за данными экспертов ВООЗ, является частой причиной детской заболеваемости и смертности, а также важной причиной истощения, вследствие недостаточного поступления в организм питательных веществ.\r\n\r\nУ взрослых дегидратация нередко приводит к сгущению крови, повышению риска тромбообразования; сопровождается нарушением сердечного ритма и снижением артериального давления, поэтому очень важно вовремя и правильно пополнять дефицит жидкости и электролитов в организме.\r\n\r\nКстати говоря, каждый второй украинец в той или иной мере страдает от обезвоживания. Поэтому проблема является весьма актуальной.\r\n\r\nНо необходимо помнить: в границах фармацевтической помощи мы можем давать совет лишь в неосложненных случаях.\r\n\r\nЕсли имеют место угрожающие симптомы сильного обезвоживания (ухудшение общего самочувствия, отсутствие слюны, бледность, запавшие глаза, аномальное дыхание, плач без слез), необходимо срочно вызвать скорую помощь.\r\n<h2>Сбалансированный состав</h2>\r\nОбращаем ваше внимание на то, что питье должно не только восстанавливать уровень жидкости, но и компенсировать потерю солей, а также покрывать энергетические потребности организма.\r\n\r\nНе стоит забывать о том, что потеря жидкости и электролитов приводит к нарушению рН крови в кислую сторону и в результате к нарушению работы важнейших органов и систем.\r\nВот почему «просто пить» во время интоксикации – это не выход. Вода поможет. Но не любая.\r\n\r\nХорошая рекомендация для устранения обезвоживания – специальная вода РеО, которая имеет хорошо сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n\r\nВ составе воды для медицинских целей РеО содержится оптимальный состав микроэлементов, в первую очередь натрия и калия, которые интенсивно теряет организм во время обезвоживания. Также в этой воде есть необходимые организму порции кальция, магния, гидрокарбонатов и хлоридов. Таким образом, вода помогает быстро возобновить кислотно-щелочной баланс.\r\n<h2>Качество и вкусовые свойства</h2>\r\nКстати говоря, слабогазированная вода РеО – это первая вода для медицинских целей, которую разработали для максимально быстрого всасывания воды и электролитов.\r\nВода снижает концентрацию токсических продуктов и устраняет признаки дегидратации. Важное значение в этом процессе имеет уровень ее минерализации – 2500-3000 мг/дм 3, что делает ее водой малой минерализации. Дело в том, что маломинерализованная лечебная вода оказывает более сложное действие, чем вода с высокой минерализацией. Работает правило: чем более сложным является раствор, тем большее количество солей распадается на ионы, а именно они влияют на организм. Маломинерализованные воды на более длительное время задерживаются в желудке, чем воды средней или высокой минерализации, всасываются практически полностью в тонкой кишке, не требуют дополнительных затрат энергии или времени для распада минеральной воды на ионы, получая их уже готовыми для процесса всасывания.\r\n\r\nИменно поэтому вода для медицинских целей РеО так быстро устраняет признаки обезвоживания и помогает улучшить самочувствие человека.\r\n\r\nВода рекомендована при состояниях, которые сопровождаются дегидратацией и интоксикацией организма, среди которых – токсикоз у беременных, физические нагрузки, острые кишечные инфекции у детей, алкогольная интоксикация, отравления, диарея, лихорадка.\r\n\r\nВода РеО имеет приятный солоноватый вкус, ее легко пить и можно принимать даже при тошноте.\r\n\r\nОтличные вкусовые качества воды обеспечивают более комфортное отпаивание не только у взрослых, но и у детей.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав воды для медицинских целей РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\">Концентрация</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому стоит посоветовать воду для медицинских целей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\r\n\r\nReO - больше, чем вода!','Выбор аптечной воды','','inherit','closed','closed','','1197-revision-v1','','','2021-07-14 17:48:26','2021-07-14 14:48:26','',1197,'https://reo.ua/?p=1204',0,'revision','',0),(1205,1,'2021-07-14 17:49:00','2021-07-14 14:49:00','Во многих странах минеральную воду можно приобрести лишь в аптеках. Таким образом подчеркивают ее лечебные свойства, о которых думали великие врачи Архигинес, Гиппократ, Гален еще с древних времен. И сейчас её целительные свойства не уменьшились – наоборот, исследования показывают новые преимущества в результате правильного употребления нужной воды, в правильное время и при верных показания.\r\nНо возникает вопрос: в каких случаях можно рекомендовать аптечную воду посетителям?\r\nНа примере специальной воды РеО для регидратации и дезинтоксикации организма от ведущей Международной специализированной фармацевтической корпорации «Юрия-Фарм» посмотрим, когда данный продукт является целесообразным для употребления.\r\n<h2>Матрица жизни</h2>\r\nВода – самое распространенное соединение водорода и кислорода в природе. Это универсальный растворитель многих веществ, поэтому химически чистой воды в природе не существует.\r\n\r\nПричем вода, которая содержится в организме, качественно отличается от обычной, поскольку она структурирована.\r\n\r\nТакие кристаллические структуры воды – матрица жизни. Их присутствие дает возможность протекания важных биофизических процессов и биохимических реакций. Недостаточное поступление воды в организм или чрезмерная ее потеря приводят к обезвоживанию.\r\n\r\nПричинами обезвоживания могут быть диарея и рвота – не только при отравлениях, но и при токсикозе беременных; интенсивные физические нагрузки; алкогольная интоксикация; лихорадка; острые кишечные инфекции.\r\n\r\nВ любом случае дефицит воды и солей приводит к негативным последствиям для организма.\r\n\r\nВ частности, обезвоживание при длительной рвоте или диарее, за данными экспертов ВООЗ, является частой причиной детской заболеваемости и смертности, а также важной причиной истощения, вследствие недостаточного поступления в организм питательных веществ.\r\n\r\nУ взрослых дегидратация нередко приводит к сгущению крови, повышению риска тромбообразования; сопровождается нарушением сердечного ритма и снижением артериального давления, поэтому очень важно вовремя и правильно пополнять дефицит жидкости и электролитов в организме.\r\n\r\nКстати говоря, каждый второй украинец в той или иной мере страдает от обезвоживания. Поэтому проблема является весьма актуальной.\r\n\r\nНо необходимо помнить: в границах фармацевтической помощи мы можем давать совет лишь в неосложненных случаях.\r\n\r\nЕсли имеют место угрожающие симптомы сильного обезвоживания (ухудшение общего самочувствия, отсутствие слюны, бледность, запавшие глаза, аномальное дыхание, плач без слез), необходимо срочно вызвать скорую помощь.\r\n<h2>Сбалансированный состав</h2>\r\nОбращаем ваше внимание на то, что питье должно не только восстанавливать уровень жидкости, но и компенсировать потерю солей, а также покрывать энергетические потребности организма.\r\n\r\nНе стоит забывать о том, что потеря жидкости и электролитов приводит к нарушению рН крови в кислую сторону и в результате к нарушению работы важнейших органов и систем.\r\nВот почему «просто пить» во время интоксикации – это не выход. Вода поможет. Но не любая.\r\n\r\nХорошая рекомендация для устранения обезвоживания – специальная вода РеО, которая имеет хорошо сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n\r\nВ составе воды для медицинских целей РеО содержится оптимальный состав микроэлементов, в первую очередь натрия и калия, которые интенсивно теряет организм во время обезвоживания. Также в этой воде есть необходимые организму порции кальция, магния, гидрокарбонатов и хлоридов. Таким образом, вода помогает быстро возобновить кислотно-щелочной баланс.\r\n<h2>Качество и вкусовые свойства</h2>\r\nКстати говоря, слабогазированная вода РеО – это первая вода для медицинских целей, которую разработали для максимально быстрого всасывания воды и электролитов.\r\nВода снижает концентрацию токсических продуктов и устраняет признаки дегидратации. Важное значение в этом процессе имеет уровень ее минерализации – 2500-3000 мг/дм 3, что делает ее водой малой минерализации. Дело в том, что маломинерализованная лечебная вода оказывает более сложное действие, чем вода с высокой минерализацией. Работает правило: чем более сложным является раствор, тем большее количество солей распадается на ионы, а именно они влияют на организм. Маломинерализованные воды на более длительное время задерживаются в желудке, чем воды средней или высокой минерализации, всасываются практически полностью в тонкой кишке, не требуют дополнительных затрат энергии или времени для распада минеральной воды на ионы, получая их уже готовыми для процесса всасывания.\r\n\r\nИменно поэтому вода для медицинских целей РеО так быстро устраняет признаки обезвоживания и помогает улучшить самочувствие человека.\r\n\r\nВода рекомендована при состояниях, которые сопровождаются дегидратацией и интоксикацией организма, среди которых – токсикоз у беременных, физические нагрузки, острые кишечные инфекции у детей, алкогольная интоксикация, отравления, диарея, лихорадка.\r\n\r\nВода РеО имеет приятный солоноватый вкус, ее легко пить и можно принимать даже при тошноте.\r\n\r\nОтличные вкусовые качества воды обеспечивают более комфортное отпаивание не только у взрослых, но и у детей.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав воды для медицинских целей РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\">Концентрация</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Кому стоит посоветовать воду для медицинских целей ReO?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\r\n\r\nReO - больше, чем вода!','Выбор аптечной воды','','inherit','closed','closed','','1197-revision-v1','','','2021-07-14 17:49:00','2021-07-14 14:49:00','',1197,'https://reo.ua/?p=1205',0,'revision','',0),(1206,1,'2021-07-15 10:49:37','2021-07-15 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Чим молодша людина, тим більший вміст води у її клітинах і тим вища потреба людини у воді. Зокрема, у немовлят на частку води припадає більше 80% ваги. З віком цей показник поступово зменшується, становлячи приблизно 60% у дорослих та в межах 45% у людей старше 65 років.\r\n\r\nПри зневодненні внаслідок сильного блювання, проносу, недостатнього пиття тощо, організм втрачає не лише воду, а й солі (іони натрію, хлору, калію, магнію та кальцію), що спричиняє порушення водно-електролітного балансу у всіх біологічних рідинах. На жаль, організм людини не здатен синтезувати втрачені іони, тому він повинен отримувати їх із напоями та продуктами харчування (Корягіна Ю. та співав., 2018; Єршова І. та співав., 2012).\r\n\r\nДля вагітних додатковою небезпекою є утворення кетонових тіл при гестозі. Лабораторна діагностика дозволяє виявити кетонові тіла лише через деякий час після їхнього формування, тому важливо заздалегідь запобігати їх утворенню. Це можливо за умови підтримки належного балансу води в організмі жінки, зниження інтенсивності нудоти та нормалізації харчування (Кучук Д. та співав., 2018). З цією метою доцільно застосовувати розчин для оральної регідратації ReO корпорації «Юрія-Фарм», Україна. Вживання води для медичних цілей ReO забезпечує швидке всмоктування не лише рідини, а й необхідних іонів, ліквідує неприємні симптоми дегідратації (втомлюваність, головний біль, сухість шкіри та слизових оболонок), запобігає подальшому зневодненню, знижує вираженість інтоксикації, нормалізує діурез.\r\n<h2>Переваги ReO над звичайною водою</h2>\r\nОскільки вода являє собою основу всіх біологічних рідин, важливість складу води, яку ми п’ємо, важко переоцінити. Воді для медичних цілей ReO притаманна збалансована мінералізація. Важливо також те, що до складу ReO не входять барвники, консерванти та вуглеводи.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Питна вода ReO для медичних цілей містить такі складники:</h2>\r\n<ul>\r\n 	<li>Натрій – макроелемент, що відповідає за підтримку водно-сольової рівноваги загалом, регулює осмотичний тиск у позаклітинному рідинному середовищі та затримує воду в організмі.</li>\r\n 	<li>Калій – катіон, що забезпечує підтримку осмотичного тиску у внутрішньоклітинному середовищі, бере участь у роботі серця, нервів та м’язів, зменшує набряки та втомлюваність.</li>\r\n 	<li>Хлор – ще один важливий регулятор водно-електролітної рівноваги поряд із попередніми іонами і складник низки біологічно активних речовин. Іони хлору покращують апетиту, відновлюють функції печінки та виводять токсини.</li>\r\n 	<li>Кальцій – основний складник кісток, а також учасник усіх нервово-м’язових процесів (передача нервового збудження, відповідь м’язових клітин на електричний імпульс, скорочення м’язів) і регулятор серцевого ритму. Іонам кальцію властива здатність зменшувати частоту серцевих скорочень, знижувати артеріальний тиск та протидіяти стресу.</li>\r\n 	<li>Магній – регулятор обміну інших макро- та мікроелементів, зокрема, кальцію, фосфору, натрію та калію. Крім того, іони магнію беруть участь у розщепленні вуглеводів та перетворенні глюкози на енергію і виступають зв’язувальними ланками між кисневмісними органічними молекулами. Тому дефіцит магнію є фактором ризику біоенергетичного дефіциту і руйнування органічних молекулярних груп.</li>\r\n 	<li>Гідрокарбонати – сполуки, що беруть участь у виведенні токсинів, регуляції водно-електролітного балансу, метаболізмі білків та вуглеводів, контролі процесів травлення (гальмування кислотоутворення, покращення засвоєння деяких мікро- та макроелементів).</li>\r\n 	<li>Сорбітол – шестиатомний спирт, що сприяє нормалізації кишкової мікрофлори. Це має особливе значення для вагітних, у яких нерідко спостерігаються закрепи. Крім того, сорбітол є цінним джерелом енергії, що також важливо для вагітних у зв’язку з підвищеними енергетичними потребами (Бєлоконова Н. та співав., 2016; Єгорова І., Комарова С., 2015; Єршова І. та співав., 2012; Лисіков Ю. та співав., 2009).</li>\r\n</ul>\r\nТакий склад води ReO зменшує виражені симптоми токсикозу, запобігає дегідратації, стабілізує водно-електролітну рівновагу і кровотік у мікроциркуляторному руслі, пришвидшує видалення із організму вагітної жінки токсинів. Перелічені ефекти пришвидшують видужання, поліпшують самопочуття, зменшують частоту блювання, знижують вміст ацетону в сечі. Воді ReO притаманний приємний солонуватий смак, тому її легко пити навіть при нудоті.\r\n\r\nОтже, вживання води ReO може допомогти вагітним жінкам в усуненні нудоти і блювання як проявів токсикозу.','Як впоратися з неприємними симптомами токсикозу?','','publish','open','open','','yak-vporatisya-z-nepri%d1%94mnimi-simptomami-toksikozu','','','2021-07-19 16:44:05','2021-07-19 13:44:05','',0,'https://reo.ua/?p=1219',8,'post','',0),(1221,1,'2021-07-16 17:11:23','2021-07-16 14:11:23','','prew','','inherit','open','closed','','prew-2-2','','','2021-07-16 17:11:23','2021-07-16 14:11:23','',0,'https://reo.ua/wp-content/uploads/2021/07/prew.png',0,'attachment','image/png',0),(1222,1,'2021-07-16 17:11:43','2021-07-16 14:11:43','','Як впоратися з неприємними симптомами токсикозу','','inherit','open','closed','','yak-vporatisya-z-nepri%d1%94mnimi-simptomami-toksikozu','','','2021-07-16 17:11:43','2021-07-16 14:11:43','',1219,'https://reo.ua/wp-content/uploads/2021/07/yak-vporatisya-z-nepriєmnimi-simptomami-toksikozu.pdf',0,'attachment','application/pdf',0),(1223,1,'2021-07-16 17:11:43','2021-07-16 14:11:43','','Як впоратися з неприємними симптомами токсикозу','','inherit','open','closed','','yak-vporatisya-z-nepri%d1%94mnimi-simptomami-toksikozu-2','','','2021-07-16 17:11:43','2021-07-16 14:11:43','',1228,'https://reo.ua/wp-content/uploads/2021/07/yak-vporatisya-z-nepriєmnimi-simptomami-toksikozu.pdf',0,'attachment','application/pdf',0),(1227,1,'2021-07-16 17:15:38','2021-07-16 14:15:38','50-80% жінок у першому триместрі вагітності скаржаться на нудоту та/або блювання різної інтенсивності. Зазвичай ці симптоми виникають на 8-12 тижні вагітності і самостійно минають у межах 16-18 тижня. Переважно нудота та блювання не мають негативного впливу на перебіг вагітності і вважаються фізіологічною відповіддю організму на процеси гестації. Тим не менше, навіть незначна нудота та/або блювання можуть сильно знижувати якість життя вагітної жінки, викликаючи посилену втомлюваність та слабкість, порушуючи сон та пригнічуючи апетит (Ребров Б. та співав., 2010; Ушкалова Є. та співав., 2011). Токсикоз вагітних також може спричинити нестачу води та мікроелементів, що є небезпечним, оскільки у вагітних жінок потреба в мікроелементах підвищена (Давидова Ю. та співав., 2014). З метою профілактики водно-сольового дисбалансу можна застосовувати розроблений фармацевтичною корпорацією «Юрія-Фарм» розчин для оральної регідратації ReO.\r\n\r\nУ людському організмі вода виконує низку життєво важливих функцій, зокрема бере участь у різноманітних хімічних, фізичних та ферментативних процесах. Чим молодша людина, тим більший вміст води у її клітинах і тим вища потреба людини у воді. Зокрема, у немовлят на частку води припадає більше 80% ваги. З віком цей показник поступово зменшується, становлячи приблизно 60% у дорослих та в межах 45% у людей старше 65 років.\r\n\r\nПри зневодненні внаслідок сильного блювання, проносу, недостатнього пиття тощо, організм втрачає не лише воду, а й солі (іони натрію, хлору, калію, магнію та кальцію), що спричиняє порушення водно-електролітного балансу у всіх біологічних рідинах. На жаль, організм людини не здатен синтезувати втрачені іони, тому він повинен отримувати їх із напоями та продуктами харчування (Корягіна Ю. та співав., 2018; Єршова І. та співав., 2012).\r\n\r\nДля вагітних додатковою небезпекою є утворення кетонових тіл при гестозі. Лабораторна діагностика дозволяє виявити кетонові тіла лише через деякий час після їхнього формування, тому важливо заздалегідь запобігати їх утворенню. Це можливо за умови підтримки належного балансу води в організмі жінки, зниження інтенсивності нудоти та нормалізації харчування (Кучук Д. та співав., 2018). З цією метою доцільно застосовувати розчин для оральної регідратації ReO корпорації «Юрія-Фарм», Україна. Вживання води для медичних цілей ReO забезпечує швидке всмоктування не лише рідини, а й необхідних іонів, ліквідує неприємні симптоми дегідратації (втомлюваність, головний біль, сухість шкіри та слизових оболонок), запобігає подальшому зневодненню, знижує вираженість інтоксикації, нормалізує діурез.\r\n<h2>Переваги ReO над звичайною водою</h2>\r\nОскільки вода являє собою основу всіх біологічних рідин, важливість складу води, яку ми п’ємо, важко переоцінити. Воді для медичних цілей ReO притаманна збалансована мінералізація. Важливо також те, що до складу ReO не входять барвники, консерванти та вуглеводи.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Питна вода ReO для медичних цілей містить такі складники:</h2>\r\n<ul>\r\n 	<li>Натрій – макроелемент, що відповідає за підтримку водно-сольової рівноваги загалом, регулює осмотичний тиск у позаклітинному рідинному середовищі та затримує воду в організмі.</li>\r\n 	<li>Калій – катіон, що забезпечує підтримку осмотичного тиску у внутрішньоклітинному середовищі, бере участь у роботі серця, нервів та м’язів, зменшує набряки та втомлюваність.</li>\r\n 	<li>Хлор – ще один важливий регулятор водно-електролітної рівноваги поряд із попередніми іонами і складник низки біологічно активних речовин. Іони хлору покращують апетиту, відновлюють функції печінки та виводять токсини.</li>\r\n 	<li>Кальцій – основний складник кісток, а також учасник усіх нервово-м’язових процесів (передача нервового збудження, відповідь м’язових клітин на електричний імпульс, скорочення м’язів) і регулятор серцевого ритму. Іонам кальцію властива здатність зменшувати частоту серцевих скорочень, знижувати артеріальний тиск та протидіяти стресу.</li>\r\n 	<li>Магній – регулятор обміну інших макро- та мікроелементів, зокрема, кальцію, фосфору, натрію та калію. Крім того, іони магнію беруть участь у розщепленні вуглеводів та перетворенні глюкози на енергію і виступають зв’язувальними ланками між кисневмісними органічними молекулами. Тому дефіцит магнію є фактором ризику біоенергетичного дефіциту і руйнування органічних молекулярних груп.</li>\r\n 	<li>Гідрокарбонати – сполуки, що беруть участь у виведенні токсинів, регуляції водно-електролітного балансу, метаболізмі білків та вуглеводів, контролі процесів травлення (гальмування кислотоутворення, покращення засвоєння деяких мікро- та макроелементів).</li>\r\n 	<li>Сорбітол – шестиатомний спирт, що сприяє нормалізації кишкової мікрофлори. Це має особливе значення для вагітних, у яких нерідко спостерігаються закрепи. Крім того, сорбітол є цінним джерелом енергії, що також важливо для вагітних у зв’язку з підвищеними енергетичними потребами (Бєлоконова Н. та співав., 2016; Єгорова І., Комарова С., 2015; Єршова І. та співав., 2012; Лисіков Ю. та співав., 2009).</li>\r\n</ul>\r\nТакий склад води ReO зменшує виражені симптоми токсикозу, запобігає дегідратації, стабілізує водно-електролітну рівновагу і кровотік у мікроциркуляторному руслі, пришвидшує видалення із організму вагітної жінки токсинів. Перелічені ефекти пришвидшують видужання, поліпшують самопочуття, зменшують частоту блювання, знижують вміст ацетону в сечі. Воді ReO притаманний приємний солонуватий смак, тому її легко пити навіть при нудоті.\r\n\r\nОтже, вживання води ReO може допомогти вагітним жінкам в усуненні нудоти і блювання як проявів токсикозу.','Як впоратися з неприємними симптомами токсикозу?','','inherit','closed','closed','','1219-revision-v1','','','2021-07-16 17:15:38','2021-07-16 14:15:38','',1219,'https://reo.ua/?p=1227',0,'revision','',0),(1224,1,'2021-07-16 17:11:50','2021-07-16 14:11:50','50-80% жінок у першому триместрі вагітності скаржаться на нудоту та/або блювання різної інтенсивності. Зазвичай ці симптоми виникають на 8-12 тижні вагітності і самостійно минають у межах 16-18 тижня. Переважно нудота та блювання не мають негативного впливу на перебіг вагітності і вважаються фізіологічною відповіддю організму на процеси гестації. Тим не менше, навіть незначна нудота та/або блювання можуть сильно знижувати якість життя вагітної жінки, викликаючи посилену втомлюваність та слабкість, порушуючи сон та пригнічуючи апетит (Ребров Б. та співав., 2010; Ушкалова Є. та співав., 2011). Токсикоз вагітних також може спричинити нестачу води та мікроелементів, що є небезпечним, оскільки у вагітних жінок потреба в мікроелементах підвищена (Давидова Ю. та співав., 2014). З метою профілактики водно-сольового дисбалансу можна застосовувати розроблений фармацевтичною корпорацією «Юрія-Фарм» розчин для оральної регідратації ReO.\r\n\r\nУ людському організмі вода виконує низку життєво важливих функцій, зокрема бере участь у різноманітних хімічних, фізичних та ферментативних процесах. Чим молодша людина, тим більший вміст води у її клітинах і тим вища потреба людини у воді. Зокрема, у немовлят на частку води припадає більше 80% ваги. З віком цей показник поступово зменшується, становлячи приблизно 60% у дорослих та в межах 45% у людей старше 65 років.\r\n\r\nПри зневодненні внаслідок сильного блювання, проносу, недостатнього пиття тощо, організм втрачає не лише воду, а й солі (іони натрію, хлору, калію, магнію та кальцію), що спричиняє порушення водно-електролітного балансу у всіх біологічних рідинах. На жаль, організм людини не здатен синтезувати втрачені іони, тому він повинен отримувати їх із напоями та продуктами харчування (Корягіна Ю. та співав., 2018; Єршова І. та співав., 2012).\r\n\r\nДля вагітних додатковою небезпекою є утворення кетонових тіл при гестозі. Лабораторна діагностика дозволяє виявити кетонові тіла лише через деякий час після їхнього формування, тому важливо заздалегідь запобігати їх утворенню. Це можливо за умови підтримки належного балансу води в організмі жінки, зниження інтенсивності нудоти та нормалізації харчування (Кучук Д. та співав., 2018). З цією метою доцільно застосовувати розчин для оральної регідратації ReO корпорації «Юрія-Фарм», Україна. Вживання води для медичних цілей ReO забезпечує швидке всмоктування не лише рідини, а й необхідних іонів, ліквідує неприємні симптоми дегідратації (втомлюваність, головний біль, сухість шкіри та слизових оболонок), запобігає подальшому зневодненню, знижує вираженість інтоксикації, нормалізує діурез.\r\n<h2>Переваги ReO над звичайною водою</h2>\r\nОскільки вода являє собою основу всіх біологічних рідин, важливість складу води, яку ми п’ємо, важко переоцінити. Воді для медичних цілей ReO притаманна збалансована мінералізація. Важливо також те, що до складу ReO не входять барвники, консерванти та вуглеводи.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Склад води РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Концентрація</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбітол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Вуглекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Мінералізація (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nПитна вода ReO для медичних цілей містить такі складники:\r\n<ul>\r\n 	<li>Натрій – макроелемент, що відповідає за підтримку водно-сольової рівноваги загалом, регулює осмотичний тиск у позаклітинному рідинному середовищі та затримує воду в організмі.</li>\r\n 	<li>Калій – катіон, що забезпечує підтримку осмотичного тиску у внутрішньоклітинному середовищі, бере участь у роботі серця, нервів та м’язів, зменшує набряки та втомлюваність.</li>\r\n 	<li>Хлор – ще один важливий регулятор водно-електролітної рівноваги поряд із попередніми іонами і складник низки біологічно активних речовин. Іони хлору покращують апетиту, відновлюють функції печінки та виводять токсини.</li>\r\n 	<li>Кальцій – основний складник кісток, а також учасник усіх нервово-м’язових процесів (передача нервового збудження, відповідь м’язових клітин на електричний імпульс, скорочення м’язів) і регулятор серцевого ритму. Іонам кальцію властива здатність зменшувати частоту серцевих скорочень, знижувати артеріальний тиск та протидіяти стресу.</li>\r\n 	<li>Магній – регулятор обміну інших макро- та мікроелементів, зокрема, кальцію, фосфору, натрію та калію. Крім того, іони магнію беруть участь у розщепленні вуглеводів та перетворенні глюкози на енергію і виступають зв’язувальними ланками між кисневмісними органічними молекулами. Тому дефіцит магнію є фактором ризику біоенергетичного дефіциту і руйнування органічних молекулярних груп.</li>\r\n 	<li>Гідрокарбонати – сполуки, що беруть участь у виведенні токсинів, регуляції водно-електролітного балансу, метаболізмі білків та вуглеводів, контролі процесів травлення (гальмування кислотоутворення, покращення засвоєння деяких мікро- та макроелементів).</li>\r\n 	<li>Сорбітол – шестиатомний спирт, що сприяє нормалізації кишкової мікрофлори. Це має особливе значення для вагітних, у яких нерідко спостерігаються закрепи. Крім того, сорбітол є цінним джерелом енергії, що також важливо для вагітних у зв’язку з підвищеними енергетичними потребами (Бєлоконова Н. та співав., 2016; Єгорова І., Комарова С., 2015; Єршова І. та співав., 2012; Лисіков Ю. та співав., 2009).</li>\r\n</ul>\r\nТакий склад води ReO зменшує виражені симптоми токсикозу, запобігає дегідратації, стабілізує водно-електролітну рівновагу і кровотік у мікроциркуляторному руслі, пришвидшує видалення із організму вагітної жінки токсинів. Перелічені ефекти пришвидшують видужання, поліпшують самопочуття, зменшують частоту блювання, знижують вміст ацетону в сечі. Воді ReO притаманний приємний солонуватий смак, тому її легко пити навіть при нудоті.\r\n\r\nОтже, вживання води ReO може допомогти вагітним жінкам в усуненні нудоти і блювання як проявів токсикозу.','Як впоратися з неприємними симптомами токсикозу?','','inherit','closed','closed','','1219-revision-v1','','','2021-07-16 17:11:50','2021-07-16 14:11:50','',1219,'https://reo.ua/?p=1224',0,'revision','',0),(1225,1,'2021-07-16 17:14:38','2021-07-16 14:14:38','','prew','','inherit','open','closed','','prew-3','','','2021-07-16 17:14:38','2021-07-16 14:14:38','',1219,'https://reo.ua/wp-content/uploads/2021/07/prew-1.png',0,'attachment','image/png',0),(1226,1,'2021-07-16 17:14:38','2021-07-16 14:14:38','','prew','','inherit','open','closed','','prew-3-2','','','2021-07-16 17:14:38','2021-07-16 14:14:38','',1228,'https://reo.ua/wp-content/uploads/2021/07/prew-1.png',0,'attachment','image/png',0),(1228,1,'2021-07-16 17:11:50','2021-07-16 14:11:50','Тошнота и рвота – распространенная проблема, с которой в первом триместре беременности, в той или иной мере, сталкиваются 50-80% женщин.\r\n\r\nСимптомы появляются на 8-12 неделе беременности, а на 16-18 неделе, как правило, ослабевают или исчезают.\r\n\r\nВ большей части случаев эти симптомы не влияют на течение беременности и рассматриваются как физиологическое состояние.\r\n\r\nНо наличие таких проявлений, даже слабо выраженных, может значительно ухудшать качество жизни беременной: повышается утомляемость, слабость, появляются расстройства сна, происходит снижение аппетита  и другое (Ушкалова Е. и соавт., 2011; Ребров Б. А. и соавт., 2010).\r\n\r\nКроме этого, рвота при токсикозе может привести к дефициту воды и микроэлементов, потребность в которых при беременности повышена (Давыдова Ю. В. и соавт., 2014).\r\n\r\nВ этом случае выручит «помощник» – специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм».\r\n<h2>Роль воды в поддержании жизнедеятельности очень многогранна.</h2>\r\nПодтверждением этого служат связанные с ней жизненно важные процессы – химические, физические, ферментативные.\r\n\r\nИнтересно, что чем младше человек, тем больше у него потребность в воде и тем выше ее содержание в организме. Так, у новорожденных больше 80% массы тела составляет жидкость. У взрослых этот показатель снижается, однако все равно содержание воды приблизительно 60% (от 45% у пожилых людей до 70% у молодых мужчин).\r\n\r\nВажно отметить, что при обезвоживании, причинами которого могут быть рвота, низкое употребление воды и т.п., человек теряет минеральные элементы, что становится причиной возникновения электролитного дисбаланса во всех жидкостных системах организма.\r\n\r\nВместе с водой организм теряет значительное количество ионов <strong>Na, Cl, K, Mg, Са.</strong>\r\n\r\nВ ввиду того, что организм человека не может самостоятельно синтезировать минеральные и другие ионы, они должны поступать с едой и водой (Ершова И. Б. и соавт., 2012; Корягина Ю. В. и соавт., 2018).\r\n\r\nКогда речь идет о беременных, нужно учитывать то, что при гестозе часто наблюдается формирование кетоновых тел, которые могут определяться лабораторно уже поздно. Поэтому необходимо сделать особенный акцент на предотвращении их формирования путем регидратации, уменьшения тошноты и возвращения женщины к нормальному питанию (Кучук Д. О. и соавт., 2018).\r\n\r\nВ этом случае может пригодиться специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм». Она была разработана специально для:\r\n<ul>\r\n 	<li>максимально быстрого всасывания воды и электролитов;</li>\r\n 	<li>устранения симптомов дегидратации (утомляемость, головная боль, сухость кожи и слизистых оболочек);</li>\r\n 	<li>предотвращения обезвоживания, нормализации диуреза и снижения интоксикации.</li>\r\n</ul>\r\n<h2>РеО – когда обычной воды мало.</h2>\r\nВода – основа биологических жидкостей организма, поэтому изменение состава употребляемой воды приводит к изменению состава и свойств биологических жидкостей организма.\r\n\r\nВода для медицинских целей РеО имеет сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав специальной воды для регидратации и дезинтоксикации организма ReO</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Химический состав РеО включает:</h2>\r\n<ul>\r\n 	<li>натрий – один из самых важных макроэлементов, который обеспечивает баланс жидкости в организме. Он поддерживает осмотическое давление внеклеточной жидкости организма, задерживает воду;</li>\r\n 	<li>калий, в отличие от натрия, является внутриклеточным катионом, который поддерживает осмотическое давление жидкостей организма внутри клеток. В эритроцитах калия в 10,5 раз больше, чем натрия, а в плазме крови, наоборот, натрия почти в 30 раз больше, чем калия. От калия зависит работа сердца, его ритм, а также нервно-мышечная деятельность. Он уменьшает отеки и снижает утомляемость.</li>\r\n 	<li>Хлор – макроэлемент, который вместе с натрием и калием регулирует водно-солевой баланс, входит в состав биологически активных соединений в организме, нормализует осмотическое давление в крови, лимфе, спинномозговой и других жидкостях. А еще хлор стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов.</li>\r\n 	<li>Кальций – не только основа костной ткани. Он принимает активное участие в обеспечении функций движения (сокращение мышц, передача нервного  импульса, реакция мышц на нервное возбуждение), а также в изменении активности гормонов, регуляции ритма сердечных сокращений. Кальций снижает частоту пульса, нормализует артериальное давление и противодействует стрессу.</li>\r\n 	<li>Магний также играет значительную роль в организме человека: он необходим для обмена кальция, витамина С, фосфора, натрия и калия. Магний принимает участие в процессе расщепления углеводов (гликолизе), в перенесении ионов натрия, калия, кальция через мембраны клеток, в нервно-мышечной передаче импульсов, важен для превращения глюкозы в энергию. Благодаря своим маленьким размерам ионы магния очень хорошо вступают в ионно-ковалентную связь со всеми органическими молекулами, которые содержат кислород, скрепляя их между собой. Удаление магния может привести к распаду молекулярных групп, например, рибосом, в которых происходит синтез белковых молекул.</li>\r\n 	<li>Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят кислородообразование в желудке и улучшают усвоение микро- и макроэлементов.</li>\r\n 	<li>Сорбитол – шестиатомный спирт, который имеет характерный сладкий вкус.</li>\r\n</ul>\r\nУчитывая то, что у беременных часто отмечают такую проблему, как запор, целесообразно восстановительное действие сорбитола на микрофлору кишечника. К тому же сорбитол придает женщине энергию, которая ей особенно необходима (Белоконова Н. А. и соавт., 2016; Лысиков Ю. А., 2009; Ершова И. Б. и соавт., 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nБлагодаря такому составу РеО способствует послаблению симптомов токсикоза, предотвращает обезвоживание, нормализует водно-электролитный обмен и микроциркуляцию, выводит токсины из организма, что ускоряет выздоровление, улучшает самочувствие беременной, уменьшает частоту рвот и уровень ацетона в моче.\r\n\r\n<strong>Значительное преимущество специальной воды для регидратации и дезинтоксикации организма РеО – ее отличные вкусовые качества:</strong>\r\n<ul>\r\n 	<li>имеет приятный солоноватый вкус;</li>\r\n 	<li>легко пьется;</li>\r\n 	<li>может быть использована даже при тошноте.</li>\r\n</ul>\r\nТакой «помощник», как РеО, действительно может пригодиться беременным и помочь справиться с «неприятными» симптомами токсикоза.','Как справиться с «неприятными» симптомами токсикоза?','','publish','open','open','','kak-spravitsya-s-nepriyatnymi-simptomami-toksikoza','','','2021-07-16 17:22:33','2021-07-16 14:22:33','',0,'https://reo.ua/bez-kategorii/yak-vporatisya-z-nepri%d1%94mnimi-simptomami-toksikozu/',7,'post','',0),(1229,1,'2021-07-16 17:20:03','2021-07-16 14:20:03','Тошнота и рвота – распространенная проблема, с которой в первом триместре беременности, в той или иной мере, сталкиваются 50-80% женщин.\n\nСимптомы появляются на 8-12 неделе беременности, а на 16-18 неделе, как правило, ослабевают или исчезают.\n\nВ большей части случаев эти симптомы не влияют на течение беременности и рассматриваются как физиологическое состояние.\n\nНо наличие таких проявлений, даже слабо выраженных, может значительно ухудшать качество жизни беременной: повышается утомляемость, слабость, появляются расстройства сна, происходит снижение аппетита  и другое (Ушкалова Е. и соавт., 2011; Ребров Б. А. и соавт., 2010).\n\nКроме этого, рвота при токсикозе может привести к дефициту воды и микроэлементов, потребность в которых при беременности повышена (Давыдова Ю. В. и соавт., 2014).\n\nВ этом случае выручит «помощник» – специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм».\n<h2>Роль воды в поддержании жизнедеятельности очень многогранна.</h2>\nПодтверждением этого служат связанные с ней жизненно важные процессы – химические, физические, ферментативные.\n\nИнтересно, что чем младше человек, тем больше у него потребность в воде и тем выше ее содержание в организме. Так, у новорожденных больше 80% массы тела составляет жидкость. У взрослых этот показатель снижается, однако все равно содержание воды приблизительно 60% (от 45% у пожилых людей до 70% у молодых мужчин).\n\nВажно отметить, что при обезвоживании, причинами которого могут быть рвота, низкое употребление воды и т.п., человек теряет минеральные элементы, что становится причиной возникновения электролитного дисбаланса во всех жидкостных системах организма.\n\nВместе с водой организм теряет значительное количество ионов <strong>Na, Cl, K, Mg, Са.</strong>\n\nВ ввиду того, что организм человека не может самостоятельно синтезировать минеральные и другие ионы, они должны поступать с едой и водой (Ершова И. Б. и соавт., 2012; Корягина Ю. В. и соавт., 2018).\n\nКогда речь идет о беременных, нужно учитывать то, что при гестозе часто наблюдается формирование кетоновых тел, которые могут определяться лабораторно уже поздно. Поэтому необходимо сделать особенный акцент на предотвращении их формирования путем регидратации, уменьшения тошноты и возвращения женщины к нормальному питанию (Кучук Д. О. и соавт., 2018).\n\nВ этом случае может пригодиться специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм». Она была разработана специально для:\n<ul>\n 	<li>максимально быстрого всасывания воды и электролитов;</li>\n 	<li>устранения симптомов дегидратации (утомляемость, головная боль, сухость кожи и слизистых оболочек);</li>\n 	<li>предотвращения обезвоживания, нормализации диуреза и снижения интоксикации.</li>\n</ul>\n<h2>РеО – когда обычной воды мало.</h2>\nВода – основа биологических жидкостей организма, поэтому изменение состава употребляемой воды приводит к изменению состава и свойств биологических жидкостей организма.\n\nВода для медицинских целей РеО имеет сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. Состав специальной воды для регидратации и дезинтоксикации организма ReO</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Компонент</strong></th>\n<th width=\"151\"><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Химический состав РеО включает:</h2>\n<ul>\n 	<li>натрий – один из самых важных макроэлементов, который обеспечивает баланс жидкости в организме. Он поддерживает осмотическое давление внеклеточной жидкости организма, задерживает воду;</li>\n 	<li>калий, в отличие от натрия, является внутриклеточным катионом, который поддерживает осмотическое давление жидкостей организма внутри клеток. В эритроцитах калия в 10,5 раз больше, чем натрия, а в плазме крови, наоборот, натрия почти в 30 раз больше, чем калия. От калия зависит работа сердца, его ритм, а также нервно-мышечная деятельность. Он уменьшает отеки и снижает утомляемость.</li>\n 	<li>Хлор – макроэлемент, который вместе с натрием и калием регулирует водно-солевой баланс, входит в состав биологически активных соединений в организме, нормализует осмотическое давление в крови, лимфе, спинномозговой и других жидкостях. А еще хлор стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов.</li>\n 	<li>Кальций – не только основа костной ткани. Он принимает активное участие в обеспечении функций движения (сокращение мышц, передача нервного  импульса, реакция мышц на нервное возбуждение), а также в изменении активности гормонов, регуляции ритма сердечных сокращений. Кальций снижает частоту пульса, нормализует артериальное давление и противодействует стрессу.</li>\n 	<li>Магний также играет значительную роль в организме человека: он необходим для обмена кальция, витамина С, фосфора, натрия и калия. Магний принимает участие в процессе расщепления углеводов (гликолизе), в перенесении ионов натрия, калия, кальция через мембраны клеток, в нервно-мышечной передаче импульсов, важен для превращения глюкозы в энергию. Благодаря своим маленьким размерам ионы магния очень хорошо вступают в ионно-ковалентную связь со всеми органическими молекулами, которые содержат кислород, скрепляя их между собой. Удаление магния может привести к распаду молекулярных групп, например, рибосом, в которых происходит синтез белковых молекул.</li>\n 	<li>Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят кислородообразование в желудке и улучшают усвоение микро- и макроэлементов.</li>\n 	<li>Сорбитол – шестиатомный спирт, который имеет характерный сладкий вкус.</li>\n</ul>\nУчитывая то, что у беременных часто отмечают такую проблему, как запор, целесообразно восстановительное действие сорбитола на микрофлору кишечника. К тому же сорбитол придает женщине энергию, которая ей особенно необходима (Белоконова Н. А. и соавт., 2016; Лысиков Ю. А., 2009; Ершова И. Б. и соавт., 2012; Егорова И. А., Комарова С. Г., 2015).\n\nБлагодаря такому составу РеО способствует послаблению симптомов токсикоза, предотвращает обезвоживание, нормализует водно-электролитный обмен и микроциркуляцию, выводит токсины из организма, что ускоряет выздоровление, улучшает самочувствие беременной, уменьшает частоту рвот и уровень ацетона в моче.\n\nЗначительное преимущество специальной воды для регидратации и дезинтоксикации организма РеО – ее отличные вкусовые качества:\n<ul>\n 	<li>имеет приятный солоноватый вкус;</li>\n 	<li>легко пьется;</li>\n 	<li>может быть использована даже при тошноте.</li>\n</ul>\nТакой «помощник», как РеО, действительно может пригодиться беременным и помочь справиться с «неприятными» симптомами токсикоза.','Как справиться с «неприятными» симптомами токсикоза?','','inherit','closed','closed','','1228-autosave-v1','','','2021-07-16 17:20:03','2021-07-16 14:20:03','',1228,'https://reo.ua/?p=1229',0,'revision','',0),(1230,1,'2021-07-16 17:19:58','2021-07-16 14:19:58','Тошнота и рвота – распространенная проблема, с которой в первом триместре беременности, в той или иной мере, сталкиваются 50-80% женщин.\r\n\r\nСимптомы появляются на 8-12 неделе беременности, а на 16-18 неделе, как правило, ослабевают или исчезают.\r\n\r\nВ большей части случаев эти симптомы не влияют на течение беременности и рассматриваются как физиологическое состояние.\r\n\r\nНо наличие таких проявлений, даже слабо выраженных, может значительно ухудшать качество жизни беременной: повышается утомляемость, слабость, появляются расстройства сна, происходит снижение аппетита  и другое (Ушкалова Е. и соавт., 2011; Ребров Б. А. и соавт., 2010).\r\n\r\nКроме этого, рвота при токсикозе может привести к дефициту воды и микроэлементов, потребность в которых при беременности повышена (Давыдова Ю. В. и соавт., 2014).\r\n\r\nВ этом случае выручит «помощник» – специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм».\r\n<h2>Роль воды в поддержании жизнедеятельности очень многогранна.</h2>\r\nПодтверждением этого служат связанные с ней жизненно важные процессы – химические, физические, ферментативные.\r\n\r\nИнтересно, что чем младше человек, тем больше у него потребность в воде и тем выше ее содержание в организме. Так, у новорожденных больше 80% массы тела составляет жидкость. У взрослых этот показатель снижается, однако все равно содержание воды приблизительно 60% (от 45% у пожилых людей до 70% у молодых мужчин).\r\n\r\nВажно отметить, что при обезвоживании, причинами которого могут быть рвота, низкое употребление воды и т.п., человек теряет минеральные элементы, что становится причиной возникновения электролитного дисбаланса во всех жидкостных системах организма.\r\n\r\nВместе с водой организм теряет значительное количество ионов <strong>Na, Cl, K, Mg, Са.</strong>\r\n\r\nВ ввиду того, что организм человека не может самостоятельно синтезировать минеральные и другие ионы, они должны поступать с едой и водой (Ершова И. Б. и соавт., 2012; Корягина Ю. В. и соавт., 2018).\r\n\r\nКогда речь идет о беременных, нужно учитывать то, что при гестозе часто наблюдается формирование кетоновых тел, которые могут определяться лабораторно уже поздно. Поэтому необходимо сделать особенный акцент на предотвращении их формирования путем регидратации, уменьшения тошноты и возвращения женщины к нормальному питанию (Кучук Д. О. и соавт., 2018).\r\n\r\nВ этом случае может пригодиться специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм». Она была разработана специально для:\r\n<ul>\r\n 	<li>максимально быстрого всасывания воды и электролитов;</li>\r\n 	<li>устранения симптомов дегидратации (утомляемость, головная боль, сухость кожи и слизистых оболочек);</li>\r\n 	<li>предотвращения обезвоживания, нормализации диуреза и снижения интоксикации.</li>\r\n</ul>\r\n<h2>РеО – когда обычной воды мало.</h2>\r\nВода – основа биологических жидкостей организма, поэтому изменение состава употребляемой воды приводит к изменению состава и свойств биологических жидкостей организма.\r\n\r\nВода для медицинских целей РеО имеет сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав специальной воды для регидратации и дезинтоксикации организма ReO</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Химический состав РеО включает:</h2>\r\n<ul>\r\n 	<li>натрий – один из самых важных макроэлементов, который обеспечивает баланс жидкости в организме. Он поддерживает осмотическое давление внеклеточной жидкости организма, задерживает воду;</li>\r\n 	<li>калий, в отличие от натрия, является внутриклеточным катионом, который поддерживает осмотическое давление жидкостей организма внутри клеток. В эритроцитах калия в 10,5 раз больше, чем натрия, а в плазме крови, наоборот, натрия почти в 30 раз больше, чем калия. От калия зависит работа сердца, его ритм, а также нервно-мышечная деятельность. Он уменьшает отеки и снижает утомляемость.</li>\r\n 	<li>Хлор – макроэлемент, который вместе с натрием и калием регулирует водно-солевой баланс, входит в состав биологически активных соединений в организме, нормализует осмотическое давление в крови, лимфе, спинномозговой и других жидкостях. А еще хлор стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов.</li>\r\n 	<li>Кальций – не только основа костной ткани. Он принимает активное участие в обеспечении функций движения (сокращение мышц, передача нервного  импульса, реакция мышц на нервное возбуждение), а также в изменении активности гормонов, регуляции ритма сердечных сокращений. Кальций снижает частоту пульса, нормализует артериальное давление и противодействует стрессу.</li>\r\n 	<li>Магний также играет значительную роль в организме человека: он необходим для обмена кальция, витамина С, фосфора, натрия и калия. Магний принимает участие в процессе расщепления углеводов (гликолизе), в перенесении ионов натрия, калия, кальция через мембраны клеток, в нервно-мышечной передаче импульсов, важен для превращения глюкозы в энергию. Благодаря своим маленьким размерам ионы магния очень хорошо вступают в ионно-ковалентную связь со всеми органическими молекулами, которые содержат кислород, скрепляя их между собой. Удаление магния может привести к распаду молекулярных групп, например, рибосом, в которых происходит синтез белковых молекул.</li>\r\n 	<li>Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят кислородообразование в желудке и улучшают усвоение микро- и макроэлементов.</li>\r\n 	<li>Сорбитол – шестиатомный спирт, который имеет характерный сладкий вкус.</li>\r\n</ul>\r\nУчитывая то, что у беременных часто отмечают такую проблему, как запор, целесообразно восстановительное действие сорбитола на микрофлору кишечника. К тому же сорбитол придает женщине энергию, которая ей особенно необходима (Белоконова Н. А. и соавт., 2016; Лысиков Ю. А., 2009; Ершова И. Б. и соавт., 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nБлагодаря такому составу РеО способствует послаблению симптомов токсикоза, предотвращает обезвоживание, нормализует водно-электролитный обмен и микроциркуляцию, выводит токсины из организма, что ускоряет выздоровление, улучшает самочувствие беременной, уменьшает частоту рвот и уровень ацетона в моче.\r\n\r\nЗначительное преимущество специальной воды для регидратации и дезинтоксикации организма РеО – ее отличные вкусовые качества:\r\n<ul>\r\n 	<li>имеет приятный солоноватый вкус;</li>\r\n 	<li>легко пьется;</li>\r\n 	<li>может быть использована даже при тошноте.</li>\r\n</ul>\r\nТакой «помощник», как РеО, действительно может пригодиться беременным и помочь справиться с «неприятными» симптомами токсикоза.','Как справиться с «неприятными» симптомами токсикоза?','','inherit','closed','closed','','1228-revision-v1','','','2021-07-16 17:19:58','2021-07-16 14:19:58','',1228,'https://reo.ua/?p=1230',0,'revision','',0),(1231,1,'2021-07-16 17:21:10','2021-07-16 14:21:10','Тошнота и рвота – распространенная проблема, с которой в первом триместре беременности, в той или иной мере, сталкиваются 50-80% женщин.\r\n\r\nСимптомы появляются на 8-12 неделе беременности, а на 16-18 неделе, как правило, ослабевают или исчезают.\r\n\r\nВ большей части случаев эти симптомы не влияют на течение беременности и рассматриваются как физиологическое состояние.\r\n\r\nНо наличие таких проявлений, даже слабо выраженных, может значительно ухудшать качество жизни беременной: повышается утомляемость, слабость, появляются расстройства сна, происходит снижение аппетита  и другое (Ушкалова Е. и соавт., 2011; Ребров Б. А. и соавт., 2010).\r\n\r\nКроме этого, рвота при токсикозе может привести к дефициту воды и микроэлементов, потребность в которых при беременности повышена (Давыдова Ю. В. и соавт., 2014).\r\n\r\nВ этом случае выручит «помощник» – специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм».\r\n<h2>Роль воды в поддержании жизнедеятельности очень многогранна.</h2>\r\nПодтверждением этого служат связанные с ней жизненно важные процессы – химические, физические, ферментативные.\r\n\r\nИнтересно, что чем младше человек, тем больше у него потребность в воде и тем выше ее содержание в организме. Так, у новорожденных больше 80% массы тела составляет жидкость. У взрослых этот показатель снижается, однако все равно содержание воды приблизительно 60% (от 45% у пожилых людей до 70% у молодых мужчин).\r\n\r\nВажно отметить, что при обезвоживании, причинами которого могут быть рвота, низкое употребление воды и т.п., человек теряет минеральные элементы, что становится причиной возникновения электролитного дисбаланса во всех жидкостных системах организма.\r\n\r\nВместе с водой организм теряет значительное количество ионов <strong>Na, Cl, K, Mg, Са.</strong>\r\n\r\nВ ввиду того, что организм человека не может самостоятельно синтезировать минеральные и другие ионы, они должны поступать с едой и водой (Ершова И. Б. и соавт., 2012; Корягина Ю. В. и соавт., 2018).\r\n\r\nКогда речь идет о беременных, нужно учитывать то, что при гестозе часто наблюдается формирование кетоновых тел, которые могут определяться лабораторно уже поздно. Поэтому необходимо сделать особенный акцент на предотвращении их формирования путем регидратации, уменьшения тошноты и возвращения женщины к нормальному питанию (Кучук Д. О. и соавт., 2018).\r\n\r\nВ этом случае может пригодиться специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм». Она была разработана специально для:\r\n<ul>\r\n 	<li>максимально быстрого всасывания воды и электролитов;</li>\r\n 	<li>устранения симптомов дегидратации (утомляемость, головная боль, сухость кожи и слизистых оболочек);</li>\r\n 	<li>предотвращения обезвоживания, нормализации диуреза и снижения интоксикации.</li>\r\n</ul>\r\n<h2>РеО – когда обычной воды мало.</h2>\r\nВода – основа биологических жидкостей организма, поэтому изменение состава употребляемой воды приводит к изменению состава и свойств биологических жидкостей организма.\r\n\r\nВода для медицинских целей РеО имеет сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав специальной воды для регидратации и дезинтоксикации организма ReO</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Химический состав РеО включает:</h2>\r\n<ul>\r\n 	<li>натрий – один из самых важных макроэлементов, который обеспечивает баланс жидкости в организме. Он поддерживает осмотическое давление внеклеточной жидкости организма, задерживает воду;</li>\r\n 	<li>калий, в отличие от натрия, является внутриклеточным катионом, который поддерживает осмотическое давление жидкостей организма внутри клеток. В эритроцитах калия в 10,5 раз больше, чем натрия, а в плазме крови, наоборот, натрия почти в 30 раз больше, чем калия. От калия зависит работа сердца, его ритм, а также нервно-мышечная деятельность. Он уменьшает отеки и снижает утомляемость.</li>\r\n 	<li>Хлор – макроэлемент, который вместе с натрием и калием регулирует водно-солевой баланс, входит в состав биологически активных соединений в организме, нормализует осмотическое давление в крови, лимфе, спинномозговой и других жидкостях. А еще хлор стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов.</li>\r\n 	<li>Кальций – не только основа костной ткани. Он принимает активное участие в обеспечении функций движения (сокращение мышц, передача нервного  импульса, реакция мышц на нервное возбуждение), а также в изменении активности гормонов, регуляции ритма сердечных сокращений. Кальций снижает частоту пульса, нормализует артериальное давление и противодействует стрессу.</li>\r\n 	<li>Магний также играет значительную роль в организме человека: он необходим для обмена кальция, витамина С, фосфора, натрия и калия. Магний принимает участие в процессе расщепления углеводов (гликолизе), в перенесении ионов натрия, калия, кальция через мембраны клеток, в нервно-мышечной передаче импульсов, важен для превращения глюкозы в энергию. Благодаря своим маленьким размерам ионы магния очень хорошо вступают в ионно-ковалентную связь со всеми органическими молекулами, которые содержат кислород, скрепляя их между собой. Удаление магния может привести к распаду молекулярных групп, например, рибосом, в которых происходит синтез белковых молекул.</li>\r\n 	<li>Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят кислородообразование в желудке и улучшают усвоение микро- и макроэлементов.</li>\r\n 	<li>Сорбитол – шестиатомный спирт, который имеет характерный сладкий вкус.</li>\r\n</ul>\r\nУчитывая то, что у беременных часто отмечают такую проблему, как запор, целесообразно восстановительное действие сорбитола на микрофлору кишечника. К тому же сорбитол придает женщине энергию, которая ей особенно необходима (Белоконова Н. А. и соавт., 2016; Лысиков Ю. А., 2009; Ершова И. Б. и соавт., 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nБлагодаря такому составу РеО способствует послаблению симптомов токсикоза, предотвращает обезвоживание, нормализует водно-электролитный обмен и микроциркуляцию, выводит токсины из организма, что ускоряет выздоровление, улучшает самочувствие беременной, уменьшает частоту рвот и уровень ацетона в моче.\r\n\r\n<strong>Значительное преимущество специальной воды для регидратации и дезинтоксикации организма РеО – ее отличные вкусовые качества:</strong>\r\n<ul>\r\n 	<li>имеет приятный солоноватый вкус;</li>\r\n 	<li>легко пьется;</li>\r\n 	<li>может быть использована даже при тошноте.</li>\r\n</ul>\r\nТакой «помощник», как РеО, действительно может пригодиться беременным и помочь справиться с «неприятными» симптомами токсикоза.','Как справиться с «неприятными» симптомами токсикоза?','','inherit','closed','closed','','1228-revision-v1','','','2021-07-16 17:21:10','2021-07-16 14:21:10','',1228,'https://reo.ua/?p=1231',0,'revision','',0),(1232,1,'2021-07-16 17:22:33','2021-07-16 14:22:33','Тошнота и рвота – распространенная проблема, с которой в первом триместре беременности, в той или иной мере, сталкиваются 50-80% женщин.\r\n\r\nСимптомы появляются на 8-12 неделе беременности, а на 16-18 неделе, как правило, ослабевают или исчезают.\r\n\r\nВ большей части случаев эти симптомы не влияют на течение беременности и рассматриваются как физиологическое состояние.\r\n\r\nНо наличие таких проявлений, даже слабо выраженных, может значительно ухудшать качество жизни беременной: повышается утомляемость, слабость, появляются расстройства сна, происходит снижение аппетита  и другое (Ушкалова Е. и соавт., 2011; Ребров Б. А. и соавт., 2010).\r\n\r\nКроме этого, рвота при токсикозе может привести к дефициту воды и микроэлементов, потребность в которых при беременности повышена (Давыдова Ю. В. и соавт., 2014).\r\n\r\nВ этом случае выручит «помощник» – специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм».\r\n<h2>Роль воды в поддержании жизнедеятельности очень многогранна.</h2>\r\nПодтверждением этого служат связанные с ней жизненно важные процессы – химические, физические, ферментативные.\r\n\r\nИнтересно, что чем младше человек, тем больше у него потребность в воде и тем выше ее содержание в организме. Так, у новорожденных больше 80% массы тела составляет жидкость. У взрослых этот показатель снижается, однако все равно содержание воды приблизительно 60% (от 45% у пожилых людей до 70% у молодых мужчин).\r\n\r\nВажно отметить, что при обезвоживании, причинами которого могут быть рвота, низкое употребление воды и т.п., человек теряет минеральные элементы, что становится причиной возникновения электролитного дисбаланса во всех жидкостных системах организма.\r\n\r\nВместе с водой организм теряет значительное количество ионов <strong>Na, Cl, K, Mg, Са.</strong>\r\n\r\nВ ввиду того, что организм человека не может самостоятельно синтезировать минеральные и другие ионы, они должны поступать с едой и водой (Ершова И. Б. и соавт., 2012; Корягина Ю. В. и соавт., 2018).\r\n\r\nКогда речь идет о беременных, нужно учитывать то, что при гестозе часто наблюдается формирование кетоновых тел, которые могут определяться лабораторно уже поздно. Поэтому необходимо сделать особенный акцент на предотвращении их формирования путем регидратации, уменьшения тошноты и возвращения женщины к нормальному питанию (Кучук Д. О. и соавт., 2018).\r\n\r\nВ этом случае может пригодиться специальная вода для регидратации и дезинтоксикации организма РеО от фармацевтической корпорации «Юрия-Фарм». Она была разработана специально для:\r\n<ul>\r\n 	<li>максимально быстрого всасывания воды и электролитов;</li>\r\n 	<li>устранения симптомов дегидратации (утомляемость, головная боль, сухость кожи и слизистых оболочек);</li>\r\n 	<li>предотвращения обезвоживания, нормализации диуреза и снижения интоксикации.</li>\r\n</ul>\r\n<h2>РеО – когда обычной воды мало.</h2>\r\nВода – основа биологических жидкостей организма, поэтому изменение состава употребляемой воды приводит к изменению состава и свойств биологических жидкостей организма.\r\n\r\nВода для медицинских целей РеО имеет сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. Состав специальной воды для регидратации и дезинтоксикации организма ReO</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Химический состав РеО включает:</h2>\r\n<ul>\r\n 	<li>натрий – один из самых важных макроэлементов, который обеспечивает баланс жидкости в организме. Он поддерживает осмотическое давление внеклеточной жидкости организма, задерживает воду;</li>\r\n 	<li>калий, в отличие от натрия, является внутриклеточным катионом, который поддерживает осмотическое давление жидкостей организма внутри клеток. В эритроцитах калия в 10,5 раз больше, чем натрия, а в плазме крови, наоборот, натрия почти в 30 раз больше, чем калия. От калия зависит работа сердца, его ритм, а также нервно-мышечная деятельность. Он уменьшает отеки и снижает утомляемость.</li>\r\n 	<li>Хлор – макроэлемент, который вместе с натрием и калием регулирует водно-солевой баланс, входит в состав биологически активных соединений в организме, нормализует осмотическое давление в крови, лимфе, спинномозговой и других жидкостях. А еще хлор стимулирует аппетит, улучшает функцию печени и способствует выведению из организма шлаков и токсинов.</li>\r\n 	<li>Кальций – не только основа костной ткани. Он принимает активное участие в обеспечении функций движения (сокращение мышц, передача нервного  импульса, реакция мышц на нервное возбуждение), а также в изменении активности гормонов, регуляции ритма сердечных сокращений. Кальций снижает частоту пульса, нормализует артериальное давление и противодействует стрессу.</li>\r\n 	<li>Магний также играет значительную роль в организме человека: он необходим для обмена кальция, витамина С, фосфора, натрия и калия. Магний принимает участие в процессе расщепления углеводов (гликолизе), в перенесении ионов натрия, калия, кальция через мембраны клеток, в нервно-мышечной передаче импульсов, важен для превращения глюкозы в энергию. Благодаря своим маленьким размерам ионы магния очень хорошо вступают в ионно-ковалентную связь со всеми органическими молекулами, которые содержат кислород, скрепляя их между собой. Удаление магния может привести к распаду молекулярных групп, например, рибосом, в которых происходит синтез белковых молекул.</li>\r\n 	<li>Гидрокарбонаты очищают организм от токсинов, регулируют водный баланс, углеводный и белковый обмен, способствуют пищеварению. Гидрокарбонаты тормозят кислородообразование в желудке и улучшают усвоение микро- и макроэлементов.</li>\r\n 	<li>Сорбитол – шестиатомный спирт, который имеет характерный сладкий вкус.</li>\r\n</ul>\r\nУчитывая то, что у беременных часто отмечают такую проблему, как запор, целесообразно восстановительное действие сорбитола на микрофлору кишечника. К тому же сорбитол придает женщине энергию, которая ей особенно необходима (Белоконова Н. А. и соавт., 2016; Лысиков Ю. А., 2009; Ершова И. Б. и соавт., 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nБлагодаря такому составу РеО способствует послаблению симптомов токсикоза, предотвращает обезвоживание, нормализует водно-электролитный обмен и микроциркуляцию, выводит токсины из организма, что ускоряет выздоровление, улучшает самочувствие беременной, уменьшает частоту рвот и уровень ацетона в моче.\r\n\r\n<strong>Значительное преимущество специальной воды для регидратации и дезинтоксикации организма РеО – ее отличные вкусовые качества:</strong>\r\n<ul>\r\n 	<li>имеет приятный солоноватый вкус;</li>\r\n 	<li>легко пьется;</li>\r\n 	<li>может быть использована даже при тошноте.</li>\r\n</ul>\r\nТакой «помощник», как РеО, действительно может пригодиться беременным и помочь справиться с «неприятными» симптомами токсикоза.','Как справиться с «неприятными» симптомами токсикоза?','','inherit','closed','closed','','1228-revision-v1','','','2021-07-16 17:22:33','2021-07-16 14:22:33','',1228,'https://reo.ua/?p=1232',0,'revision','',0),(1233,1,'2021-07-16 17:57:10','2021-07-16 14:57:10','<em>«Вода єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання температури навколишнього середовища, люди можуть підтримувати постійну температуру тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищується, що потенційно може призвести до теплового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слабкість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертермічні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у результаті зовнішнього перегріву організму;</li>\r\n 	<li>тепловий удар у результаті фізичного навантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення температури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які зазвичай швидко минають;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загальну слабкість та перевтому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244 alignright\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a>\r\n\r\nОписані скарги супроводжуються підвищенням частоти серцевих скорочень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічного ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазвичай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізичного навантаження — хворому слід прийняти горизонтальне положення з припіднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина розвитку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впливають на терморегуляцію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при першому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму максимально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина центральної (ядерної) температури вище 40°С є діагностичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове виснаження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевказані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи центральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного напруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного місця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського басейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спричинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 5075 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норовірус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямбліями (Giardia duodenalis), рідше дизентерійною амебою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпростішими.\r\n\r\nПри діареї мандрівників, викликаній найпростішими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвиваються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвитку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignright size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Тривалість захворювання без лікування при діареї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпростішими, може тривати від 2-3 тижнів до кількох місяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом місяців і формується постінфекційний синдром подразненого кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рідини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшого віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винятком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат рідини залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації солей (електролітів). Для ефективного відновлення водно-сольової рівноваги слід використовувати спеціальні збалансовані розчини, що містять основні електорліти і рекомендовані Всесвітньою організацією охорони здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендуються пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопераміду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступеня. </em></strong>Антибиотики можуть використовуватися для лікування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для лікування пацієнтів з тяжкою діареєю мандрівників повинні використуватися антибіотики. Кращим препаратом вважається азитроміцин. Фторхінолони (ципрофлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em><a href=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg\"><img class=\"alignright size-medium wp-image-1238\" src=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" /></a>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та порушень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, порушується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та частота дихання [28].\r\n\r\nПри дегідратації також збільшується частота серцевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речовин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього середовища супроводжується серйозним ризиком виникнення інсульту, шоку та поліорганної недостатності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і натрій втрачаються в однаковій мірі. Причинами ізотонічної втрати води є блювота, діарея, пітливість, опіки, захворювання нирок, гіперглікемія та гіпоальдостеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневоднення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки крові завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихоманка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумовлена прийомом сечогінних засобів, які спричиняють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо</em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшенням частоти дихання, а також лихоманкою, діареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка представлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбережуть від неприємних наслідків зневоднення.\r\n<h2>Що робити, якщо захворювання все таки виникло?</h2>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рідини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регідратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електролітів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отримували оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отримували парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими порціями, щоб попередити роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей ReO щохвилини добре переноситься. При зменшенні блювання можна використовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, метою якого є попередження зневоднення. Триває даний етап до виліковування пацієнта. При цьому об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких випорожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','publish','open','open','','voda-dlya-medichnih-czilej-reo-nadijnij-zahist-vid-nepri%d1%94mnih-syurpriziv-lita','','','2021-07-16 18:06:12','2021-07-16 15:06:12','',0,'https://reo.ua/?p=1233',5,'post','',0),(1234,1,'2021-07-16 17:29:40','2021-07-16 14:29:40','','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','open','closed','','voda-dlya-medichnih-czilej-reo-nadijnij-zahist-vid-nepri%d1%94mnih-syurpriziv-lita','','','2021-07-16 17:29:40','2021-07-16 14:29:40','',1233,'https://reo.ua/wp-content/uploads/2021/07/voda-dlya-medichnih-czilej-reo-nadijnij-zahist-vid-nepriєmnih-syurpriziv-lita.pdf',0,'attachment','application/pdf',0),(1235,1,'2021-07-16 17:29:40','2021-07-16 14:29:40','','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','open','closed','','voda-dlya-medichnih-czilej-reo-nadijnij-zahist-vid-nepri%d1%94mnih-syurpriziv-lita-2','','','2021-07-16 17:29:40','2021-07-16 14:29:40','',0,'https://reo.ua/wp-content/uploads/2021/07/voda-dlya-medichnih-czilej-reo-nadijnij-zahist-vid-nepriєmnih-syurpriziv-lita.pdf',0,'attachment','application/pdf',0),(1236,1,'2021-07-16 17:57:10','2021-07-16 14:57:10','<em>«Вода - єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\nНарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання тем- ператури навколишнього середовища, люди можуть підтримувати постійну тем- пературу тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищу- ється, що потенційно може призвести до те- плового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слаб- кість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертерміч- ні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у резуль- таті зовнішнього перегріву орга- нізму;</li>\r\n 	<li>тепловий удар у результаті фізичного на- вантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення темпе- ратури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які за- звичай швидко мина- ють;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загаль- ну слабкість та пере- втому.</li>\r\n</ul>\r\nОписані скарги супроводжуються підвищенням частоти серцевих скоро- чень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічно- го ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазви- чай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізич- ного навантаження — хворому слід прийняти горизонтальне положення з при- піднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина роз- витку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впли- вають на терморегуля- цію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при пер- шому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму макси- мально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина цен- тральної (ядерної) температури вище 40°С є діагнос- тичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове вис- наження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевка- зані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи цен- тральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\nНезважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного на- пруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного міс- ця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особ- ливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського ба- сейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спри- чинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 50- 75 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норові- рус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямблі- ями (Giardia duodenalis), рідше дизентерійною аме- бою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпрості- шими.\r\n\r\nПри діареї мандрівників, викликаній найпрості- шими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвива- ються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвит- ку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\nТривалість захворювання без лікування при діа- реї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпро- стішими, може тривати від 2-3 тижнів до кількох мі- сяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом міся- ців і формується постінфекційний синдром подразне- ного кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рі- дини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшо- го віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винят- ком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат ріди- ни залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації со- лей (електролітів). Для ефективного відновлення вод- но-сольової рівноваги слід використовувати спеціаль- ні збалансовані розчини, що містять основні електор- літи і рекомендовані Всесвітньою організацією охоро- ни здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендують- ся пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопера- міду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступе- ня. </em></strong>Антибиотики можуть використовуватися для лі- кування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для ліку- вання пацієнтів з тяжкою діареєю мандрівників по- винні використуватися антибіотики. Кращим препа- ратом вважається азитроміцин. Фторхінолони (ци- профлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та пору- шень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, пору- шується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та часто- та дихання [28].\r\n\r\nПри дегідратації також збільшується частота сер- цевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речо- вин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього сере- довища супроводжується серйозним ризиком ви- никнення інсульту, шоку та поліорганної недостат- ності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і на- трій втрачаються в однаковій мірі. Причинами ізото- нічної втрати води є блювота, діарея, пітливість, опі- ки, захворювання нирок, гіперглікемія та гіпоальдо- стеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневод- нення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки кро- ві завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихо- манка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумов- лена прийомом сечогінних засобів, які спричиня- ють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо- </em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшен- ням частоти дихання, а також лихоманкою, ді- ареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка пред- ставлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбе- режуть від неприємних наслідків зневоднення.\r\n<h1>Що робити, якщо захворювання все таки виникло?</h1>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рі- дини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регід- ратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побіч- них реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електро- літів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отриму- вали оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отриму- вали парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефектив- но вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими пор- ціями, щоб попередити роздуття шлунку та рефлекторну блю- воту. Як правило, 5 мл води для медичних цілей ReO щохвили- ни добре переноситься. При зменшенні блювання можна вико- ристовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, ме- тою якого є попередження зневод- нення. Триває даний етап до ви- ліковування пацієнта. При цьо- му об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких ви- порожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блю- вання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 17:57:10','2021-07-16 14:57:10','',1233,'https://reo.ua/?p=1236',0,'revision','',0),(1237,1,'2021-07-16 18:04:29','2021-07-16 15:04:29','<em>«Вода - єдиний напій, що підходить для мудрого!»</em>\n<em>Генрі Девід Торо</em>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\n<h2>Яких захворювань слід остерігатися влітку?</h2>\n<strong><em>Основні захворювання літа включають:</em></strong>\n<ul>\n 	<li>тепловий та сонячний удари;</li>\n 	<li>зневоднення;  діарею мандрівників.</li>\n</ul>\n<h2>Тепловий та сонячний удар</h2>\nНезважаючи на значні коливання тем- ператури навколишнього середовища, люди можуть підтримувати постійну тем- пературу тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищу- ється, що потенційно може призвести до те- плового удару [1].\n\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\n\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слаб- кість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертерміч- ні синдроми, які можуть виникнути влітку [3]:\n<ul>\n 	<li>теплове виснаження;</li>\n 	<li>класичний тепловий удар у резуль- таті зовнішнього перегріву орга- нізму;</li>\n 	<li>тепловий удар у результаті фізичного на- вантаження.</li>\n</ul>\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\n\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\n<ul>\n 	<li>підвищення темпе- ратури тіла, зазвичай не вище 39–40°С;</li>\n 	<li>сильну спрагу;</li>\n 	<li>виражену пітливість;</li>\n 	<li>м’язові спазми, які за- звичай швидко мина- ють;</li>\n 	<li>нудоту;</li>\n 	<li>виражену загаль- ну слабкість та пере- втому.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a>\n\nОписані скарги супроводжуються підвищенням частоти серцевих скоро- чень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічно- го ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазви- чай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\n\nПервинна допомога включає припинення дії високої температури та фізич- ного навантаження — хворому слід прийняти горизонтальне положення з при- піднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\n\nУ людей похилого віку основна причина роз- витку гіпертермії — це тяжкі порушення\n\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впли- вають на терморегуля- цію, і тяжче переносять акліматизацію.\n\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\n\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при пер- шому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму макси- мально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\n\nХоча загальновизнана формальна величина цен- тральної (ядерної) температури вище 40°С є діагнос- тичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове вис- наження у нього переходить в ТУ, немає.\n\nСимптоми теплового удару включають усі вищевка- зані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи цен- тральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\n<ul>\n 	<li>розлади мислення;</li>\n 	<li>збудження;</li>\n 	<li>галюцинації;</li>\n 	<li>порушення орієнтації в часі і просторі;</li>\n 	<li>приглушення свідомості;</li>\n 	<li>кому.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного на- пруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\n<h2>Лікування при тепловому ударі включає:</h2>\n<ul>\n 	<li>госпіталізацію;</li>\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\n</ul>\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\n<h2>Діарея мандрівника</h2>\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\n<ul>\n 	<li>спастичний біль (коліки) в животі;</li>\n 	<li>болючі позиви до дефікації (тенезми);</li>\n 	<li>нудота і блювання.</li>\n</ul>\nВищевказані симптоми, як правило, виникають при зміні постійного міс- ця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\n\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особ- ливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського ба- сейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\n\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\n<h5>Понад 80 % випадків діареї мандрівників спри- чинені різними бактеріальними збудниками [15, 17]:</h5>\n<ul>\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 50- 75 % випадків;</li>\n 	<li>ентероагрегативними штамами coli;</li>\n 	<li>Shigella ;</li>\n 	<li>jejuni;</li>\n 	<li>Salmonella ;</li>\n 	<li>Aeromonas ;</li>\n 	<li>Plesiomonas shigelloides;</li>\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\n 	<li>нехолерним вібріоном.</li>\n</ul>\nУ 12–17 % причиною діареї мандрівників є норові- рус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямблі- ями (Giardia duodenalis), рідше дизентерійною аме- бою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\n\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\n\n7–10 і більше днів при діареї, викликаній найпрості- шими.\n\nПри діареї мандрівників, викликаній найпрості- шими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвива- ються вже після повернення з поїздки [15].\n\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвит- ку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignright size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Тривалість захворювання без лікування при діа- реї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпро- стішими, може тривати від 2-3 тижнів до кількох мі- сяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом міся- ців і формується постінфекційний синдром подразне- ного кишечнику.\n\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\n<h3>1.  Оральна регідратація</h3>\nПід час будь-якої діареї відзначається втрата рі- дини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшо- го віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винят- ком випадків тривалого блювання.\n\nУ всіх категорій пацієнтів відновлення втрат ріди- ни залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\n\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації со- лей (електролітів). Для ефективного відновлення вод- но-сольової рівноваги слід використовувати спеціаль- ні збалансовані розчини, що містять основні електор- літи і рекомендовані Всесвітньою організацією охоро- ни здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\n<h3>2.  Медикаментозна терапія</h3>\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендують- ся пацієнтам з легким перебігом діареї мандрівників\n\nСлід розглянути доцільність застосування лопера- міду або вісмуту субсаліцилату для лікування легкої форми ДМ.\n\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступе- ня. </em></strong>Антибиотики можуть використовуватися для лі- кування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\n\nливе використання лопераміду в якості допоміжної терапії.\n\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для ліку- вання пацієнтів з тяжкою діареєю мандрівників по- винні використуватися антибіотики. Кращим препа- ратом вважається азитроміцин. Фторхінолони (ци- профлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\n<h2>Зневоднення</h2>\n<strong><em><a href=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg\"><img class=\"alignright size-medium wp-image-1238\" src=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" /></a>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\n\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\n\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та пору- шень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, пору- шується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та часто- та дихання [28].\n\nПри дегідратації також збільшується частота сер- цевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речо- вин [30].\n\nУ одному з досліджень було встановлено,\n\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього сере- довища супроводжується серйозним ризиком ви- никнення інсульту, шоку та поліорганної недостат- ності [31].\n\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\n<h5>Існує кілька форм зневоднення [21].</h5>\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і на- трій втрачаються в однаковій мірі. Причинами ізото- нічної втрати води є блювота, діарея, пітливість, опі- ки, захворювання нирок, гіперглікемія та гіпоальдо- стеронізм.\n\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневод- нення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки кро- ві завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихо- манка, прискорене дихання та нецукровий діабет.\n\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумов- лена прийомом сечогінних засобів, які спричиня- ють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\n\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо- </em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшен- ням частоти дихання, а також лихоманкою, ді- ареєю та блюванням, спричиненими харчовими отруєннями.\n<h2>Як профілактувати літні захворювання?</h2>\n<ol>\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\n</ol>\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка пред- ставлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбе- режуть від неприємних наслідків зневоднення.\n<h2>Що робити, якщо захворювання все таки виникло?</h2>\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рі- дини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регід- ратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побіч- них реакцій, які можуть виникнути на фоні інфузійної терапії.\n\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електро- літів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\n\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отриму- вали оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отриму- вали парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\n<ul>\n 	<li>фізичних навантаженнях;</li>\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\n 	<li>алкогольній інтоксикації;</li>\n 	<li>лихоманці;</li>\n 	<li>отруєннях;</li>\n 	<li>діареї;</li>\n 	<li>гострих кишкових інфекціях;</li>\n 	<li>токсикозі у вагітних.</li>\n</ul>\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\n<ul>\n 	<li>фізичних навантаженнях;</li>\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\n 	<li>алкогольній інтоксикації;</li>\n 	<li>лихоманці;</li>\n 	<li>отруєннях;</li>\n 	<li>діареї;</li>\n 	<li>гострих кишкових інфекціях;</li>\n 	<li>токсикозі у вагітних.</li>\n</ul>\nЛегке або помірне зневоднення зазвичай можна ефектив- но вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\n\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими пор- ціями, щоб попередити роздуття шлунку та рефлекторну блю- воту. Як правило, 5 мл води для медичних цілей ReO щохвили- ни добре переноситься. При зменшенні блювання можна вико- ристовувати більші об’єми рідини [36].\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\n<ul>\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\n 	<li><strong><em>етап (підтримуючий)</em></strong>, ме- тою якого є попередження зневод- нення. Триває даний етап до ви- ліковування пацієнта. При цьо- му об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких ви- порожнень і складає:</li>\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блю- вання;</li>\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\n</ul>\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\n\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\n\nReO вибір правильної води став простим, як ніколи!\n<h2>Список літератури</h2>\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\n\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\n\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\n\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\n\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\n\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\n\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\n\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\n\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\n\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\n\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\n\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\n\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\n\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\n\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\n\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\n\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\n\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\n\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\n\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\n\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\n\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\n\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\n\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\n\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\n\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\n\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\n\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\n\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\n\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\n\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\n\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\n\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\n\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\n\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\n\n36. Lennox H. Huang. Dehydration.\n\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-autosave-v1','','','2021-07-16 18:04:29','2021-07-16 15:04:29','',1233,'https://reo.ua/?p=1237',0,'revision','',0),(1238,1,'2021-07-16 18:00:42','2021-07-16 15:00:42','','Child drinks water.','','inherit','open','closed','','child-drinks-water','','','2021-07-16 18:00:42','2021-07-16 15:00:42','',1233,'https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg',0,'attachment','image/jpeg',0),(1239,1,'2021-07-16 18:00:42','2021-07-16 15:00:42','','Child drinks water.','','inherit','open','closed','','child-drinks-water-2','','','2021-07-16 18:00:42','2021-07-16 15:00:42','',0,'https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg',0,'attachment','image/jpeg',0),(1240,1,'2021-07-16 18:00:43','2021-07-16 15:00:43','','74f56134-32bf-47bc-8565-d7fa082c566d','','inherit','open','closed','','74f56134-32bf-47bc-8565-d7fa082c566d','','','2021-07-16 18:00:43','2021-07-16 15:00:43','',1233,'https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg',0,'attachment','image/jpeg',0),(1241,1,'2021-07-16 18:00:43','2021-07-16 15:00:43','','74f56134-32bf-47bc-8565-d7fa082c566d','','inherit','open','closed','','74f56134-32bf-47bc-8565-d7fa082c566d-2','','','2021-07-16 18:00:43','2021-07-16 15:00:43','',0,'https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg',0,'attachment','image/jpeg',0),(1242,1,'2021-07-16 18:00:46','2021-07-16 15:00:46','','breakfast-cute-girl-table_144627-13413','','inherit','open','closed','','breakfast-cute-girl-table_144627-13413','','','2021-07-16 18:00:46','2021-07-16 15:00:46','',1233,'https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg',0,'attachment','image/jpeg',0),(1243,1,'2021-07-16 18:00:46','2021-07-16 15:00:46','','breakfast-cute-girl-table_144627-13413','','inherit','open','closed','','breakfast-cute-girl-table_144627-13413-2','','','2021-07-16 18:00:46','2021-07-16 15:00:46','',0,'https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg',0,'attachment','image/jpeg',0),(1244,1,'2021-07-16 18:00:48','2021-07-16 15:00:48','','Young woman with heatstroke','Young woman with heatstroke on a beach','inherit','open','closed','','young-woman-with-heatstroke','','','2021-07-16 18:00:48','2021-07-16 15:00:48','',1233,'https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg',0,'attachment','image/jpeg',0),(1245,1,'2021-07-16 18:00:48','2021-07-16 15:00:48','','Young woman with heatstroke','Young woman with heatstroke on a beach','inherit','open','closed','','young-woman-with-heatstroke-2','','','2021-07-16 18:00:48','2021-07-16 15:00:48','',0,'https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg',0,'attachment','image/jpeg',0),(1246,1,'2021-07-16 18:00:50','2021-07-16 15:00:50','','person-washing-hands-with-soap','','inherit','open','closed','','person-washing-hands-with-soap','','','2021-07-16 18:00:50','2021-07-16 15:00:50','',1233,'https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg',0,'attachment','image/jpeg',0),(1247,1,'2021-07-16 18:00:50','2021-07-16 15:00:50','','person-washing-hands-with-soap','','inherit','open','closed','','person-washing-hands-with-soap-2','','','2021-07-16 18:00:50','2021-07-16 15:00:50','',0,'https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg',0,'attachment','image/jpeg',0),(1248,1,'2021-07-16 18:01:46','2021-07-16 15:01:46','<em>«Вода - єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання тем- ператури навколишнього середовища, люди можуть підтримувати постійну тем- пературу тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищу- ється, що потенційно може призвести до те- плового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слаб- кість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертерміч- ні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у резуль- таті зовнішнього перегріву орга- нізму;</li>\r\n 	<li>тепловий удар у результаті фізичного на- вантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення темпе- ратури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які за- звичай швидко мина- ють;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загаль- ну слабкість та пере- втому.</li>\r\n</ul>\r\nОписані скарги супроводжуються підвищенням частоти серцевих скоро- чень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічно- го ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазви- чай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізич- ного навантаження — хворому слід прийняти горизонтальне положення з при- піднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина роз- витку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впли- вають на терморегуля- цію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при пер- шому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму макси- мально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина цен- тральної (ядерної) температури вище 40°С є діагнос- тичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове вис- наження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевка- зані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи цен- тральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\nНезважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного на- пруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного міс- ця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особ- ливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського ба- сейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спри- чинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 50- 75 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норові- рус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямблі- ями (Giardia duodenalis), рідше дизентерійною аме- бою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпрості- шими.\r\n\r\nПри діареї мандрівників, викликаній найпрості- шими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвива- ються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвит- ку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\nТривалість захворювання без лікування при діа- реї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпро- стішими, може тривати від 2-3 тижнів до кількох мі- сяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом міся- ців і формується постінфекційний синдром подразне- ного кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рі- дини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшо- го віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винят- ком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат ріди- ни залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації со- лей (електролітів). Для ефективного відновлення вод- но-сольової рівноваги слід використовувати спеціаль- ні збалансовані розчини, що містять основні електор- літи і рекомендовані Всесвітньою організацією охоро- ни здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендують- ся пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопера- міду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступе- ня. </em></strong>Антибиотики можуть використовуватися для лі- кування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для ліку- вання пацієнтів з тяжкою діареєю мандрівників по- винні використуватися антибіотики. Кращим препа- ратом вважається азитроміцин. Фторхінолони (ци- профлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та пору- шень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, пору- шується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та часто- та дихання [28].\r\n\r\nПри дегідратації також збільшується частота сер- цевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речо- вин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього сере- довища супроводжується серйозним ризиком ви- никнення інсульту, шоку та поліорганної недостат- ності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і на- трій втрачаються в однаковій мірі. Причинами ізото- нічної втрати води є блювота, діарея, пітливість, опі- ки, захворювання нирок, гіперглікемія та гіпоальдо- стеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневод- нення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки кро- ві завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихо- манка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумов- лена прийомом сечогінних засобів, які спричиня- ють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо- </em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшен- ням частоти дихання, а також лихоманкою, ді- ареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка пред- ставлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбе- режуть від неприємних наслідків зневоднення.\r\n<h1>Що робити, якщо захворювання все таки виникло?</h1>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рі- дини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регід- ратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побіч- них реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електро- літів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отриму- вали оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отриму- вали парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефектив- но вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими пор- ціями, щоб попередити роздуття шлунку та рефлекторну блю- воту. Як правило, 5 мл води для медичних цілей ReO щохвили- ни добре переноситься. При зменшенні блювання можна вико- ристовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, ме- тою якого є попередження зневод- нення. Триває даний етап до ви- ліковування пацієнта. При цьо- му об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких ви- порожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блю- вання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 18:01:46','2021-07-16 15:01:46','',1233,'https://reo.ua/?p=1248',0,'revision','',0),(1249,1,'2021-07-16 18:02:57','2021-07-16 15:02:57','<em>«Вода - єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання тем- ператури навколишнього середовища, люди можуть підтримувати постійну тем- пературу тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищу- ється, що потенційно може призвести до те- плового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слаб- кість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертерміч- ні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у резуль- таті зовнішнього перегріву орга- нізму;</li>\r\n 	<li>тепловий удар у результаті фізичного на- вантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення темпе- ратури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які за- звичай швидко мина- ють;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загаль- ну слабкість та пере- втому.</li>\r\n</ul>\r\n[caption id=\"attachment_1244\" align=\"alignleft\" width=\"300\"]<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a> Young woman with heatstroke on a beach[/caption]\r\n\r\nОписані скарги супроводжуються підвищенням частоти серцевих скоро- чень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічно- го ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазви- чай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізич- ного навантаження — хворому слід прийняти горизонтальне положення з при- піднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина роз- витку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впли- вають на терморегуля- цію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при пер- шому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму макси- мально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина цен- тральної (ядерної) температури вище 40°С є діагнос- тичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове вис- наження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевка- зані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи цен- тральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного на- пруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного міс- ця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особ- ливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського ба- сейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5><a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignleft size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Понад 80 % випадків діареї мандрівників спри- чинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 50- 75 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норові- рус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямблі- ями (Giardia duodenalis), рідше дизентерійною аме- бою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпрості- шими.\r\n\r\nПри діареї мандрівників, викликаній найпрості- шими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвива- ються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвит- ку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\nТривалість захворювання без лікування при діа- реї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпро- стішими, може тривати від 2-3 тижнів до кількох мі- сяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом міся- ців і формується постінфекційний синдром подразне- ного кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рі- дини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшо- го віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винят- ком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат ріди- ни залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації со- лей (електролітів). Для ефективного відновлення вод- но-сольової рівноваги слід використовувати спеціаль- ні збалансовані розчини, що містять основні електор- літи і рекомендовані Всесвітньою організацією охоро- ни здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендують- ся пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопера- міду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступе- ня. </em></strong>Антибиотики можуть використовуватися для лі- кування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для ліку- вання пацієнтів з тяжкою діареєю мандрівників по- винні використуватися антибіотики. Кращим препа- ратом вважається азитроміцин. Фторхінолони (ци- профлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та пору- шень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, пору- шується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та часто- та дихання [28].\r\n\r\nПри дегідратації також збільшується частота сер- цевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речо- вин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього сере- довища супроводжується серйозним ризиком ви- никнення інсульту, шоку та поліорганної недостат- ності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і на- трій втрачаються в однаковій мірі. Причинами ізото- нічної втрати води є блювота, діарея, пітливість, опі- ки, захворювання нирок, гіперглікемія та гіпоальдо- стеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневод- нення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки кро- ві завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихо- манка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумов- лена прийомом сечогінних засобів, які спричиня- ють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо- </em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшен- ням частоти дихання, а також лихоманкою, ді- ареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка пред- ставлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбе- режуть від неприємних наслідків зневоднення.\r\n<h1>Що робити, якщо захворювання все таки виникло?</h1>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рі- дини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регід- ратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побіч- них реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електро- літів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отриму- вали оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отриму- вали парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефектив- но вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими пор- ціями, щоб попередити роздуття шлунку та рефлекторну блю- воту. Як правило, 5 мл води для медичних цілей ReO щохвили- ни добре переноситься. При зменшенні блювання можна вико- ристовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, ме- тою якого є попередження зневод- нення. Триває даний етап до ви- ліковування пацієнта. При цьо- му об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких ви- порожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блю- вання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 18:02:57','2021-07-16 15:02:57','',1233,'https://reo.ua/?p=1249',0,'revision','',0),(1251,1,'2021-07-16 18:05:14','2021-07-16 15:05:14','<em>«Вода єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання температури навколишнього середовища, люди можуть підтримувати постійну температуру тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищується, що потенційно може призвести до теплового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слабкість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертермічні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у результаті зовнішнього перегріву організму;</li>\r\n 	<li>тепловий удар у результаті фізичного навантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення температури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які зазвичай швидко минають;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загальну слабкість та перевтому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a>\r\n\r\nОписані скарги супроводжуються підвищенням частоти серцевих скорочень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічного ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазвичай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізичного навантаження — хворому слід прийняти горизонтальне положення з припіднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина розвитку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впливають на терморегуляцію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при першому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму максимально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина центральної (ядерної) температури вище 40°С є діагностичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове виснаження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевказані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи центральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного напруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного місця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського басейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спричинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 5075 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норовірус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямбліями (Giardia duodenalis), рідше дизентерійною амебою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпростішими.\r\n\r\nПри діареї мандрівників, викликаній найпростішими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвиваються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвитку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignright size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Тривалість захворювання без лікування при діареї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпростішими, може тривати від 2-3 тижнів до кількох місяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом місяців і формується постінфекційний синдром подразненого кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рідини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшого віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винятком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат рідини залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації солей (електролітів). Для ефективного відновлення водно-сольової рівноваги слід використовувати спеціальні збалансовані розчини, що містять основні електорліти і рекомендовані Всесвітньою організацією охорони здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендуються пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопераміду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступеня. </em></strong>Антибиотики можуть використовуватися для лікування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для лікування пацієнтів з тяжкою діареєю мандрівників повинні використуватися антибіотики. Кращим препаратом вважається азитроміцин. Фторхінолони (ципрофлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em><a href=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg\"><img class=\"alignright size-medium wp-image-1238\" src=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" /></a>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та порушень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, порушується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та частота дихання [28].\r\n\r\nПри дегідратації також збільшується частота серцевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речовин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього середовища супроводжується серйозним ризиком виникнення інсульту, шоку та поліорганної недостатності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і натрій втрачаються в однаковій мірі. Причинами ізотонічної втрати води є блювота, діарея, пітливість, опіки, захворювання нирок, гіперглікемія та гіпоальдостеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневоднення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки крові завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихоманка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумовлена прийомом сечогінних засобів, які спричиняють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо</em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшенням частоти дихання, а також лихоманкою, діареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка представлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбережуть від неприємних наслідків зневоднення.\r\n<h2>Що робити, якщо захворювання все таки виникло?</h2>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рідини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регідратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електролітів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отримували оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отримували парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими порціями, щоб попередити роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей ReO щохвилини добре переноситься. При зменшенні блювання можна використовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, метою якого є попередження зневоднення. Триває даний етап до виліковування пацієнта. При цьому об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких випорожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 18:05:14','2021-07-16 15:05:14','',1233,'https://reo.ua/?p=1251',0,'revision','',0),(1250,1,'2021-07-16 18:04:23','2021-07-16 15:04:23','<em>«Вода - єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання тем- ператури навколишнього середовища, люди можуть підтримувати постійну тем- пературу тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищу- ється, що потенційно може призвести до те- плового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слаб- кість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертерміч- ні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у резуль- таті зовнішнього перегріву орга- нізму;</li>\r\n 	<li>тепловий удар у результаті фізичного на- вантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення темпе- ратури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які за- звичай швидко мина- ють;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загаль- ну слабкість та пере- втому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a>\r\n\r\nОписані скарги супроводжуються підвищенням частоти серцевих скоро- чень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічно- го ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазви- чай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізич- ного навантаження — хворому слід прийняти горизонтальне положення з при- піднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина роз- витку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впли- вають на терморегуля- цію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при пер- шому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму макси- мально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина цен- тральної (ядерної) температури вище 40°С є діагнос- тичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове вис- наження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевка- зані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи цен- тральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного на- пруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного міс- ця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особ- ливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського ба- сейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спри- чинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 50- 75 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норові- рус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямблі- ями (Giardia duodenalis), рідше дизентерійною аме- бою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпрості- шими.\r\n\r\nПри діареї мандрівників, викликаній найпрості- шими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвива- ються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвит- ку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignright size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Тривалість захворювання без лікування при діа- реї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпро- стішими, може тривати від 2-3 тижнів до кількох мі- сяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом міся- ців і формується постінфекційний синдром подразне- ного кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рі- дини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшо- го віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винят- ком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат ріди- ни залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації со- лей (електролітів). Для ефективного відновлення вод- но-сольової рівноваги слід використовувати спеціаль- ні збалансовані розчини, що містять основні електор- літи і рекомендовані Всесвітньою організацією охоро- ни здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендують- ся пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопера- міду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступе- ня. </em></strong>Антибиотики можуть використовуватися для лі- кування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для ліку- вання пацієнтів з тяжкою діареєю мандрівників по- винні використуватися антибіотики. Кращим препа- ратом вважається азитроміцин. Фторхінолони (ци- профлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em><a href=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg\"><img class=\"alignright size-medium wp-image-1238\" src=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" /></a>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та пору- шень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, пору- шується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та часто- та дихання [28].\r\n\r\nПри дегідратації також збільшується частота сер- цевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речо- вин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього сере- довища супроводжується серйозним ризиком ви- никнення інсульту, шоку та поліорганної недостат- ності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і на- трій втрачаються в однаковій мірі. Причинами ізото- нічної втрати води є блювота, діарея, пітливість, опі- ки, захворювання нирок, гіперглікемія та гіпоальдо- стеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневод- нення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки кро- ві завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихо- манка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумов- лена прийомом сечогінних засобів, які спричиня- ють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо- </em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшен- ням частоти дихання, а також лихоманкою, ді- ареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка пред- ставлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбе- режуть від неприємних наслідків зневоднення.\r\n<h2>Що робити, якщо захворювання все таки виникло?</h2>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рі- дини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регід- ратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побіч- них реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електро- літів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отриму- вали оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отриму- вали парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією орга- нізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клі- мату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефектив- но вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими пор- ціями, щоб попередити роздуття шлунку та рефлекторну блю- воту. Як правило, 5 мл води для медичних цілей ReO щохвили- ни добре переноситься. При зменшенні блювання можна вико- ристовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, ме- тою якого є попередження зневод- нення. Триває даний етап до ви- ліковування пацієнта. При цьо- му об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких ви- порожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блю- вання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 18:04:23','2021-07-16 15:04:23','',1233,'https://reo.ua/?p=1250',0,'revision','',0),(1252,1,'2021-07-16 18:06:12','2021-07-16 15:06:12','<em>«Вода єдиний напій, що підходить для мудрого!»</em>\r\n<em>Генрі Девід Торо</em>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413.jpg\"><img class=\"alignright size-medium wp-image-1242\" src=\"https://reo.ua/wp-content/uploads/2021/07/breakfast-cute-girl-table_144627-13413-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" /></a>Нарешті на зміну сезону дощів прийшло спекотне літо, якого всі так чекали. Ця пора асоціюється у нашій свідомості з відпочинком та відновленням здоров’я, втім, часто літо приносить не тільки приємні сюрпризи. Під час сезону відпусток ми більше подорожуємо та активно відпочиваємо. Багато людей переносять свої фізичні активності із спортзалу на вулицю, заміняючи тренажери стадіонами або відкритими спортивними майданчиками. На жаль, інколи вихідні у горах, пляжний волейбол чи подорож до моря можуть стати причиною захворювань, про які слід знати кожному.\r\n<h2>Яких захворювань слід остерігатися влітку?</h2>\r\n<strong><em>Основні захворювання літа включають:</em></strong>\r\n<ul>\r\n 	<li>тепловий та сонячний удари;</li>\r\n 	<li>зневоднення;  діарею мандрівників.</li>\r\n</ul>\r\n<h2>Тепловий та сонячний удар</h2>\r\nНезважаючи на значні коливання температури навколишнього середовища, люди можуть підтримувати постійну температуру тіла, збалансовуючи вироблення (теплопродукцію) та втрати (тепловіддачу) тепла. Коли теплопродукція переважає над тепловіддачею, температура тіла підвищується, що потенційно може призвести до теплового удару [1].\r\n\r\nНадмірне нагрівання викликає розпад білків, дестабілізує фосфоліпіди та ліпопротеїни, а також розріджує ліпіди мембран, що може призвести до серцево-судинного колапсу, поліорганної недостатності та, зрештою, смерті [2].\r\n\r\nЯкщо під час роботи, занять спортом або відпочинку на сонці ви відчули слабкість і головний біль, це може бути першою ознакою перегріву (гіпертермії). Вирізняють наступні гіпертермічні синдроми, які можуть виникнути влітку [3]:\r\n<ul>\r\n 	<li>теплове виснаження;</li>\r\n 	<li>класичний тепловий удар у результаті зовнішнього перегріву організму;</li>\r\n 	<li>тепловий удар у результаті фізичного навантаження.</li>\r\n</ul>\r\nВід гіпертермічних синдромів, зокрема теплового удару, в світі гине більше людей, ніж від потопів, ураганів/ циклонів, разом взятих. Унаслідок глобального потепління останніми роками тепловий удар регулярно зустрічається вже і в таких країнах, як Данія [4].\r\n\r\n<strong><em>Теплове виснаження </em></strong>(англ. <em>heat exhaustion</em>) — це найпоширеніша форма порушення терморегуляції, спричинена високою температурою тіла в результаті втрати організмом значного об’єму рідини.\r\n<h5>Пацієнти з тепловим виснаженням скаржаться на [3]:</h5>\r\n<ul>\r\n 	<li>підвищення температури тіла, зазвичай не вище 39–40°С;</li>\r\n 	<li>сильну спрагу;</li>\r\n 	<li>виражену пітливість;</li>\r\n 	<li>м’язові спазми, які зазвичай швидко минають;</li>\r\n 	<li>нудоту;</li>\r\n 	<li>виражену загальну слабкість та перевтому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke.jpg\"><img class=\"size-medium wp-image-1244 alignright\" src=\"https://reo.ua/wp-content/uploads/2021/07/heatstroke-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" /></a>\r\n\r\nОписані скарги супроводжуються підвищенням частоти серцевих скорочень (ЧСС) та помірним зниженням артеріального тиску. Ознаки неврологічного ураження відсутні, хоча може виникати тимчасове запаморочення, яке зазвичай швидко проходить. Таке запаморочення, яке в повсякденному житті часто називають «зомління», описують терміном «теплове синкопе».\r\n\r\nПервинна допомога включає припинення дії високої температури та фізичного навантаження — хворому слід прийняти горизонтальне положення з припіднятими ногами. Лікування теплового виснаження включає відновлення втрат рідини (регідратацію) та інші загальні підтримуючі заходи. Як правило, в застосуванні методів охолодження тіла необхідності немає.\r\n\r\nУ людей похилого віку основна причина розвитку гіпертермії — це тяжкі порушення\r\n\r\nтерморегуляції, в першу чергу — потовиділення. Необхідно пам’ятати, що старі люди можуть пити менше води, потайки приймати ліки, які впливають на терморегуляцію, і тяжче переносять акліматизацію.\r\n\r\n<strong><em>Тепловий удар </em></strong>(англ. <em>heat stroke) </em>— це найтяжча форма гострої недостатності терморегуляції в умовах підвищеної температури навколишнього середовища з підвищенням центральної (ядерної) температури вище 40°С, що супроводжується порушенням свідомості [1, 5].\r\n\r\nСуттєва відмінність між тепловим виснаженням та тепловим ударом (ТУ) полягає у тому, що при першому компенсаторно-захисні функції організму все ще здатні впоратися з тепловим навантаженням. При ТУ компенсаторно-захисні функції організму максимально напружуються і врешті-решт виснажуються та наступає декомпенсація [7].\r\n\r\nХоча загальновизнана формальна величина центральної (ядерної) температури вище 40°С є діагностичним критерієм ТУ, ця цифра дещо умовна. Чіткої єдиної граничної температури, при якій відбувається декомпенсація у конкретного пацієнта і теплове виснаження у нього переходить в ТУ, немає.\r\n\r\nСимптоми теплового удару включають усі вищевказані симптоми теплового виснаження, однак у більш тяжкій формі. Критичними особливостями теплового удару є гіпертермія вище 40°С і порушення роботи центральної нервової системи (ЦНС), що у 80% випадків має раптовий початок.\r\n<h5>Симптоми можуть бути ледь помітними і включати [6]:</h5>\r\n<ul>\r\n 	<li>розлади мислення;</li>\r\n 	<li>збудження;</li>\r\n 	<li>галюцинації;</li>\r\n 	<li>порушення орієнтації в часі і просторі;</li>\r\n 	<li>приглушення свідомості;</li>\r\n 	<li>кому.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap.jpg\"><img class=\"alignright size-medium wp-image-1246\" src=\"https://reo.ua/wp-content/uploads/2021/07/person-washing-hands-with-soap-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" /></a>Незважаючи на те, що відсутність потовиділення (ангідроз) вважається класичною ознакою теплового удару, більш ніж половина хворих пітніють, особливо у випадках теплового удару в результаті фізичного напруження. Ангідроз зазвичай є пізнім симптомом [2, 6].\r\n<h2>Лікування при тепловому ударі включає:</h2>\r\n<ul>\r\n 	<li>госпіталізацію;</li>\r\n 	<li>3 підтримку дихання та серцевої діяльності;</li>\r\n 	<li>3 екстремальне охолодження тіла, яке найчастіше полягає у зануренні постраждалого в холодну воду або охолодження методомвипаровування;</li>\r\n 	<li>3 оральну регідратацію збалансованими водносольовими розчинами.</li>\r\n</ul>\r\nУ літніх осіб і людей з холодних країн ТУ може виникнути і при температурі, нижчій, ніж 40°С (близько 39°С), а у тренованих атлетів і мешканців країн з жарким кліматом навіть при температурі близько 40 °С захисні механізми можуть спрацьовувати і ТУ певний час не розвивається [3].\r\n<h2>Діарея мандрівника</h2>\r\n<strong><em>Діарея мандрівників (ДМ)</em></strong> — це 3 або більше епізодів неоформлених випорожнень протягом 24 годин у поєднанні з мінімум одним з наступних додаткових симптомів [8, 9]:\r\n<ul>\r\n 	<li>спастичний біль (коліки) в животі;</li>\r\n 	<li>болючі позиви до дефікації (тенезми);</li>\r\n 	<li>нудота і блювання.</li>\r\n</ul>\r\nВищевказані симптоми, як правило, виникають при зміні постійного місця проживання, подорожі за кордон протягом першого тижня і/або відразу після повернення з поїздки.\r\n\r\nЩорічно з 100 млн. людей, які подорожують в країни, що розвиваються, особливо в тропічні і субтропічні райони (Латинську Америку, країни Карибського басейну, Південної Азії, Близького Сходу та Африку), діареєю мандрівників хворіє від 30 до 70 % туристів і щороку реєструється понад 40 млн. нових випадків ДМ [10–12].\r\n\r\nЗа даними європейських досліджень, частота діареї мандрівників нижча, ніж була 20 років тому і становить до 40 %, тоді як в минулому вона дорівнювала 70 % [13, 14].\r\n<h5>Понад 80 % випадків діареї мандрівників спричинені різними бактеріальними збудниками [15, 17]:</h5>\r\n<ul>\r\n 	<li>ентеротоксигенними штамами coli (ЕТЕС) 5075 % випадків;</li>\r\n 	<li>ентероагрегативними штамами coli;</li>\r\n 	<li>Shigella ;</li>\r\n 	<li>jejuni;</li>\r\n 	<li>Salmonella ;</li>\r\n 	<li>Aeromonas ;</li>\r\n 	<li>Plesiomonas shigelloides;</li>\r\n 	<li>ентеротоксигенними штами Bacteroides fragilis;</li>\r\n 	<li>нехолерним вібріоном.</li>\r\n</ul>\r\nУ 12–17 % причиною діареї мандрівників є норовірус, ротавірус та астровіруси. Близько 10 % випадків ДМ мають протозойну природу і спричинені лямбліями (Giardia duodenalis), рідше дизентерійною амебою (Entamoeba histolytica), Cryptosporidium spp., Microsporidium spp.) [17–20].\r\n\r\nІнкубаційний період залежить від збудника і може коливатися від 6–72 годин при діареї, викликаній ETEC, Vibrio parahaemolyticus та деякими вірусами до\r\n\r\n7–10 і більше днів при діареї, викликаній найпростішими.\r\n\r\nПри діареї мандрівників, викликаній найпростішими, симптоми захворювання рідко виникають в перші кілька тижнів подорожі і, як правило, розвиваються вже після повернення з поїздки [15].\r\n\r\nКлінічні симптоми зазвичай виникають на 3–4-й день подорожі, хоча можливий і другий пік розвитку захворювання на 10-й день. У більшості пацієнтів частота діареї не перевищує 3–5 разів на добу, проте у 20 % вона може доходити до 10–15 разів. Часто діарея супроводжується болем у животі (55–65 % випадків) та лихоманкою (50–60 %). Кров в калі відзначається у 10 % випадків [15].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d.jpg\"><img class=\"alignright size-medium wp-image-1240\" src=\"https://reo.ua/wp-content/uploads/2021/07/74f56134-32bf-47bc-8565-d7fa082c566d-300x187.jpg\" alt=\"\" width=\"300\" height=\"187\" /></a>Тривалість захворювання без лікування при діареї мандрівників вірусної природи становить 2–4 дні, бактеріальної від 3 до 7 діб, а ДМ, викликана найпростішими, може тривати від 2-3 тижнів до кількох місяців [15]. У деяких пацієнтів скарги на болі в животі і нестійкі випорожнення зберігаються протягом місяців і формується постінфекційний синдром подразненого кишечнику.\r\n\r\n<strong><em>Основні принципи лікування пацієнтів з діареєю мандрівників, у відповідності до рекомендацій </em></strong><strong><em>Центрів по профілактиці та контролю за захворюваннями США (CDC), наступні [15]:</em></strong>\r\n<h3>1.  Оральна регідратація</h3>\r\nПід час будь-якої діареї відзначається втрата рідини і електролітів, тому їх відновлення є важливим компонентом лікування, особливо у дітей молодшого віку і у дорослих з хронічними захворюваннями. У дорослих мандрівників, які не страждають хронічною патологією, важке зневоднення (дегідратація) на фоні ДМ зустрічається вкрай рідко, за винятком за винятком випадків тривалого блювання.\r\n\r\nУ всіх категорій пацієнтів відновлення втрат рідини залишається обов’язковим доповненням основної терапії і допомагає мандрівникові швидше віднови-\r\n\r\nтися після інфекції [15]. Звичайна столова вода, соки і газовані напої містять дуже низькі концентрації солей (електролітів). Для ефективного відновлення водно-сольової рівноваги слід використовувати спеціальні збалансовані розчини, що містять основні електорліти і рекомендовані Всесвітньою організацією охорони здоров’я. До таких розчинів відноситься <strong>вода для медичних цілей ReO </strong>[15].\r\n<h3>2.  Медикаментозна терапія</h3>\r\n<strong><em>Терапія  діареї  мандрівників  легкого  ступеня. </em></strong>Антибактеріальні препарати (АБП) не рекомендуються пацієнтам з легким перебігом діареї мандрівників\r\n\r\nСлід розглянути доцільність застосування лопераміду або вісмуту субсаліцилату для лікування легкої форми ДМ.\r\n\r\n<strong><em>Т</em></strong><strong><em>е</em></strong><strong><em>р</em></strong><strong><em>а</em></strong><strong><em>п</em></strong><strong><em>і</em></strong><strong><em>я діареї мандрівників середнього ступеня. </em></strong>Антибиотики можуть використовуватися для лікування пацієнтів із середньотяжким перебігом ДМ. Перевагу надають фторхінолонам (ципрофлоксацин, левофлоксацин), азитроміцину і рифаксиміну. Мож-\r\n\r\nливе використання лопераміду в якості допоміжної терапії.\r\n\r\n<strong><em>Терапія важкої діареї мандрівників. </em></strong>Для лікування пацієнтів з тяжкою діареєю мандрівників повинні використуватися антибіотики. Кращим препаратом вважається азитроміцин. Фторхінолони (ципрофлоксацин, левофлоксацин) і рифаксимін можуть використовуватися для лікування пацієнтів з важким перебігом ДМ нешигельозного походження.\r\n<h2>Зневоднення</h2>\r\n<strong><em><a href=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29.jpg\"><img class=\"alignright size-medium wp-image-1238\" src=\"https://reo.ua/wp-content/uploads/2021/07/6bd7dc24d4e2718cb35d3caee8166c29-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" /></a>Зневоднення організму </em></strong>можливе при обмеженому надходженні рідини або збільшеному її виведенні, а також при одночасній дії цих двох факторів [21, 22].\r\n\r\nЗміни, які відбуваються в організмі влітку, з метою підтримки нормальної температури тіла, збільшують втрати рідини, у порівнянні з холодною порою року. Так, при збільшенні частоти дихання втрати рідини з повітрям, що видихається, зростають на 5–20 мл/кг/добу. У пацієнтів зі значним потовиділенням на 5–25 мл/кг/добу збільшується випаровування з поверхні шкіри [23–27].\r\n\r\nВтрата понад 1 % рідини організму призводить до відчуття втоми, слабкості, зниження апетиту та порушень механізмів терморегуляції. Якщо зневоднення прогресує і дефіцит води становить 4 % і більше, порушується концентрація уваги, виникає головний біль, сонливість, підвищується температура тіла та частота дихання [28].\r\n\r\nПри дегідратації також збільшується частота серцевих скорочень та знижується артеріальний тиск [29]. При зниженні тиску у серце потрапляє менше крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речовин [30].\r\n\r\nУ одному з досліджень було встановлено,\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла, при високій температурі навколишнього середовища супроводжується серйозним ризиком виникнення інсульту, шоку та поліорганної недостатності [31].\r\n\r\nДіти, особливо раннього віку, більш чутливі до втрат рідини, ніж дорослі. Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла відносно маси, більшим вмістом води (понад 70 % маси тіла у немовлят, близько 65 % в ранньому віці та 60 % у дорослих) [32, 33].\r\n<h5>Існує кілька форм зневоднення [21].</h5>\r\n<strong><em>Ізотонічна дегідратація </em></strong>виникає, коли вода і натрій втрачаються в однаковій мірі. Причинами ізотонічної втрати води є блювота, діарея, пітливість, опіки, захворювання нирок, гіперглікемія та гіпоальдостеронізм.\r\n\r\n<strong><em>Гіпертонічна дегідратація </em></strong>— форма зневоднення, при якій втрати води перевищують втрати натрію. Рівень натрію та осмолярність сироватки крові завжди будуть підвищеними при гіпертонічній дегідратації. Надмірна втрата води відбувається через шкіру, легені та нирки. Причиною найчастіше є лихоманка, прискорене дихання та нецукровий діабет.\r\n\r\n<strong><em>Гіпотонічна дегідратація </em></strong>в основному обумовлена прийомом сечогінних засобів, які спричиняють більшу втрату натрію, ніж води. Гіпотонічна що втрата води у кількості від 5 до 7 % маси тіла у здорових молодих чоловіків, які займалися фізичними навантаженнями у спеку, призводила до аритмій та передчасних скорочень  шлуночків [7].\r\n\r\nВлітку внаслідок зневоднення найчастіше виникає <strong><em>ізо</em></strong>та <strong><em>гіпертонічна дегідратація</em></strong>, зумовлені підвищеною пітливістю, збільшенням частоти дихання, а також лихоманкою, діареєю та блюванням, спричиненими харчовими отруєннями.\r\n<h2>Як профілактувати літні захворювання?</h2>\r\n<ol>\r\n 	<li>Мийте руки. Це правило вбереже вас не тільки від коронавірусу, але і від багатьох збудників харчових отруєнь.</li>\r\n 	<li>Ретельно мийте свіжі фрукти, овочі і ягоди.</li>\r\n 	<li>Не купайтеся в невеликих водоймах зі стоячою водою (озерах і ставках).</li>\r\n 	<li>Зберігайте і розморожуйте продукти в холодильнику.</li>\r\n 	<li>Не зберігайте приготовані і сирі продукти поруч.</li>\r\n 	<li>Для запобігання тепловому удару носіть сонцезахисні окуляри, головний убір і світлий одяг з натуральних тканин.</li>\r\n</ol>\r\nПийте достатньо збалансованої за складом рідини. Найкраще для цього підходить <strong>вода для медичних цілей ReO</strong>, яка представлена на фармацевтичному ринку України компанією <strong>Юрія Фарм</strong>. Кілька ковтків <strong>води ReO </strong>при перших ознаках спраги вбережуть від неприємних наслідків зневоднення.\r\n<h2>Що робити, якщо захворювання все таки виникло?</h2>\r\nОсновою лікування усіх вище описаних захворювань, окрім усунення їх причини, є відновлення втрат рідини, тобто регідратаційна терапія. У ряді досліджень доведено, що швидка оральна регідратаційна терапія (ОРТ) відповідним розчином є такою ж ефективною, як внутрішньовенна інфузія розчинів. При цьому регідратація водно-сольовими розчинами пероральним шляхом неінвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nОРТ <strong>водою ReO </strong>завдяки збалансованому складу дозволяє компенсувати втрати рідини, основних електролітів та енергії й має високий профіль безпеки при лікуванні зневоднення будь-якої природи [34].\r\n\r\nЕфективність оральної регідратації була продемонстрована в численних дослідженнях. Так, систематичний огляд, що включив 16 досліджень за участі 1545 дітей віком до 15 років з діареєю, показав, що діти, які отримували оральну регідратацію, мали значно меншу частоту несприятливих клінічних наслідків (зокрема, судоми, летальні наслідки) та вірогідне скорочення строків їх перебування у лікарні порівняно з дітьми, які отримували парентеральну регідратацію. На підставі цього було зроблено висновок, що оральна регідратація є більш ефективним та безпечним методом відновлення втрат рідини порівняно з парентеральною регідратацією [35].\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\n<h2><strong>Коли слід пити воду для медичних цілей ReO?</strong></h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях;</li>\r\n 	<li>токсикозі у вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідратаційної терапії <strong>водою ReO</strong>.\r\n\r\n<strong>Воду ReO </strong>при зневодненні слід пити часто невеликими порціями, щоб попередити роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей ReO щохвилини добре переноситься. При зменшенні блювання можна використовувати більші об’єми рідини [36].\r\n<h5>Лікування зневоднення проводиться у 2 етапи [37]:</h5>\r\n<ul>\r\n 	<li><strong><em>етап (власне регідратації)</em></strong>, який направлений на швидке відновлення запасів втраченої рідини та триває 3–4 години. Необхідний об’єм <strong>води ReO </strong>на даному етапі, залежить від віку та маси тіла хворого і становить:</li>\r\n 	<li>для немовлят та дітей вагою до 30 кг — 50–100 мл/кг води ReO протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг — 2–4 л води ReO протягом 4 годин.</li>\r\n 	<li><strong><em>етап (підтримуючий)</em></strong>, метою якого є попередження зневоднення. Триває даний етап до виліковування пацієнта. При цьому об’єм <strong>води ReO, </strong>окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких випорожнень і складає:</li>\r\n 	<li>якщо маса тіла менше 10 кг — по 60–120 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10–30 кг — по 120– 240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг — стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\nВода для медичних цілей ReO — найкращий супутник для літніх активностей.\r\n\r\nЗбалансований склад води ReO забезпечує максимально швидке всмоктування води та електролітів та рятує організм від дегідратації, незалежно від її причини. Вода ReO не містить консервантів, барвників та вуглеводів, що забезпечує її безпеку навіть у дітей та людей, схильних до алергічних реакцій. З появою на полицях аптек та магазинів\r\n\r\nReO вибір правильної води став простим, як ніколи!\r\n<h2>Список літератури</h2>\r\nLipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med. 2013 Dec. 24(4):351-61.\r\n\r\n2. Robert S. Helman, Joe Alcock. Heat Stroke. Medscape.\r\n\r\n3. Бондар М. В. Гіпертермічні синдроми: етіологія, патогенез, діагностика та інтенсивна терапія / М. В. Бондар, М. М. Пилипенко, Т. В. Овсієнко, І. М. Невмержицький // Медицина неотложных состояний. — 2018. — № 2. — С. 7-16.\r\n\r\n4. Morch S.S., Andersen J.D.H., Bestle M.H. Heat Stroke: A Medical Emergency Appearing in New Regions // Case Rep. Crit. Care. — 2017. — № 2017. — Р. 6219236\r\n\r\n5. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20. 346 (25):1978-88.\r\n\r\n6. Рахимбаев Р.Б., Ташенов Д.К., Седенко В.А.. Тепловое истошение и тепловой удар // Наука о жизни и здоровье. — № 6 (1-2).\r\n\r\n7. David Tanen. Heatstroke. MSD and the MSD Manuals.\r\n\r\n8. Hill D.R., Beeching N.J. Travelers’ diarrhea. Curr Opin Infect Dis. 2010;23(5):481-487.\r\n\r\n9. Steffen R., Hill D.R., DuPont H.L. Traveler’s diarrhea: a clinical review. JAMA. 2015;313(1):71-80.\r\n\r\n10. Greenwood Z., Black J., Weld L., et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15:221228.\r\n\r\n11. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n12. Jelinek T., Nothdurft H.D., Haditsch M., et al. Consensus paper treatment of acute traveler’s diarrhea. Practice recommendation for travel advice. MMW Fortschr Med. 2017;159(Suppl 4):4-11.\r\n\r\n13. Pitzurra R., Steffen R., Tschopp A., et al. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations. BMC Infect Dis. 2010;10:231.\r\n\r\n14. Steffen R., Tornieporth N., Clemens S.A., et al. Epidemiology of travelers’ diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-237\r\n\r\n15. Centers for Disease Control and Prevention. Yellow Book, 2017, Chapter 2. Travelers’ Diarrhea.\r\n\r\n16. de la Cabada Bauche J., Dupont H.L. New Developments in Traveler’s Diarrhea. Gastroenterol Hepatol (NY). 2011;7(2):88-95.\r\n\r\n17. Taylor D.N., Bourgeois A.L., Ericsson C.D., et al. A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74(6):1060-1066.\r\n\r\n18. Jiang Z.D., Lowe B., Verenkar M.P., et al. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis. 2002;185(4):497-502.\r\n\r\n19. Koo H.L., Ajami N.J., Jiang Z.D., et al. Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol. 2010;48(5):1673-1676.\r\n\r\n20. Pandey P., Bodhidatta L., Lewis M., et al. Travelers’ diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011;18(2):102-108\r\n\r\n21. Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6.\r\n\r\n22. Крамарьов С.О. Сучасні підходи до регідратаційної терапії при інфекційних захворюваннях у дітей / С.О. Крамарьов, В.В. Євтушенко, О.М. Євтушенко // Сімейна медицина. — 2016. — № 1. — С. 130-133.\r\n\r\n23. Graneto JW. Emergent Management of Pediatric Patients with Fever.\r\n\r\n24. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/ EBP.2010.8.2.72\r\n\r\n25. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Pediatrics. 2003 Feb;111(2):424-5.PMID: 12563072.\r\n\r\n26. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n27. Manz F. Hydration in Children. J Am Coll Nutr. 2007 Oct;26(5 Suppl):562S-569S. PMID: 17921466.\r\n\r\n28. Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644.\r\n\r\n29. Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91.\r\n\r\n30. Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, 1985. Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401.\r\n\r\n31. Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988.\r\n\r\n32. National Collaborating Centre for Women’s and Children’s Health (UK). Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years. London: Royal College of Obstetricians &amp; Gynaecologists (UK); 2013 May. PMID: 25340238.\r\n\r\n33. ESPGHAN. Fluid and electrolytes (Na, Cl and K). J Pediatr Gastroenterol Nutr. 2005;41:S33-38. doi: 10.1097/01. mpg.0000181846.93628.0e.\r\n\r\n34. World Health Organization. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva, Switzerland: WHO Press; 2000. 162 p.\r\n\r\n35. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2004 May;158(5):483-90. doi:10.1001/archpedi.158.5.483.\r\n\r\n36. Lennox H. Huang. Dehydration.\r\n\r\n37. Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669','Вода для медичних цілей ReO надійний захист від неприємних сюрпризів літа','','inherit','closed','closed','','1233-revision-v1','','','2021-07-16 18:06:12','2021-07-16 15:06:12','',1233,'https://reo.ua/?p=1252',0,'revision','',0),(1254,1,'2021-07-19 17:09:58','2021-07-19 14:09:58','Водний гомеостаз (ВГ) – необхідна умова життєдіяльності будь-якого організму. Підтримка ВГ відбувається за рахунок трьох злагоджених процесів: надходження води ззовні, адекватної абсорбції у шлунково-кишковому тракті (ШКТ) та ниркової екскреції. Підтримка оптимального балансу води й електролітів є результатом складних контрольованих фізіологічних механізмів, які врівноважують їх надходження та виділення, забезпечуючи сталість внутрішнього середовища. Порушення будь-якої ланки ВГ супроводжується розвитком патологічного процесу, при якому органи та системи не можуть адекватно виконувати свою функцію. Тому обрання оптимальних заходів щодо запобігання зневодненню організму при різних патологічних станах є необхідним навиком сучасного лікаря.\r\n<h2>Дегідратація</h2>\r\nДегідратація (зневоднення) – патологічний стан, який виникає внаслідок зменшення в організмі води з порушенням водно-сольового обміну та метаболізму. Слід зазначити, що не існує ізольованого водного чи електролітного дисбалансу, адже виникнення одного з цих порушень є пусковим механізмом для розвитку іншого.\r\n\r\nВтрата води може мати ниркове та позаниркове походження. У клінічній практиці частіше виділяють такі типи зневоднення за співвідношенням втрати води й електролітів:\r\n<ul>\r\n 	<li>гіпертонічний (вододефіцитний) тип зневоднення – виникає при ураженні нирок із розвитком хронічної ниркової недостатності, при гострій нирковій недостатності (поліурична стадія), надмірному застосуванні осмотичних діуретиків,  цукровому та нецукровому діабеті, втраті води через дихальні шляхи (гіпервентиляційний синдром) та шкіру (опіки), неправильне проведення регідратації гіперосмолярними розчинами, надмірне надходження солей натрію в організм;</li>\r\n 	<li>гіпотонічний (соледефіцитний) тип зневоднення може розвиватися у пацієнтів після хірургічного втручання на органах черевної порожнини, а також в осіб із хронічною діареєю;</li>\r\n 	<li>ізотонічний тип зневоднення найчастіше виникає на тлі втрати води через ШКТ (блювання, діарея різної етіології, у тому числі інфекційної), при лихоманці, значному потовиділенні, зниженні продукції гормонів надниркових залоз, поліуричній стадії хронічної ниркової недостатності.</li>\r\n</ul>\r\n<strong>Діти, особливо раннього віку, більш чутливі до втрати рідини, ніж дорослі. </strong>Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла порівняно з масою, більшим умістом води (понад 70% маси тіла у немовлят, близько 65% – у дітей раннього віку та 60% у дорослих).\r\n\r\nДегідратація – дуже небезпечний стан, який може призвести до тяжкого порушення роботи органів та смерті. Якщо перший ступінь зневоднення не має виражених клінічних проявів (завдяки механізмам компенсації), то вже при другому настає виснаження компенсаторних можливостей (олігурія, сухість шкіри та слизових оболонок, субнормальний артеріальний тиск, недостатність периферичного кровообігу тощо), а подальше прогресування може спричинити критичне зниження артеріального тиску, тяжкий електролітний дисбаланс, анурію та порушення свідомості. Тому педіатр повинен бути насторожений при виникненні станів, які можуть ініціювати розвиток зневоднення, враховувати цей аспекттпри визначенні терапевтичної тактики та своєчасно призначати розчини для запобігання дегідратації.\r\n\r\nПовне розуміння ВГ неможливе без усвідомлення значення деяких електролітів для організму (табл.). Як ужезгадувалосявище,порушенняводно-електролітного балансу є комплексною проблемою, тому ефективна регідратація організму передбачає застосування саме водно-сольових розчинів, а не просто води. Наведемо найчастіші причини зневоднення дитячого організму, якому можна запобігти шляхом своєчасного призначення водно-сольових розчинів.\r\n<h2>Найчастіші причини дегідратації у дітей</h2>\r\n<strong>Гостра діарея</strong>\r\n\r\nНайчастішою причиною дегідратації у дітей є гостра діарея, яка, за даними Всесвітньої організації охорони здоров’я, вважається другою за значимістю причиною смерті дітей віком до 5 років. Діарея – це 3 чи більше епізодів неоформлених або рідких випорожнень порівняно з такими за попередні 24 год; при цьому епізодом вважаються рідкі випорожнення протягом 1 дня і більше, а його закінченням – принаймні 2 дні після нормалізації випорожнень. Наявність частих оформлених чи пастоподібних випорожнень у  дітей,  які  перебувають на грудному вигодовуванні, не є діареєю.\r\n\r\nЩороку реєструється близько 1,7 млрд випадків діареї у всьому світі. Протягом останніх десятиліть\r\n\r\nсмертність від гострої діареї у дітей віком до 5 років істотно знизилася: з 1,2 млн у 2000 р. до 0,5 млн – у 2016. Найбільше значення у цій тенденції має впровадження ефективних методів лікування, а саме пероральної регідратації та дієтотерапії (зокрема, підтримка грудного вигодовування в період захворювання). Найважливіший меседж у всіх міжнародних  і  вітчизняних  рекомендаціях  – не  зволікати з регідратацією, а починати поповнювати водносольові втрати організму при перших симптомах основного захворювання.\r\n\r\nЗастосування при гострій кишковій інфекції водно-сольових розчинів є ефективним, простим, економічно доступним, не потребує переривання годування дитини.\r\n\r\n<strong>Гострі респіраторні захворювання</strong>\r\n\r\nЗа даними літератури, у 25-50% дітей з гострими респіраторними інфекціями наявні ознаки порушення ВГ. Дегідратація організму виникає внаслідок перспіраційних втрат через шкіру (надмірне потовиділення) та дихальні шляхи (почастішання дихання), а також через зменшення надходження рідини з їжею на тлі зниження апетиту. Через активацію катаболізму при інфекційному захворюванні збільшується вивільнення води, виведення її та розчинених у ній електролітів із сечею. Крім того, посилення енергетичного обміну призводить до виснаження запасів\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"691\">Таблиця. <strong>Електроліти та їх значення для організму (D. Crawford, 2018)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"400\"><strong>Функція</strong></th>\r\n<th width=\"93\"><strong>Норма </strong><strong>(ммоль/л)</strong></th>\r\n<th width=\"126\"><strong>Добова потреба </strong><strong>(ммоль/кг)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний позаклітинний іон, який має значний вплив на осмос та осмолярність. Гіпонатріємія (&lt;135 ммоль/л) розвивається внаслідок надмірного надходження води чи втрати солей, гіпернатріємія (&gt;145 ммоль/л) – через недостатнє надходження/втрату води чи надлишкове вживання солей. Ці два стани становлять серйозну небезпеку для дітей. Дефіцит натрію супроводжується порушенням дета реполяризації клітин і може провокувати появу судом, апное, кому</td>\r\n<td width=\"93\">135-145</td>\r\n<td width=\"126\">2-4</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний внутрішньоклітинний іон. Концентрація всередині клітини становить 140-150 ммоль/л, поза клітиною цей показник значно нижчий. Рівень калію в організмі регулюється нирками та за допомогою механізму міжклітинного транспорту. Відхилення рівня калію потребує негайної корекції, адже іон бере участь у роботі серцевого м’яза</td>\r\n<td width=\"93\">Недоношені немовлята – 4,5-7,2; доношені немовлята – 3,6-6,4; діти – 3,5-5,0</td>\r\n<td width=\"126\">1-2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Функція магнію та кальцію тісно пов’язана з рівнем фосфатів. Основне значення магнію полягає у забезпеченні енергетичного обміну, функціонування натрій-калієвого насоса для передачі нервових імпульсів</td>\r\n<td width=\"93\">0,6-1,0</td>\r\n<td width=\"126\">0,07-0,2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основним «сховищем» іона є кістки. Невелика кількість кальцію перебуває у зв’язаній з білком або іонізованій формі. Лише іонізований кальцій здатний покидати кровоносне русло та брати участь у внутрішньоклітинних процесах (регуляція ферментів, вплив на мембранний потенціал, збудливість нейронів, скорочення м’язів,\r\n\r\nу тому числі міокарда). Тяжка гіпокальціємія (&lt;1,75 ммоль/л) може спричинити тетанію, ларингоспазм і генералізовані судоми</td>\r\n<td width=\"93\">&nbsp;\r\n\r\nЗагальний – 2,1-2,7; іонізований – 1,2-1,3</td>\r\n<td width=\"126\">0,3</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Існує переважно в позаклітинному просторі. Бере участь у підтримці цілісності клітини, впливає на осмотичний тиск і водний баланс, а також має роль у підтримці кислотноосновного стану</td>\r\n<td width=\"93\">Немовлята – 96-111; діти  102-112</td>\r\n<td width=\"126\">Пов’язана з натрієм</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nглюкози й глікогену та супроводжується накопиченням кетонових тіл. У цьому аспекті запобігання виникненню   водно-електролітного    дисбалансу та корекція кетонемії мають значення при веденні дітей з гострими  респіраторними  інфекціями (С.О. Крамарьов, 2019).\r\n\r\nДля уникнення дегідратації у дітей на тлі ГРІ педіатри часто рекомендують вживати більшу ніж зазвичай кількість рідини. Проте лікарям важливо пам’ятати про таке явище, як водна інтоксикація, яка виникає при вживанні води без вмісту електролітів. Це супроводжується зниженням рівня натрію в крові, що характеризується розвитком набряків (навіть головного мозку). Тому крім поповнення втрат рідини необхідно коригувати дефіцит електролітів (особливо натрію та калію).\r\n<h2>Ацетонемічний синдром</h2>\r\nАцетонемічний синдром (АС, cиндром ацетонемічного блювання, кетонемічний синдром, cиндром циклічного блювання) – сукупність симптомів, що зумовлені підвищенням вмісту у крові кетонових тіл: ацетону, ацетооцтової та  b-оксимасляної  кислот на тлі відносного чи абсолютного дефіциту вуглеводів та/або переважання утворення кетогенних амінокислот і жирних кислот. Первинний АС є клінічним проявом нервово-артритичного діатезу. Причинами вторинного АС є інфекційні та соматичні захворювання, гіпертермія, післяопераційні стани, блювання різного генезу.\r\n\r\nОсновна небезпека при АС – метаболічний ацидоз, що призводить до гіперкапнії (через гіпервентиляцію), вазоконстрикції, пошкодження ліпідних мембран клітин. Проникаючи до ЦНС, кетонові тіла подразнюють блювотний центр в головному мозку. Ці патологічні зміни призводять до тяжких метаболічних розладів, електролітного дисбалансу, дегідратації,  інтоксикації,   гемодинамічних   порушень, у тяжких випадках – до розладів свідомості.\r\n\r\nОсновними напрямами  лікування  дітей  з  АС є усунення його тригерів шляхом дотримання дієти, <strong>поповнення водного дефіциту за рахунок регідра</strong><strong>таційної терапії, </strong>медикаментозне лікування (ентеросорбенти, седативні засоби, протиблювотні препарати та ін.).\r\n<h2>Як уникнути дегідратації у дітей</h2>\r\nКожному педіатру важливо пам’ятати, що дегідратація організму дитини настає з моменту виникнення симптомів основного захворювання (наприклад, з першого епізоду діареї при гострій кишковій інфекції чи підвищення температури тіла при гострій  респіраторній  інфекції),  але  може  одразу не проявлятися через включення компенсаторних механізмів. Своєчасно вжиті заходи дозволяють уникнути розвитку дегідратації та відновити ВГ організму.\r\n\r\nФізіологічна потреба у воді розраховується за методом Holiday Segar та залежить від маси тіла дитини:\r\n<ul>\r\n 	<li><strong>1-10 кг – 100 мл/кг;</strong></li>\r\n 	<li><strong>10,1-20,0 кг – 1000 мл + 50 мл на кожен кілограм понад 10 кг;</strong></li>\r\n 	<li><strong>більше 20 кг – 1500 мл + 20 мл на кожен кілограм понад 20 кг.</strong></li>\r\n</ul>\r\nПри патологічній втраті рідини збільшується потреба у воді з метою компенсації її дефіциту. Вже з перших годин захворювання дитині дають підвищену кількість рідини: при гострій діареї дітям молодшим 2 років – по 50-100 мл після кожного випорожнення; дітям від 2 до 10 років – по 100-200 мл після кожного випорожнення; дітям старшим 10 років – скільки бажають випити. Підвищення температури тіла супроводжується збільшенням потреби у рідині на 10 мл/кг на кожен 1 °С. При наявності тахіпное втрати рідини з перспірацією зростають на 5-20 мл/кг за добу, при значному потовиділенні – на 5-25 мл/кг за добу (С.О. Крамарьов, 2019).\r\n\r\nУ більшості випадків разом з водою організм дитини втрачає й електроліти, тому вживання звичайної води для своєчасного запобігання дегідратації нерідко недостатньо. Для швидкого відновлення водноелектролітного балансу підходять розчини, які містять усі необхідні електроліти (натрій, калій, кальцій, магній, хлор). Такою є вода <strong>ReO </strong>(фармацевтична компанія «Юрія-Фарм»), яка не містить консервантів, барвників, має приємний смак, що важливо для засобів, які застосовуються у педіатричній практиці.\r\n\r\nВода <strong>ReO </strong>розроблена для своєчасного запобігання втраті рідини дитячим організмом та розвитку дегідратації, що може настати за різних умов:\r\n<ul>\r\n 	<li>захворювання, які супроводжуються блюванням і діареєю;</li>\r\n 	<li>підвищене потовиділення;</li>\r\n 	<li>підвищена втрата рідини під час фізичного навантаження чи у спеку тощо.</li>\r\n</ul>\r\n<strong>Отже, дегідратація організму – це частий патологічний стан у дітей, який виникає при різних захворюваннях. Педіатр повинен чітко розуміти, у яких випадках існує ризик зневоднення організму, та не допустити його розвитку шляхом своєчасного призначення водно-сольових розчинів. Вода ReO – оптимальний за складом і доступний водно-сольовий розчин для запобігання розвитку дегідратації як у дітей, так і у дорослих. При веденні пацієнта доцільніше вжити заходів для уникнення зневоднення, ніж боротися з його наслідками.</strong>\r\n\r\n<em>Підготувала </em><strong><em>Ілона Цюпа</em></strong>','Зневоднення у дітей: як запобігти, а не боротися з наслідками?','','publish','open','open','','znevodnennya-u-ditej-yak-zapobigti-a-ne-borotisya-z-naslidkami','','','2021-07-19 17:13:18','2021-07-19 14:13:18','',0,'https://reo.ua/?p=1254',4,'post','',0),(1257,1,'2021-07-19 17:07:45','2021-07-19 14:07:45','','Зневоднення у дітей_як запобігти, а не боротися з наслідками','','inherit','open','closed','','znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami','','','2021-07-19 17:07:45','2021-07-19 14:07:45','',1254,'https://reo.ua/wp-content/uploads/2021/07/znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami.pdf',0,'attachment','application/pdf',0),(1258,1,'2021-07-19 17:07:45','2021-07-19 14:07:45','','Зневоднення у дітей_як запобігти, а не боротися з наслідками','','inherit','open','closed','','znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami-2','','','2021-07-19 17:07:45','2021-07-19 14:07:45','',0,'https://reo.ua/wp-content/uploads/2021/07/znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami.pdf',0,'attachment','application/pdf',0),(1256,1,'2021-07-19 17:07:18','2021-07-19 14:07:18','','2. Зневоднення у дітей_як запобігти, а не боротися з наслідками_укр_ИСХОДНИК','','inherit','open','closed','','2-znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami_ukr_ishodnik-2','','','2021-07-19 17:07:18','2021-07-19 14:07:18','',0,'https://reo.ua/wp-content/uploads/2021/07/2.-znevodnennya-u-ditej_yak-zapobigti-a-ne-borotisya-z-naslidkami_ukr_ishodnik.pdf',0,'attachment','application/pdf',0),(1261,1,'2021-07-19 17:12:46','2021-07-19 14:12:46','Водний гомеостаз (ВГ) – необхідна умова життєдіяльності будь-якого організму. Підтримка ВГ відбувається за рахунок трьох злагоджених процесів: надходження води ззовні, адекватної абсорбції у шлунково-кишковому тракті (ШКТ) та ниркової екскреції. Підтримка оптимального балансу води й електролітів є результатом складних контрольованих фізіологічних механізмів, які врівноважують їх надходження та виділення, забезпечуючи сталість внутрішнього середовища. Порушення будь-якої ланки ВГ супроводжується розвитком патологічного процесу, при якому органи та системи не можуть адекватно виконувати свою функцію. Тому обрання оптимальних заходів щодо запобігання зневодненню організму при різних патологічних станах є необхідним навиком сучасного лікаря.\r\n<h2>Дегідратація</h2>\r\nДегідратація (зневоднення) – патологічний стан, який виникає внаслідок зменшення в організмі води з порушенням водно-сольового обміну та метаболізму. Слід зазначити, що не існує ізольованого водного чи електролітного дисбалансу, адже виникнення одного з цих порушень є пусковим механізмом для розвитку іншого.\r\n\r\nВтрата води може мати ниркове та позаниркове походження. У клінічній практиці частіше виділяють такі типи зневоднення за співвідношенням втрати води й електролітів:\r\n<ul>\r\n 	<li>гіпертонічний (вододефіцитний) тип зневоднення – виникає при ураженні нирок із розвитком хронічної ниркової недостатності, при гострій нирковій недостатності (поліурична стадія), надмірному застосуванні осмотичних діуретиків,  цукровому та нецукровому діабеті, втраті води через дихальні шляхи (гіпервентиляційний синдром) та шкіру (опіки), неправильне проведення регідратації гіперосмолярними розчинами, надмірне надходження солей натрію в організм;</li>\r\n 	<li>гіпотонічний (соледефіцитний) тип зневоднення може розвиватися у пацієнтів після хірургічного втручання на органах черевної порожнини, а також в осіб із хронічною діареєю;</li>\r\n 	<li>ізотонічний тип зневоднення найчастіше виникає на тлі втрати води через ШКТ (блювання, діарея різної етіології, у тому числі інфекційної), при лихоманці, значному потовиділенні, зниженні продукції гормонів надниркових залоз, поліуричній стадії хронічної ниркової недостатності.</li>\r\n</ul>\r\n<strong>Діти, особливо раннього віку, більш чутливі до втрати рідини, ніж дорослі. </strong>Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла порівняно з масою, більшим умістом води (понад 70% маси тіла у немовлят, близько 65% – у дітей раннього віку та 60% у дорослих).\r\n\r\nДегідратація – дуже небезпечний стан, який може призвести до тяжкого порушення роботи органів та смерті. Якщо перший ступінь зневоднення не має виражених клінічних проявів (завдяки механізмам компенсації), то вже при другому настає виснаження компенсаторних можливостей (олігурія, сухість шкіри та слизових оболонок, субнормальний артеріальний тиск, недостатність периферичного кровообігу тощо), а подальше прогресування може спричинити критичне зниження артеріального тиску, тяжкий електролітний дисбаланс, анурію та порушення свідомості. Тому педіатр повинен бути насторожений при виникненні станів, які можуть ініціювати розвиток зневоднення, враховувати цей аспекттпри визначенні терапевтичної тактики та своєчасно призначати розчини для запобігання дегідратації.\r\n\r\nПовне розуміння ВГ неможливе без усвідомлення значення деяких електролітів для організму (табл.). Як ужезгадувалосявище,порушенняводно-електролітного балансу є комплексною проблемою, тому ефективна регідратація організму передбачає застосування саме водно-сольових розчинів, а не просто води. Наведемо найчастіші причини зневоднення дитячого організму, якому можна запобігти шляхом своєчасного призначення водно-сольових розчинів.\r\n<h2>Найчастіші причини дегідратації у дітей</h2>\r\n<strong>Гостра діарея</strong>\r\n\r\nНайчастішою причиною дегідратації у дітей є гостра діарея, яка, за даними Всесвітньої організації охорони здоров’я, вважається другою за значимістю причиною смерті дітей віком до 5 років. Діарея – це 3 чи більше епізодів неоформлених або рідких випорожнень порівняно з такими за попередні 24 год; при цьому епізодом вважаються рідкі випорожнення протягом 1 дня і більше, а його закінченням – принаймні 2 дні після нормалізації випорожнень. Наявність частих оформлених чи пастоподібних випорожнень у  дітей,  які  перебувають на грудному вигодовуванні, не є діареєю.\r\n\r\nЩороку реєструється близько 1,7 млрд випадків діареї у всьому світі. Протягом останніх десятиліть\r\n\r\nсмертність від гострої діареї у дітей віком до 5 років істотно знизилася: з 1,2 млн у 2000 р. до 0,5 млн – у 2016. Найбільше значення у цій тенденції має впровадження ефективних методів лікування, а саме пероральної регідратації та дієтотерапії (зокрема, підтримка грудного вигодовування в період захворювання). Найважливіший меседж у всіх міжнародних  і  вітчизняних  рекомендаціях  – не  зволікати з регідратацією, а починати поповнювати водносольові втрати організму при перших симптомах основного захворювання.\r\n\r\nЗастосування при гострій кишковій інфекції водно-сольових розчинів є ефективним, простим, економічно доступним, не потребує переривання годування дитини.\r\n\r\n<strong>Гострі респіраторні захворювання</strong>\r\n\r\nЗа даними літератури, у 25-50% дітей з гострими респіраторними інфекціями наявні ознаки порушення ВГ. Дегідратація організму виникає внаслідок перспіраційних втрат через шкіру (надмірне потовиділення) та дихальні шляхи (почастішання дихання), а також через зменшення надходження рідини з їжею на тлі зниження апетиту. Через активацію катаболізму при інфекційному захворюванні збільшується вивільнення води, виведення її та розчинених у ній електролітів із сечею. Крім того, посилення енергетичного обміну призводить до виснаження запасів\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"691\">Таблиця. <strong>Електроліти та їх значення для організму (D. Crawford, 2018)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"400\"><strong>Функція</strong></th>\r\n<th width=\"93\"><strong>Норма </strong><strong>(ммоль/л)</strong></th>\r\n<th width=\"126\"><strong>Добова потреба </strong><strong>(ммоль/кг)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний позаклітинний іон, який має значний вплив на осмос та осмолярність. Гіпонатріємія (&lt;135 ммоль/л) розвивається внаслідок надмірного надходження води чи втрати солей, гіпернатріємія (&gt;145 ммоль/л) – через недостатнє надходження/втрату води чи надлишкове вживання солей. Ці два стани становлять серйозну небезпеку для дітей. Дефіцит натрію супроводжується порушенням дета реполяризації клітин і може провокувати появу судом, апное, кому</td>\r\n<td width=\"93\">135-145</td>\r\n<td width=\"126\">2-4</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний внутрішньоклітинний іон. Концентрація всередині клітини становить\r\n\r\n140-150 ммоль/л, поза клітиною цей показник значно нижчий. Рівень калію в організмі регулюється нирками та за допомогою механізму міжклітинного транспорту.\r\n\r\nВідхилення рівня калію потребує негайної корекції, адже іон бере участь у роботі серцевого м’яза</td>\r\n<td width=\"93\">Недоношені немовлята – 4,5-7,2; доношені немовлята – 3,6-6,4; діти – 3,5-5,0</td>\r\n<td width=\"126\">1-2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Функція магнію та кальцію тісно пов’язана з рівнем фосфатів. Основне значення магнію полягає у забезпеченні енергетичного обміну, функціонування натрій-калієвого насоса для передачі нервових імпульсів</td>\r\n<td width=\"93\">0,6-1,0</td>\r\n<td width=\"126\">0,07-0,2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основним «сховищем» іона є кістки. Невелика кількість кальцію перебуває у зв’язаній з білком або іонізованій формі. Лише іонізований кальцій здатний покидати кровоносне русло та брати участь у внутрішньоклітинних процесах (регуляція ферментів, вплив на мембранний потенціал, збудливість нейронів, скорочення м’язів,\r\n\r\nу тому числі міокарда). Тяжка гіпокальціємія (&lt;1,75 ммоль/л) може спричинити тетанію, ларингоспазм і генералізовані судоми</td>\r\n<td width=\"93\">&nbsp;\r\n\r\nЗагальний – 2,1-2,7; іонізований – 1,2-1,3</td>\r\n<td width=\"126\">0,3</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Існує переважно в позаклітинному просторі. Бере участь у підтримці цілісності клітини, впливає на осмотичний тиск і водний баланс, а також має роль у підтримці кислотноосновного стану</td>\r\n<td width=\"93\">Немовлята – 96-111; діти  102-112</td>\r\n<td width=\"126\">Пов’язана з натрієм</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nглюкози й глікогену та супроводжується накопиченням кетонових тіл. У цьому аспекті запобігання виникненню   водно-електролітного    дисбалансу та корекція кетонемії мають значення при веденні дітей з гострими  респіраторними  інфекціями (С.О. Крамарьов, 2019).\r\n\r\nДля уникнення дегідратації у дітей на тлі ГРІ педіатри часто рекомендують вживати більшу ніж зазвичай кількість рідини. Проте лікарям важливо пам’ятати про таке явище, як водна інтоксикація, яка виникає при вживанні води без вмісту електролітів. Це супроводжується зниженням рівня натрію в крові, що характеризується розвитком набряків (навіть головного мозку). Тому крім поповнення втрат рідини необхідно коригувати дефіцит електролітів (особливо натрію та калію).\r\n<h2>Ацетонемічний синдром</h2>\r\nАцетонемічний синдром (АС, cиндром ацетонемічного блювання, кетонемічний синдром, cиндром циклічного блювання) – сукупність симптомів, що зумовлені підвищенням вмісту у крові кетонових тіл: ацетону, ацетооцтової та  b-оксимасляної  кислот на тлі відносного чи абсолютного дефіциту вуглеводів та/або переважання утворення кетогенних амінокислот і жирних кислот. Первинний АС є клінічним проявом нервово-артритичного діатезу. Причинами вторинного АС є інфекційні та соматичні захворювання, гіпертермія, післяопераційні стани, блювання різного генезу.\r\n\r\nОсновна небезпека при АС – метаболічний ацидоз, що призводить до гіперкапнії (через гіпервентиляцію), вазоконстрикції, пошкодження ліпідних мембран клітин. Проникаючи до ЦНС, кетонові тіла подразнюють блювотний центр в головному мозку. Ці патологічні зміни призводять до тяжких метаболічних розладів, електролітного дисбалансу, дегідратації,  інтоксикації,   гемодинамічних   порушень, у тяжких випадках – до розладів свідомості.\r\n\r\nОсновними напрямами  лікування  дітей  з  АС є усунення його тригерів шляхом дотримання дієти, <strong>поповнення водного дефіциту за рахунок регідра</strong><strong>таційної терапії, </strong>медикаментозне лікування (ентеросорбенти, седативні засоби, протиблювотні препарати та ін.).\r\n<h2>Як уникнути дегідратації у дітей</h2>\r\nКожному педіатру важливо пам’ятати, що дегідратація організму дитини настає з моменту виникнення симптомів основного захворювання (наприклад, з першого епізоду діареї при гострій кишковій інфекції чи підвищення температури тіла при гострій  респіраторній  інфекції),  але  може  одразу не проявлятися через включення компенсаторних механізмів. Своєчасно вжиті заходи дозволяють уникнути розвитку дегідратації та відновити ВГ організму.\r\n\r\nФізіологічна потреба у воді розраховується за методом Holiday Segar та залежить від маси тіла дитини:\r\n<ul>\r\n 	<li><strong>1-10 кг – 100 мл/кг;</strong></li>\r\n 	<li><strong>10,1-20,0 кг – 1000 мл + 50 мл на кожен кілограм понад 10 кг;</strong></li>\r\n 	<li><strong>більше 20 кг – 1500 мл + 20 мл на кожен кілограм понад 20 кг.</strong></li>\r\n</ul>\r\nПри патологічній втраті рідини збільшується потреба у воді з метою компенсації її дефіциту. Вже з перших годин захворювання дитині дають підвищену кількість рідини: при гострій діареї дітям молодшим 2 років – по 50-100 мл після кожного випорожнення; дітям від 2 до 10 років – по 100-200 мл після кожного випорожнення; дітям старшим 10 років – скільки бажають випити. Підвищення температури тіла супроводжується збільшенням потреби у рідині на 10 мл/кг на кожен 1 °С. При наявності тахіпное втрати рідини з перспірацією зростають на 5-20 мл/кг за добу, при значному потовиділенні – на 5-25 мл/кг за добу (С.О. Крамарьов, 2019).\r\n\r\nУ більшості випадків разом з водою організм дитини втрачає й електроліти, тому вживання звичайної води для своєчасного запобігання дегідратації нерідко недостатньо. Для швидкого відновлення водноелектролітного балансу підходять розчини, які містять усі необхідні електроліти (натрій, калій, кальцій, магній, хлор). Такою є вода <strong>ReO </strong>(фармацевтична компанія «Юрія-Фарм»), яка не містить консервантів, барвників, має приємний смак, що важливо для засобів, які застосовуються у педіатричній практиці.\r\n\r\nВода <strong>ReO </strong>розроблена для своєчасного запобігання втраті рідини дитячим організмом та розвитку дегідратації, що може настати за різних умов:\r\n<ul>\r\n 	<li>захворювання, які супроводжуються блюванням і діареєю;</li>\r\n 	<li>підвищене потовиділення;</li>\r\n 	<li>підвищена втрата рідини під час фізичного навантаження чи у спеку тощо.</li>\r\n</ul>\r\n<strong>Отже, дегідратація організму – це частий патологічний стан у дітей, який виникає при різних захворюваннях. Педіатр повинен чітко розуміти, у яких випадках існує ризик зневоднення організму, та не допустити його розвитку шляхом своєчасного призначення водно-сольових розчинів. Вода ReO – оптимальний за складом і доступний водно-сольовий розчин для запобігання розвитку дегідратації як у дітей, так і у дорослих. При веденні пацієнта доцільніше вжити заходів для уникнення зневоднення, ніж боротися з його наслідками.</strong>\r\n\r\n<em>Підготувала </em><strong><em>Ілона Цюпа</em></strong>','Зневоднення у дітей: як запобігти, а не боротися з наслідками?','','inherit','closed','closed','','1254-revision-v1','','','2021-07-19 17:12:46','2021-07-19 14:12:46','',1254,'https://reo.ua/?p=1261',0,'revision','',0),(1260,1,'2021-07-19 17:11:58','2021-07-19 14:11:58','Водний гомеостаз (ВГ) – необхідна умова життєдіяльності будь-якого організму. Підтримка ВГ відбувається за рахунок трьох злагоджених процесів: надходження води ззовні, адекватної абсорбції у шлунково-кишковому тракті (ШКТ) та ниркової екскреції. Підтримка оптимального балансу води й електролітів є результатом складних контрольованих фізіологічних механізмів, які врівноважують їх надходження та виділення, забезпечуючи сталість внутрішнього середовища. Порушення будь-якої ланки ВГ супроводжується розвитком патологічного процесу, при якому органи та системи не можуть адекватно виконувати свою функцію. Тому обрання оптимальних заходів щодо запобігання зневодненню організму при різних патологічних станах є необхідним навиком сучасного лікаря.\r\n<h2>Дегідратація</h2>\r\nДегідратація (зневоднення) – патологічний стан, який виникає внаслідок зменшення в організмі води з порушенням водно-сольового обміну та метаболізму. Слід зазначити, що не існує ізольованого водного чи електролітного дисбалансу, адже виникнення одного з цих порушень є пусковим механізмом для розвитку іншого.\r\n\r\nВтрата води може мати ниркове та позаниркове походження. У клінічній практиці частіше виділяють такі типи зневоднення за співвідношенням втрати води й електролітів:\r\n<ul>\r\n 	<li>гіпертонічний (вододефіцитний) тип зневоднення – виникає при ураженні нирок із розвитком хронічної ниркової недостатності, при гострій нирковій недостатності (поліурична стадія), надмірному застосуванні осмотичних діуретиків,  цукровому та нецукровому діабеті, втраті води через дихальні шляхи (гіпервентиляційний синдром) та шкіру (опіки), неправильне проведення регідратації гіперосмолярними розчинами, надмірне надходження солей натрію в організм;</li>\r\n 	<li>гіпотонічний (соледефіцитний) тип зневоднення може розвиватися у пацієнтів після хірургічного втручання на органах черевної порожнини, а також в осіб із хронічною діареєю;</li>\r\n 	<li>ізотонічний тип зневоднення найчастіше виникає на тлі втрати води через ШКТ (блювання, діарея різної етіології, у тому числі інфекційної), при лихоманці, значному потовиділенні, зниженні продукції гормонів надниркових залоз, поліуричній стадії хронічної ниркової недостатності.</li>\r\n</ul>\r\n<strong>Діти, особливо раннього віку, більш чутливі до втрати рідини, ніж дорослі. </strong>Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла порівняно з масою, більшим умістом води (понад 70% маси тіла у немовлят, близько 65% – у дітей раннього віку та 60% у дорослих).\r\n\r\nДегідратація – дуже небезпечний стан, який може призвести до тяжкого порушення роботи органів та смерті. Якщо перший ступінь зневоднення не має виражених клінічних проявів (завдяки механізмам компенсації), то вже при другому настає виснаження компенсаторних можливостей (олігурія, сухість шкіри та слизових оболонок, субнормальний артеріальний тиск, недостатність периферичного кровообігу тощо), а подальше прогресування може спричинити критичне зниження артеріального тиску, тяжкий електролітний дисбаланс, анурію та порушення свідомості. Тому педіатр повинен бути насторожений при виникненні станів, які можуть ініціювати розвиток зневоднення, враховувати цей аспекттпри визначенні терапевтичної тактики та своєчасно призначати розчини для запобігання дегідратації.\r\n\r\nПовне розуміння ВГ неможливе без усвідомлення значення деяких електролітів для організму (табл.). Як ужезгадувалосявище,порушенняводно-електролітного балансу є комплексною проблемою, тому ефективна регідратація організму передбачає застосування саме водно-сольових розчинів, а не просто води. Наведемо найчастіші причини зневоднення дитячого організму, якому можна запобігти шляхом своєчасного призначення водно-сольових розчинів.\r\n<h2>Найчастіші причини дегідратації у дітей</h2>\r\n<strong>Гостра діарея</strong>\r\n\r\nНайчастішою причиною дегідратації у дітей є гостра діарея, яка, за даними Всесвітньої організації охорони здоров’я, вважається другою за значимістю причиною смерті дітей віком до 5 років. Діарея – це 3 чи більше епізодів неоформлених або рідких випорожнень порівняно з такими за попередні 24 год; при цьому епізодом вважаються рідкі випорожнення протягом 1 дня і більше, а його закінченням – принаймні 2 дні після нормалізації випорожнень. Наявність частих оформлених чи пастоподібних випорожнень у  дітей,  які  перебувають на грудному вигодовуванні, не є діареєю.\r\n\r\nЩороку реєструється близько 1,7 млрд випадків діареї у всьому світі. Протягом останніх десятиліть\r\n\r\nсмертність від гострої діареї у дітей віком до 5 років істотно знизилася: з 1,2 млн у 2000 р. до 0,5 млн – у 2016. Найбільше значення у цій тенденції має впровадження ефективних методів лікування, а саме пероральної регідратації та дієтотерапії (зокрема, підтримка грудного вигодовування в період захворювання). Найважливіший меседж у всіх міжнародних  і  вітчизняних  рекомендаціях  – не  зволікати з регідратацією, а починати поповнювати водносольові втрати організму при перших симптомах основного захворювання.\r\n\r\nЗастосування при гострій кишковій інфекції водно-сольових розчинів є ефективним, простим, економічно доступним, не потребує переривання годування дитини.\r\n\r\n<strong>Гострі респіраторні захворювання</strong>\r\n\r\nЗа даними літератури, у 25-50% дітей з гострими респіраторними інфекціями наявні ознаки порушення ВГ. Дегідратація організму виникає внаслідок перспіраційних втрат через шкіру (надмірне потовиділення) та дихальні шляхи (почастішання дихання), а також через зменшення надходження рідини з їжею на тлі зниження апетиту. Через активацію катаболізму при інфекційному захворюванні збільшується вивільнення води, виведення її та розчинених у ній електролітів із сечею. Крім того, посилення енергетичного обміну призводить до виснаження запасів\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"691\">Таблиця. <strong>Електроліти та їх значення для організму (D. Crawford, 2018)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"400\"><strong>Функція</strong></th>\r\n<th width=\"93\"><strong>Норма </strong><strong>(ммоль/л)</strong></th>\r\n<th width=\"126\"><strong>Добова потреба </strong><strong>(ммоль/кг)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний позаклітинний іон, який має значний вплив на осмос та осмолярність. Гіпонатріємія (&lt;135 ммоль/л) розвивається внаслідок надмірного надходження води чи втрати солей, гіпернатріємія (&gt;145 ммоль/л) – через недостатнє надходження/втрату води чи надлишкове вживання солей. Ці два стани становлять серйозну небезпеку для дітей. Дефіцит натрію супроводжується порушенням дета реполяризації клітин і може провокувати появу судом, апное, кому</td>\r\n<td width=\"93\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n135-145</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n2-4</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний внутрішньоклітинний іон. Концентрація всередині клітини становить\r\n\r\n140-150 ммоль/л, поза клітиною цей показник значно нижчий. Рівень калію в організмі регулюється нирками та за допомогою механізму міжклітинного транспорту.\r\n\r\nВідхилення рівня калію потребує негайної корекції, адже іон бере участь у роботі серцевого м’яза</td>\r\n<td width=\"93\">Недоношені немовлята – 4,5-\r\n\r\n7,2; доношені\r\n\r\nнемовлята – 3,6-\r\n\r\n6,4; діти – 3,5-5,0</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n1-2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Функція магнію та кальцію тісно пов’язана з рівнем фосфатів. Основне значення магнію полягає у забезпеченні енергетичного обміну, функціонування натрій-калієвого насоса для передачі нервових імпульсів</td>\r\n<td width=\"93\">&nbsp;\r\n\r\n0,6-1,0</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n0,07-0,2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основним «сховищем» іона є кістки. Невелика кількість кальцію перебуває у зв’язаній з білком або іонізованій формі. Лише іонізований кальцій здатний покидати кровоносне русло та брати участь у внутрішньоклітинних процесах (регуляція ферментів, вплив на мембранний потенціал, збудливість нейронів, скорочення м’язів,\r\n\r\nу тому числі міокарда). Тяжка гіпокальціємія (&lt;1,75 ммоль/л) може спричинити тетанію, ларингоспазм і генералізовані судоми</td>\r\n<td width=\"93\">&nbsp;\r\n\r\nЗагальний – 2,1-\r\n\r\n2,7; іонізований –\r\n\r\n1,2-1,3</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n0,3</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Існує переважно в позаклітинному просторі. Бере участь у підтримці цілісності клітини, впливає на осмотичний тиск і водний баланс, а також має роль у підтримці кислотноосновного стану</td>\r\n<td width=\"93\">Немовлята – 96-111; діти –\r\n\r\n102-112</td>\r\n<td width=\"126\">&nbsp;\r\n\r\nПов’язана з натрієм</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nглюкози й глікогену та супроводжується накопиченням кетонових тіл. У цьому аспекті запобігання виникненню   водно-електролітного    дисбалансу та корекція кетонемії мають значення при веденні дітей з гострими  респіраторними  інфекціями (С.О. Крамарьов, 2019).\r\n\r\nДля уникнення дегідратації у дітей на тлі ГРІ педіатри часто рекомендують вживати більшу ніж зазвичай кількість рідини. Проте лікарям важливо пам’ятати про таке явище, як водна інтоксикація, яка виникає при вживанні води без вмісту електролітів. Це супроводжується зниженням рівня натрію в крові, що характеризується розвитком набряків (навіть головного мозку). Тому крім поповнення втрат рідини необхідно коригувати дефіцит електролітів (особливо натрію та калію).\r\n<h2>Ацетонемічний синдром</h2>\r\nАцетонемічний синдром (АС, cиндром ацетонемічного блювання, кетонемічний синдром, cиндром циклічного блювання) – сукупність симптомів, що зумовлені підвищенням вмісту у крові кетонових тіл: ацетону, ацетооцтової та  b-оксимасляної  кислот на тлі відносного чи абсолютного дефіциту вуглеводів та/або переважання утворення кетогенних амінокислот і жирних кислот. Первинний АС є клінічним проявом нервово-артритичного діатезу. Причинами вторинного АС є інфекційні та соматичні захворювання, гіпертермія, післяопераційні стани, блювання різного генезу.\r\n\r\nОсновна небезпека при АС – метаболічний ацидоз, що призводить до гіперкапнії (через гіпервентиляцію), вазоконстрикції, пошкодження ліпідних мембран клітин. Проникаючи до ЦНС, кетонові тіла подразнюють блювотний центр в головному мозку. Ці патологічні зміни призводять до тяжких метаболічних розладів, електролітного дисбалансу, дегідратації,  інтоксикації,   гемодинамічних   порушень, у тяжких випадках – до розладів свідомості.\r\n\r\nОсновними напрямами  лікування  дітей  з  АС є усунення його тригерів шляхом дотримання дієти, <strong>поповнення водного дефіциту за рахунок регідра</strong><strong>таційної терапії, </strong>медикаментозне лікування (ентеросорбенти, седативні засоби, протиблювотні препарати та ін.).\r\n<h2>Як уникнути дегідратації у дітей</h2>\r\nКожному педіатру важливо пам’ятати, що дегідратація організму дитини настає з моменту виникнення симптомів основного захворювання (наприклад, з першого епізоду діареї при гострій кишковій інфекції чи підвищення температури тіла при гострій  респіраторній  інфекції),  але  може  одразу не проявлятися через включення компенсаторних механізмів. Своєчасно вжиті заходи дозволяють уникнути розвитку дегідратації та відновити ВГ організму.\r\n\r\nФізіологічна потреба у воді розраховується за методом Holiday Segar та залежить від маси тіла дитини:\r\n<ul>\r\n 	<li><strong>1-10 кг – 100 мл/кг;</strong></li>\r\n 	<li><strong>10,1-20,0 кг – 1000 мл + 50 мл на кожен кілограм понад 10 кг;</strong></li>\r\n 	<li><strong>більше 20 кг – 1500 мл + 20 мл на кожен кілограм понад 20 кг.</strong></li>\r\n</ul>\r\nПри патологічній втраті рідини збільшується потреба у воді з метою компенсації її дефіциту. Вже з перших годин захворювання дитині дають підвищену кількість рідини: при гострій діареї дітям молодшим 2 років – по 50-100 мл після кожного випорожнення; дітям від 2 до 10 років – по 100-200 мл після кожного випорожнення; дітям старшим 10 років – скільки бажають випити. Підвищення температури тіла супроводжується збільшенням потреби у рідині на 10 мл/кг на кожен 1 °С. При наявності тахіпное втрати рідини з перспірацією зростають на 5-20 мл/кг за добу, при значному потовиділенні – на 5-25 мл/кг за добу (С.О. Крамарьов, 2019).\r\n\r\nУ більшості випадків разом з водою організм дитини втрачає й електроліти, тому вживання звичайної води для своєчасного запобігання дегідратації нерідко недостатньо. Для швидкого відновлення водноелектролітного балансу підходять розчини, які містять усі необхідні електроліти (натрій, калій, кальцій, магній, хлор). Такою є вода <strong>ReO </strong>(фармацевтична компанія «Юрія-Фарм»), яка не містить консервантів, барвників, має приємний смак, що важливо для засобів, які застосовуються у педіатричній практиці.\r\n\r\nВода <strong>ReO </strong>розроблена для своєчасного запобігання втраті рідини дитячим організмом та розвитку дегідратації, що може настати за різних умов:\r\n<ul>\r\n 	<li>захворювання, які супроводжуються блюванням і діареєю;</li>\r\n 	<li>підвищене потовиділення;</li>\r\n 	<li>підвищена втрата рідини під час фізичного навантаження чи у спеку тощо.</li>\r\n</ul>\r\n<strong>Отже, дегідратація організму – це частий патологічний стан у дітей, який виникає при різних захворюваннях. Педіатр повинен чітко розуміти, у яких випадках існує ризик зневоднення організму, та не допустити його розвитку шляхом своєчасного призначення водно-сольових розчинів. Вода ReO – оптимальний за складом і доступний водно-сольовий розчин для запобігання розвитку дегідратації як у дітей, так і у дорослих. При веденні пацієнта доцільніше вжити заходів для уникнення зневоднення, ніж боротися з його наслідками.</strong>\r\n\r\n<em>Підготувала </em><strong><em>Ілона Цюпа</em></strong>','Зневоднення у дітей: як запобігти, а не боротися з наслідками?','','inherit','closed','closed','','1254-revision-v1','','','2021-07-19 17:11:58','2021-07-19 14:11:58','',1254,'https://reo.ua/?p=1260',0,'revision','',0),(1259,1,'2021-07-19 17:09:58','2021-07-19 14:09:58','Водний гомеостаз (ВГ) – необхідна умова життєдіяльності будь-якого організму. Підтримка ВГ відбувається за рахунок трьох злагоджених процесів: надходження води ззовні, адекватної абсорбції у шлунково-кишковому тракті (ШКТ) та ниркової екскреції. Підтримка оптимального балансу води й електролітів є результатом складних контрольованих фізіологічних механізмів, які врівноважують їх надходження та виділення, забезпечуючи сталість внутрішнього середовища. Порушення будь-якої ланки ВГ супроводжується розвитком патологічного процесу, при якому органи та системи не можуть адекватно виконувати свою функцію. Тому обрання оптимальних заходів щодо запобігання зневодненню організму при різних патологічних станах є необхідним навиком сучасного лікаря.\r\n<h2>Дегідратація</h2>\r\nДегідратація (зневоднення) – патологічний стан, який виникає внаслідок зменшення в організмі води з порушенням водно-сольового обміну та метаболіз- му. Слід зазначити, що не існує ізольованого водно- го чи електролітного дисбалансу, адже виникнення одного з цих порушень є пусковим механізмом для розвитку іншого.\r\n\r\nВтрата води може мати ниркове та позаниркове походження. У клінічній практиці частіше виділя- ють такі типи зневоднення за співвідношенням втрати води й електролітів:\r\n<ul>\r\n 	<li>гіпертонічний (вододефіцитний) тип зневод- нення – виникає при ураженні нирок із розвитком хронічної ниркової недостатності, при гострій нир- ковій недостатності (поліурична стадія), надмірному застосуванні осмотичних діуретиків,  цукровому та нецукровому діабеті, втраті води через дихальні шляхи (гіпервентиляційний синдром) та шкіру (опі- ки), неправильне проведення регідратації гіпер- осмолярними розчинами, надмірне надходження солей натрію в організм;</li>\r\n 	<li>гіпотонічний (соледефіцитний) тип зневоднен- ня може розвиватися у пацієнтів після хірургічного втручання на органах черевної порожнини, а також в осіб із хронічною діареєю;</li>\r\n 	<li>ізотонічний тип зневоднення найчастіше вини- кає на тлі втрати води через ШКТ (блювання, діарея різної етіології, у тому числі інфекційної), при лихо- манці, значному потовиділенні, зниженні продукції гормонів надниркових залоз, поліуричній стадії хро- нічної ниркової недостатності.</li>\r\n</ul>\r\n<strong>Діти, особливо раннього віку, більш чутливі до втра- ти рідини, ніж дорослі. </strong>Це пов’язано з відносно ви- щим рівнем основного обміну, більшою поверхнею тіла порівняно з масою, більшим умістом води (по- над 70% маси тіла у немовлят, близько 65% – у дітей раннього віку та 60% у дорослих).\r\n\r\nДегідратація – дуже небезпечний стан, який може призвести до тяжкого порушення роботи органів та смерті. Якщо перший ступінь зневоднення не має виражених клінічних проявів (завдяки механізмам компенсації), то вже при другому настає виснажен- ня компенсаторних можливостей (олігурія, сухість шкіри та слизових оболонок, субнормальний артері- альний тиск, недостатність периферичного крово- обігу тощо), а подальше прогресування може спри- чинити критичне зниження артеріального тиску, тяжкий електролітний дисбаланс, анурію та пору- шення свідомості. Тому педіатр повинен бути насто- рожений при виникненні станів, які можуть ініцію- вати розвиток зневоднення, враховувати цей аспекттпри визначенні терапевтичної тактики та своєчасно призначати розчини для запобігання дегідратації.\r\n\r\nПовне розуміння ВГ неможливе без усвідомлення значення деяких електролітів для організму (табл.). Як ужезгадувалосявище,порушенняводно-електролітного балансу є комплексною проблемою, тому ефективна регідратація організму передбачає застосування саме водно-сольових розчинів, а не просто води. Наведемо найчастіші причини зневоднення дитячого організму, якому можна запобігти шляхом своєчасного призна- чення водно-сольових розчинів.\r\n<h2>Найчастіші причини дегідратації у дітей</h2>\r\n<strong>Гостра діарея</strong>\r\n\r\nНайчастішою причиною дегідратації у дітей є гос- тра діарея, яка, за даними Всесвітньої організації охорони здоров’я, вважається другою за значимістю причиною смерті дітей віком до 5 років. Діарея – це 3 чи більше епізодів неоформлених або рідких випорожнень порівняно з такими за попередні 24 год; при цьому епізодом вважаються рідкі випо- рожнення протягом 1 дня і більше, а його закін- ченням – принаймні 2 дні після нормалізації випо- рожнень. Наявність частих оформлених чи пастопо- дібних випорожнень у  дітей,  які  перебувають на грудному вигодовуванні, не є діареєю.\r\n\r\nЩороку реєструється близько 1,7 млрд випадків діареї у всьому світі. Протягом останніх десятиліть\r\n\r\nсмертність від гострої діареї у дітей віком до 5 років істотно знизилася: з 1,2 млн у 2000 р. до 0,5 млн – у 2016. Найбільше значення у цій тенденції має впровадження ефективних методів лікування, а саме пероральної регідратації та дієтотерапії (зокрема, підтримка грудного вигодовування в період захво- рювання). Найважливіший меседж у всіх міжнарод- них  і  вітчизняних  рекомендаціях  – не  зволікати з регідратацією, а починати поповнювати водно- сольові втрати організму при перших симптомах основного захворювання.\r\n\r\nЗастосування при гострій кишковій інфекції водно-сольових розчинів є ефективним, простим, економічно доступним, не потребує переривання годування дитини.\r\n\r\n<strong>Гострі респіраторні захворювання</strong>\r\n\r\nЗа даними літератури, у 25-50% дітей з гострими респіраторними інфекціями наявні ознаки пору- шення ВГ. Дегідратація організму виникає внаслідок перспіраційних втрат через шкіру (надмірне потови- ділення) та дихальні шляхи (почастішання дихання), а також через зменшення надходження рідини з їжею на тлі зниження апетиту. Через активацію катаболіз- му при інфекційному захворюванні збільшується вивільнення води, виведення її та розчинених у ній електролітів із сечею. Крім того, посилення енерге- тичного обміну призводить до виснаження запасів\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"691\">Таблиця. <strong>Електроліти та їх значення для організму (D. Crawford, 2018)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"400\"><strong>Функція</strong></th>\r\n<th width=\"93\"><strong>Норма </strong><strong>(ммоль/л)</strong></th>\r\n<th width=\"126\"><strong>Добова потреба </strong><strong>(ммоль/кг)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний позаклітинний іон, який має значний вплив на осмос та осмолярність. Гіпонатріємія (&lt;135 ммоль/л) розвивається внаслідок надмірного надходження води чи втрати солей, гіпернатріємія (&gt;145 ммоль/л) – через недостатнє надходження/втрату води чи надлишкове вживання солей. Ці два стани становлять серйозну небезпеку для дітей. Дефіцит натрію супроводжується порушенням де- та реполяризації клітин і може провокувати появу судом, апное, кому</td>\r\n<td width=\"93\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n135-145</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n2-4</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний внутрішньоклітинний іон. Концентрація всередині клітини становить\r\n\r\n140-150 ммоль/л, поза клітиною цей показник значно нижчий. Рівень калію в організмі регулюється нирками та за допомогою механізму міжклітинного транспорту.\r\n\r\nВідхилення рівня калію потребує негайної корекції, адже іон бере участь у роботі сер- цевого м’яза</td>\r\n<td width=\"93\">Недоношені немовлята – 4,5-\r\n\r\n7,2; доношені\r\n\r\nнемовлята – 3,6-\r\n\r\n6,4; діти – 3,5-5,0</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n1-2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Функція магнію та кальцію тісно пов’язана з рівнем фосфатів. Основне значення магнію полягає у забезпеченні енергетичного обміну, функціонування натрій-калієвого насоса для передачі нервових імпульсів</td>\r\n<td width=\"93\">&nbsp;\r\n\r\n0,6-1,0</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n0,07-0,2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основним «сховищем» іона є кістки. Невелика кількість кальцію перебуває у зв’язаній з білком або іонізованій формі. Лише іонізований кальцій здатний покидати кровоносне русло та брати участь у внутрішньоклітинних процесах (регуляція ферментів, вплив на мембранний потенціал, збудливість нейронів, скорочення м’язів,\r\n\r\nу тому числі міокарда). Тяжка гіпокальціємія (&lt;1,75 ммоль/л) може спричинити тетанію, ларингоспазм і генералізовані судоми</td>\r\n<td width=\"93\">&nbsp;\r\n\r\nЗагальний – 2,1-\r\n\r\n2,7; іонізований –\r\n\r\n1,2-1,3</td>\r\n<td width=\"126\">&nbsp;\r\n\r\n&nbsp;\r\n\r\n0,3</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Існує переважно в позаклітинному просторі. Бере участь у підтримці цілісності клітини, впливає на осмотичний тиск і водний баланс, а також має роль у підтримці кислотно- основного стану</td>\r\n<td width=\"93\">Немовлята – 96-111; діти –\r\n\r\n102-112</td>\r\n<td width=\"126\">&nbsp;\r\n\r\nПов’язана з натрієм</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nглюкози й глікогену та супроводжується накопи- ченням кетонових тіл. У цьому аспекті запобігання виникненню   водно-електролітного    дисбалансу та корекція кетонемії мають значення при веденні дітей з гострими  респіраторними  інфекціями (С.О. Крамарьов, 2019).\r\n\r\nДля уникнення дегідратації у дітей на тлі ГРІ педі- атри часто рекомендують вживати більшу ніж зазви- чай кількість рідини. Проте лікарям важливо пам’я- тати про таке явище, як водна інтоксикація, яка ви- никає при вживанні води без вмісту електролітів. Це супроводжується зниженням рівня натрію в крові, що характеризується розвитком набряків (навіть го- ловного мозку). Тому крім поповнення втрат рідини необхідно коригувати дефіцит електролітів (особли- во натрію та калію).\r\n<h2>Ацетонемічний синдром</h2>\r\nАцетонемічний синдром (АС, cиндром ацетоне- мічного блювання, кетонемічний синдром, cиндром циклічного блювання) – сукупність симптомів, що зумовлені підвищенням вмісту у крові кетонових тіл: ацетону, ацетооцтової та  b-оксимасляної  кислот на тлі відносного чи абсолютного дефіциту вуглево- дів та/або переважання утворення кетогенних амі- нокислот і жирних кислот. Первинний АС є клініч- ним проявом нервово-артритичного діатезу. При- чинами вторинного АС є інфекційні та соматичні захворювання, гіпертермія, післяопераційні стани, блювання різного генезу.\r\n\r\nОсновна небезпека при АС – метаболічний аци- доз, що призводить до гіперкапнії (через гіпервенти- ляцію), вазоконстрикції, пошкодження ліпідних мембран клітин. Проникаючи до ЦНС, кетонові тіла подразнюють блювотний центр в головному мозку. Ці патологічні зміни призводять до тяжких метабо- лічних розладів, електролітного дисбалансу, дегідра- тації,  інтоксикації,   гемодинамічних   порушень, у тяжких випадках – до розладів свідомості.\r\n\r\nОсновними напрямами  лікування  дітей  з  АС є усунення його тригерів шляхом дотримання діє- ти, <strong>поповнення водного дефіциту за рахунок регідра- </strong><strong>таційної терапії, </strong>медикаментозне лікування (енте- росорбенти, седативні засоби, протиблювотні пре- парати та ін.).\r\n<h2>Як уникнути дегідратації у дітей</h2>\r\nКожному педіатру важливо пам’ятати, що дегід- ратація організму дитини настає з моменту виник- нення симптомів основного захворювання (напри- клад, з першого епізоду діареї при гострій кишковій інфекції чи підвищення температури тіла при го- стрій  респіраторній  інфекції),  але  може  одразу не проявлятися через включення компенсаторних механізмів. Своєчасно вжиті заходи дозволяють уникнути розвитку дегідратації та відновити ВГ ор- ганізму.\r\n\r\nФізіологічна потреба у воді розраховується за ме- тодом Holiday Segar та залежить від маси тіла дитини:\r\n<ul>\r\n 	<li><strong>1-10 кг – 100 мл/кг;</strong></li>\r\n 	<li><strong>10,1-20,0 кг – 1000 мл + 50 мл на кожен кілограм понад 10 кг;</strong></li>\r\n 	<li><strong>більше 20 кг – 1500 мл + 20 мл на кожен кілограм понад 20 кг.</strong></li>\r\n</ul>\r\nПри патологічній втраті рідини збільшується по- треба у воді з метою компенсації її дефіциту. Вже з перших годин захворювання дитині дають підви- щену кількість рідини: при гострій діареї дітям мо- лодшим 2 років – по 50-100 мл після кожного випо- рожнення; дітям від 2 до 10 років – по 100-200 мл після кожного випорожнення; дітям старшим 10 ро- ків – скільки бажають випити. Підвищення темпе- ратури тіла супроводжується збільшенням потреби у рідині на 10 мл/кг на кожен 1 °С. При наявності тахіпное втрати рідини з перспірацією зростають на 5-20 мл/кг за добу, при значному потовиділенні – на 5-25 мл/кг за добу (С.О. Крамарьов, 2019).\r\n\r\nУ більшості випадків разом з водою організм дити- ни втрачає й електроліти, тому вживання звичайної води для своєчасного запобігання дегідратації нерідко недостатньо. Для швидкого відновлення водно- електролітного балансу підходять розчини, які міс- тять усі необхідні електроліти (натрій, калій, кальцій, магній, хлор). Такою є вода <strong>ReO </strong>(фармацевтична компанія «Юрія-Фарм»), яка не містить консервантів, барвників, має приємний смак, що важливо для засо- бів, які застосовуються у педіатричній практиці.\r\n\r\nВода <strong>ReO </strong>розроблена для своєчасного запобігання втраті рідини дитячим організмом та розвитку дегід- ратації, що може настати за різних умов:\r\n<ul>\r\n 	<li>захворювання, які супроводжуються блюванням і діареєю;</li>\r\n 	<li>підвищене потовиділення;</li>\r\n 	<li>підвищена втрата рідини під час фізичного на- вантаження чи у спеку тощо.</li>\r\n</ul>\r\n<strong>Отже, дегідратація організму – це частий патоло- гічний стан у дітей, який виникає при різних захво- рюваннях. Педіатр повинен чітко розуміти, у яких випадках існує ризик зневоднення організму, та не допустити його розвитку шляхом своєчасного призначення водно-сольових розчинів. Вода ReO – оптимальний за складом і доступний водно-сольовий розчин для запобігання розвитку дегідратації як у ді- тей, так і у дорослих. При веденні пацієнта доцільні- ше вжити заходів для уникнення зневоднення, ніж боротися з його наслідками.</strong>\r\n\r\n<em>Підготувала </em><strong><em>Ілона Цюпа</em></strong>','Зневоднення у дітей: як запобігти, а не боротися з наслідками?','','inherit','closed','closed','','1254-revision-v1','','','2021-07-19 17:09:58','2021-07-19 14:09:58','',1254,'https://reo.ua/?p=1259',0,'revision','',0),(1262,1,'2021-07-19 17:13:18','2021-07-19 14:13:18','Водний гомеостаз (ВГ) – необхідна умова життєдіяльності будь-якого організму. Підтримка ВГ відбувається за рахунок трьох злагоджених процесів: надходження води ззовні, адекватної абсорбції у шлунково-кишковому тракті (ШКТ) та ниркової екскреції. Підтримка оптимального балансу води й електролітів є результатом складних контрольованих фізіологічних механізмів, які врівноважують їх надходження та виділення, забезпечуючи сталість внутрішнього середовища. Порушення будь-якої ланки ВГ супроводжується розвитком патологічного процесу, при якому органи та системи не можуть адекватно виконувати свою функцію. Тому обрання оптимальних заходів щодо запобігання зневодненню організму при різних патологічних станах є необхідним навиком сучасного лікаря.\r\n<h2>Дегідратація</h2>\r\nДегідратація (зневоднення) – патологічний стан, який виникає внаслідок зменшення в організмі води з порушенням водно-сольового обміну та метаболізму. Слід зазначити, що не існує ізольованого водного чи електролітного дисбалансу, адже виникнення одного з цих порушень є пусковим механізмом для розвитку іншого.\r\n\r\nВтрата води може мати ниркове та позаниркове походження. У клінічній практиці частіше виділяють такі типи зневоднення за співвідношенням втрати води й електролітів:\r\n<ul>\r\n 	<li>гіпертонічний (вододефіцитний) тип зневоднення – виникає при ураженні нирок із розвитком хронічної ниркової недостатності, при гострій нирковій недостатності (поліурична стадія), надмірному застосуванні осмотичних діуретиків,  цукровому та нецукровому діабеті, втраті води через дихальні шляхи (гіпервентиляційний синдром) та шкіру (опіки), неправильне проведення регідратації гіперосмолярними розчинами, надмірне надходження солей натрію в організм;</li>\r\n 	<li>гіпотонічний (соледефіцитний) тип зневоднення може розвиватися у пацієнтів після хірургічного втручання на органах черевної порожнини, а також в осіб із хронічною діареєю;</li>\r\n 	<li>ізотонічний тип зневоднення найчастіше виникає на тлі втрати води через ШКТ (блювання, діарея різної етіології, у тому числі інфекційної), при лихоманці, значному потовиділенні, зниженні продукції гормонів надниркових залоз, поліуричній стадії хронічної ниркової недостатності.</li>\r\n</ul>\r\n<strong>Діти, особливо раннього віку, більш чутливі до втрати рідини, ніж дорослі. </strong>Це пов’язано з відносно вищим рівнем основного обміну, більшою поверхнею тіла порівняно з масою, більшим умістом води (понад 70% маси тіла у немовлят, близько 65% – у дітей раннього віку та 60% у дорослих).\r\n\r\nДегідратація – дуже небезпечний стан, який може призвести до тяжкого порушення роботи органів та смерті. Якщо перший ступінь зневоднення не має виражених клінічних проявів (завдяки механізмам компенсації), то вже при другому настає виснаження компенсаторних можливостей (олігурія, сухість шкіри та слизових оболонок, субнормальний артеріальний тиск, недостатність периферичного кровообігу тощо), а подальше прогресування може спричинити критичне зниження артеріального тиску, тяжкий електролітний дисбаланс, анурію та порушення свідомості. Тому педіатр повинен бути насторожений при виникненні станів, які можуть ініціювати розвиток зневоднення, враховувати цей аспекттпри визначенні терапевтичної тактики та своєчасно призначати розчини для запобігання дегідратації.\r\n\r\nПовне розуміння ВГ неможливе без усвідомлення значення деяких електролітів для організму (табл.). Як ужезгадувалосявище,порушенняводно-електролітного балансу є комплексною проблемою, тому ефективна регідратація організму передбачає застосування саме водно-сольових розчинів, а не просто води. Наведемо найчастіші причини зневоднення дитячого організму, якому можна запобігти шляхом своєчасного призначення водно-сольових розчинів.\r\n<h2>Найчастіші причини дегідратації у дітей</h2>\r\n<strong>Гостра діарея</strong>\r\n\r\nНайчастішою причиною дегідратації у дітей є гостра діарея, яка, за даними Всесвітньої організації охорони здоров’я, вважається другою за значимістю причиною смерті дітей віком до 5 років. Діарея – це 3 чи більше епізодів неоформлених або рідких випорожнень порівняно з такими за попередні 24 год; при цьому епізодом вважаються рідкі випорожнення протягом 1 дня і більше, а його закінченням – принаймні 2 дні після нормалізації випорожнень. Наявність частих оформлених чи пастоподібних випорожнень у  дітей,  які  перебувають на грудному вигодовуванні, не є діареєю.\r\n\r\nЩороку реєструється близько 1,7 млрд випадків діареї у всьому світі. Протягом останніх десятиліть\r\n\r\nсмертність від гострої діареї у дітей віком до 5 років істотно знизилася: з 1,2 млн у 2000 р. до 0,5 млн – у 2016. Найбільше значення у цій тенденції має впровадження ефективних методів лікування, а саме пероральної регідратації та дієтотерапії (зокрема, підтримка грудного вигодовування в період захворювання). Найважливіший меседж у всіх міжнародних  і  вітчизняних  рекомендаціях  – не  зволікати з регідратацією, а починати поповнювати водносольові втрати організму при перших симптомах основного захворювання.\r\n\r\nЗастосування при гострій кишковій інфекції водно-сольових розчинів є ефективним, простим, економічно доступним, не потребує переривання годування дитини.\r\n\r\n<strong>Гострі респіраторні захворювання</strong>\r\n\r\nЗа даними літератури, у 25-50% дітей з гострими респіраторними інфекціями наявні ознаки порушення ВГ. Дегідратація організму виникає внаслідок перспіраційних втрат через шкіру (надмірне потовиділення) та дихальні шляхи (почастішання дихання), а також через зменшення надходження рідини з їжею на тлі зниження апетиту. Через активацію катаболізму при інфекційному захворюванні збільшується вивільнення води, виведення її та розчинених у ній електролітів із сечею. Крім того, посилення енергетичного обміну призводить до виснаження запасів\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"691\">Таблиця. <strong>Електроліти та їх значення для організму (D. Crawford, 2018)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"400\"><strong>Функція</strong></th>\r\n<th width=\"93\"><strong>Норма </strong><strong>(ммоль/л)</strong></th>\r\n<th width=\"126\"><strong>Добова потреба </strong><strong>(ммоль/кг)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний позаклітинний іон, який має значний вплив на осмос та осмолярність. Гіпонатріємія (&lt;135 ммоль/л) розвивається внаслідок надмірного надходження води чи втрати солей, гіпернатріємія (&gt;145 ммоль/л) – через недостатнє надходження/втрату води чи надлишкове вживання солей. Ці два стани становлять серйозну небезпеку для дітей. Дефіцит натрію супроводжується порушенням дета реполяризації клітин і може провокувати появу судом, апное, кому</td>\r\n<td width=\"93\">135-145</td>\r\n<td width=\"126\">2-4</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основний внутрішньоклітинний іон. Концентрація всередині клітини становить 140-150 ммоль/л, поза клітиною цей показник значно нижчий. Рівень калію в організмі регулюється нирками та за допомогою механізму міжклітинного транспорту. Відхилення рівня калію потребує негайної корекції, адже іон бере участь у роботі серцевого м’яза</td>\r\n<td width=\"93\">Недоношені немовлята – 4,5-7,2; доношені немовлята – 3,6-6,4; діти – 3,5-5,0</td>\r\n<td width=\"126\">1-2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Функція магнію та кальцію тісно пов’язана з рівнем фосфатів. Основне значення магнію полягає у забезпеченні енергетичного обміну, функціонування натрій-калієвого насоса для передачі нервових імпульсів</td>\r\n<td width=\"93\">0,6-1,0</td>\r\n<td width=\"126\">0,07-0,2</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Основним «сховищем» іона є кістки. Невелика кількість кальцію перебуває у зв’язаній з білком або іонізованій формі. Лише іонізований кальцій здатний покидати кровоносне русло та брати участь у внутрішньоклітинних процесах (регуляція ферментів, вплив на мембранний потенціал, збудливість нейронів, скорочення м’язів,\r\n\r\nу тому числі міокарда). Тяжка гіпокальціємія (&lt;1,75 ммоль/л) може спричинити тетанію, ларингоспазм і генералізовані судоми</td>\r\n<td width=\"93\">&nbsp;\r\n\r\nЗагальний – 2,1-2,7; іонізований – 1,2-1,3</td>\r\n<td width=\"126\">0,3</td>\r\n</tr>\r\n<tr>\r\n<td width=\"400\">Існує переважно в позаклітинному просторі. Бере участь у підтримці цілісності клітини, впливає на осмотичний тиск і водний баланс, а також має роль у підтримці кислотноосновного стану</td>\r\n<td width=\"93\">Немовлята – 96-111; діти  102-112</td>\r\n<td width=\"126\">Пов’язана з натрієм</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nглюкози й глікогену та супроводжується накопиченням кетонових тіл. У цьому аспекті запобігання виникненню   водно-електролітного    дисбалансу та корекція кетонемії мають значення при веденні дітей з гострими  респіраторними  інфекціями (С.О. Крамарьов, 2019).\r\n\r\nДля уникнення дегідратації у дітей на тлі ГРІ педіатри часто рекомендують вживати більшу ніж зазвичай кількість рідини. Проте лікарям важливо пам’ятати про таке явище, як водна інтоксикація, яка виникає при вживанні води без вмісту електролітів. Це супроводжується зниженням рівня натрію в крові, що характеризується розвитком набряків (навіть головного мозку). Тому крім поповнення втрат рідини необхідно коригувати дефіцит електролітів (особливо натрію та калію).\r\n<h2>Ацетонемічний синдром</h2>\r\nАцетонемічний синдром (АС, cиндром ацетонемічного блювання, кетонемічний синдром, cиндром циклічного блювання) – сукупність симптомів, що зумовлені підвищенням вмісту у крові кетонових тіл: ацетону, ацетооцтової та  b-оксимасляної  кислот на тлі відносного чи абсолютного дефіциту вуглеводів та/або переважання утворення кетогенних амінокислот і жирних кислот. Первинний АС є клінічним проявом нервово-артритичного діатезу. Причинами вторинного АС є інфекційні та соматичні захворювання, гіпертермія, післяопераційні стани, блювання різного генезу.\r\n\r\nОсновна небезпека при АС – метаболічний ацидоз, що призводить до гіперкапнії (через гіпервентиляцію), вазоконстрикції, пошкодження ліпідних мембран клітин. Проникаючи до ЦНС, кетонові тіла подразнюють блювотний центр в головному мозку. Ці патологічні зміни призводять до тяжких метаболічних розладів, електролітного дисбалансу, дегідратації,  інтоксикації,   гемодинамічних   порушень, у тяжких випадках – до розладів свідомості.\r\n\r\nОсновними напрямами  лікування  дітей  з  АС є усунення його тригерів шляхом дотримання дієти, <strong>поповнення водного дефіциту за рахунок регідра</strong><strong>таційної терапії, </strong>медикаментозне лікування (ентеросорбенти, седативні засоби, протиблювотні препарати та ін.).\r\n<h2>Як уникнути дегідратації у дітей</h2>\r\nКожному педіатру важливо пам’ятати, що дегідратація організму дитини настає з моменту виникнення симптомів основного захворювання (наприклад, з першого епізоду діареї при гострій кишковій інфекції чи підвищення температури тіла при гострій  респіраторній  інфекції),  але  може  одразу не проявлятися через включення компенсаторних механізмів. Своєчасно вжиті заходи дозволяють уникнути розвитку дегідратації та відновити ВГ організму.\r\n\r\nФізіологічна потреба у воді розраховується за методом Holiday Segar та залежить від маси тіла дитини:\r\n<ul>\r\n 	<li><strong>1-10 кг – 100 мл/кг;</strong></li>\r\n 	<li><strong>10,1-20,0 кг – 1000 мл + 50 мл на кожен кілограм понад 10 кг;</strong></li>\r\n 	<li><strong>більше 20 кг – 1500 мл + 20 мл на кожен кілограм понад 20 кг.</strong></li>\r\n</ul>\r\nПри патологічній втраті рідини збільшується потреба у воді з метою компенсації її дефіциту. Вже з перших годин захворювання дитині дають підвищену кількість рідини: при гострій діареї дітям молодшим 2 років – по 50-100 мл після кожного випорожнення; дітям від 2 до 10 років – по 100-200 мл після кожного випорожнення; дітям старшим 10 років – скільки бажають випити. Підвищення температури тіла супроводжується збільшенням потреби у рідині на 10 мл/кг на кожен 1 °С. При наявності тахіпное втрати рідини з перспірацією зростають на 5-20 мл/кг за добу, при значному потовиділенні – на 5-25 мл/кг за добу (С.О. Крамарьов, 2019).\r\n\r\nУ більшості випадків разом з водою організм дитини втрачає й електроліти, тому вживання звичайної води для своєчасного запобігання дегідратації нерідко недостатньо. Для швидкого відновлення водноелектролітного балансу підходять розчини, які містять усі необхідні електроліти (натрій, калій, кальцій, магній, хлор). Такою є вода <strong>ReO </strong>(фармацевтична компанія «Юрія-Фарм»), яка не містить консервантів, барвників, має приємний смак, що важливо для засобів, які застосовуються у педіатричній практиці.\r\n\r\nВода <strong>ReO </strong>розроблена для своєчасного запобігання втраті рідини дитячим організмом та розвитку дегідратації, що може настати за різних умов:\r\n<ul>\r\n 	<li>захворювання, які супроводжуються блюванням і діареєю;</li>\r\n 	<li>підвищене потовиділення;</li>\r\n 	<li>підвищена втрата рідини під час фізичного навантаження чи у спеку тощо.</li>\r\n</ul>\r\n<strong>Отже, дегідратація організму – це частий патологічний стан у дітей, який виникає при різних захворюваннях. Педіатр повинен чітко розуміти, у яких випадках існує ризик зневоднення організму, та не допустити його розвитку шляхом своєчасного призначення водно-сольових розчинів. Вода ReO – оптимальний за складом і доступний водно-сольовий розчин для запобігання розвитку дегідратації як у дітей, так і у дорослих. При веденні пацієнта доцільніше вжити заходів для уникнення зневоднення, ніж боротися з його наслідками.</strong>\r\n\r\n<em>Підготувала </em><strong><em>Ілона Цюпа</em></strong>','Зневоднення у дітей: як запобігти, а не боротися з наслідками?','','inherit','closed','closed','','1254-revision-v1','','','2021-07-19 17:13:18','2021-07-19 14:13:18','',1254,'https://reo.ua/?p=1262',0,'revision','',0),(1263,1,'2021-07-19 17:25:37','2021-07-19 14:25:37','<em>«Воді була дана чарівна влада стати </em><em>соком життя на Землі.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nНаш організм — це жива лабораторія, в якій щосекунди виникають сотні складних хімічних реакцій. Їхнє нормальне протікання неможливе без води. Вона бере участь в абсолютно усіх процесах в організмі. Ось кілька найважливіших із них [2]: z регуляція температури тіла;\r\n<ul>\r\n 	<li>зволоження та захист слизових оболонок очей, дихального та шлунково-кишкового трактів;</li>\r\n 	<li>транспорт поживних речовин та кисню до клітин;</li>\r\n 	<li>змащення суглобів;</li>\r\n 	<li>знешкодження та виведення шкідливих речовин печінкою та нирками;</li>\r\n 	<li>розчинення мінералів та поживних речовин для того, щоб тіло могло їх засвоїти.</li>\r\n</ul>\r\n<h3>ЦIКАВИЙ ФАКТ!</h3>\r\nТіло середньостатистичної дорослої людини на 60 % складається з води.\r\n\r\nПри цьому кількість рідини в окремих органах відрізняється. Так, наші.\r\n\r\nВтрата понад 1 % рідини організму послідовно призводить до порушення терморегуляції, зниження працездатності та апетиту. Якщо дегідратація продовжується і дефіцит становить 4 % і більше, виникають труднощі з концентрацією уваги, головні болі, дратівливість, сонливість, підвищується температура тіла та частота дихання [3].\r\n\r\nПрогресуюче зневоднення негативно відображається і на стані серцево-судинної системи. Втрата води супроводжується зростанням частоти серцевих скорочень та розладами артеріального тиску. Легке зневоднення (2 % втрати маси тіла) притупляє чутливість барорецепторів, які відповідають за підтримку тиску в нормі [4]. При зниженні артеріального тиску у серце потрапляє мало крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речовин [5]. Помірне зневоднення також посилює пролапс мітрального клапана, ймовірно, через нижчий тиск і об›єм наповнення передсердь [6].\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла при високій температурі навколишнього середовища, супроводжується серйозним ризиком інсульту, шоку та поліорганної недостатності [8].\r\n\r\nХронічне зневоднення може збільшити ризик розвитку інфекцій, особливо сечовивідних шляхів. В той самий час збільшення об’єму прийнятої рідини супроводжується зменшенням частоти повторних інфекцій [10].\r\n\r\nДекілька досліджень повідомляють про підвищений ризик виникнення раку сечового міхура у осіб, які зазвичай споживають мало води. Так, в одному з досліджень було оцінено загальне добове споживання рідини у 47909 чоловіків. Через 10 років спостереження у тих, хто споживав менше 1,3 л/добу, значно (p = 0,002) зростав ризик виникнення раку сечового міхура порівняно з тими, хто споживав більше 2,5 л/добу [11].\r\n\r\n<strong>ЯКІ БУВАЮТЬ ТИПИ ЗНЕВОДНЕННЯ?</strong>\r\n\r\n<strong><em>Існує кілька форм зневоднення [12]:</em></strong>\r\n<ul>\r\n 	<li><strong><em>Ізотонічне</em></strong>, коли вода і натрій втрачаються разом. крові завжди будуть підвищеними при гіпертонічПричинами ізотонічної втрати води є блювота,   ній дегідратації. Даний стан виникає при лихомандіарея, пітливість, опіки, хвороби нирок, гіпергліці, задишці та нецукровому діабеті.</li>\r\n 	<li> <strong><em>Гіпотонічне</em></strong>, при якому організм втрачає більше кемія та гіпоальдостеронізм.</li>\r\n 	<li><strong><em>Гіпертонічне</em></strong>, коли втрати води перевищують натрію, ніж води. Найчастіше це пов’язано з виковтрати натрію. Натрій та осмолярність сироватки ристанням сечогінних препаратів.</li>\r\n</ul>\r\n<h2>У КОГО НАЙЧАСТІШЕ ВИНИКАЄ ЗНЕВОДНЕННЯ?</h2>\r\nАбсолютно ніхто не застрахований від дегідратації, однак у деяких ситуаціях та у певних груп пацієнтів даний стан зустрічається частіше та може супроводжуватися важкими ускладненнями.\r\n<h2>Діти</h2>\r\nДегідратація є однією з частих причин захворюваності та смертності немовлят та маленьких дітей у всьому світі.\r\n\r\nБільшість випадків зневоднення у дітей є наслідком гострого гастроентериту. В загальному, немовлята та маленькі діти особливо схильні до діареї та зневоднення.\r\n\r\nПричиною цього є вищий рівень метаболізму, неможливість повідомити про свої потреби або самостійно випити води. Іншими причинами зневоднення у дітей можуть бути діабетичний кетоацидоз (ДКА), нецукровий діабет, ацетонемічний синдром, опіки, сонячний та тепловий удари, надмірне потовиділення [13].\r\n<h2>Люди літнього віку</h2>\r\nУ будь-якої дорослої людини дегідратація може розвинутися на фоні гіперглікемії. Дегідратація може бути як причиною захворювання, так і її наслідком.\r\n\r\nУ людей похилого віку вірогідність розвитку дегідратації на 20–30 % вища, ніж у популяції молодого та середнього віку. Це пов’язано зі зменшенням фізичної активності, меншою чутливістю до спраги, цукровим діабетом та захворюваннями нирок [14, 15].\r\n<h2>Вагітні</h2>\r\nБільше половини вагітних страждають від нудоти та блювання, які зазвичай починаються на 4 і зникають на 16-му тижні вагітності.\r\n\r\nУ 1 з 200 жінок стан прогресує до нестримного блювання вагітних (hyperemesis gravidarum), який характеризується тривалою та сильною нудотою і блюванням, зневодненням та втратою ваги [16].\r\n<h2>Спортсмени та люди, які займаються фізичною працею</h2>\r\nПід час фізичних вправ підвищення метаболізму викликає підви-\r\n\r\nщення температури тіла. Для того, щоб вберегти тіло від перегрівання, наш організм починає активно випаровувати воду, що і викликає зневоднення [17].\r\n<h2>Пацієнти з лихоманкою</h2>\r\nПідвищення температури тіла змушує нашу шкіру та легені посилено випаровувати воду. Крім того, лихоманка часто супроводжується втратою апетиту, відповідно, організм перестає отримувати рідину з продуктами харчування [18].\r\n<h2>Хворі з діареєю та блюванням</h2>\r\nГастроентерит — найчастіша причина зневоднення у світі. Якщо він супроводжується вираженим блюванням та діареєю, зневоднення може прогресувати дуже стрімко [19, 20].\r\n<h2>Люди у стані алкогольної інтоксикації</h2>\r\nДегідратація є однією із причин, яка викликає симптоми похмілля після вживання алкоголю. Результати досліджень підтвердили, що прийом достатньої кількості рідини прискорює відновлення після безсонної вечірки [22].\r\n<h2>ЯК ЗРОЗУМІТИ, ЩО У ВАС ЗНЕВОДНЕННЯ?</h2>\r\nОзнаки та симптоми зневоднення можуть відрізнятися в залежності від віку. <strong><em>Так, у немовлят або ма</em></strong><strong><em>леньких дітей дегідратація проявляється [23]:</em></strong>\r\n<ul>\r\n 	<li>сухістю слизових ротової порожнини та язика;</li>\r\n 	<li>відсутністю сліз при плачі;</li>\r\n 	<li>сухістю підгузників протягом 3 і більше годин;</li>\r\n 	<li>запалістю очей, щік, тім’ячка;</li>\r\n 	<li>в’ялістю або дратівливістю.</li>\r\n</ul>\r\nДорослі скаржаться на сильну спрагу, рідше сечовипускання і потемніння сечі, втому, запамороченість та затуманеність в голові.\r\n<h2>ЯК ЛІКУВАТИ ЗНЕВОДНЕННЯ?</h2>\r\nОсновою лікування зневоднення будь-якої причини є оральна регідратаційна терапія (ОРТ). Для того, щоб полегшити всмоктування води, ідеальний розчин для регідратації має містити мікроелементи в правильних пропорціях, найважливішим з яких є натрій. Натрій та інші мікроелементи можуть пасивно транспортуватися рідиною з просвіту кишечника в кров’яне русло. У ряді досліджень доведено, що швидка пероральна регідратація відповідним розчином є такою ж ефективною, як внутрішньовенне інфузійне введення розчинів. При цьому регідратація водно-сольовими розчинами через рот не інвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nВода для медичних цілей, яка має збалансований водно-електролітний склад для проведення пероральної регідратації та ефективність і безпеку, підтверджену багаторічним досвідом використання в умовах реальної клінічної практики, представлена на ринку України фармацевтичною компанією <strong>ЮРІЯ ФАРМ </strong>під брендовою назвою <strong>RеO</strong>.\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях у дітей;</li>\r\n 	<li>токсикозі вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідратаційної терапії (ОРТ), використовуючи <strong>воду</strong> <strong>RеO</strong>. Блювота, як правило, не є протипоказанням до ОРТ, окрім випадків кишкової непрохідності та гострого живота.\r\n\r\nПри гострих кишкових інфекціях та інших розладах, які супроводжуються блюванням і діареєю, особливо у дітей, дефіцит рідини слід поповнювати протягом 4 годин. <strong>Воду RеO </strong>слід вводити у невеликих обсягах дуже часто, щоб мінімізувати роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей <strong>ReO </strong>щохвилини добре переноситься. По мірі відновлення водних запасів організму, блювання часто зменшується і можуть використовуватися більші обсяги рідини [18].\r\n\r\n<strong><em>Лікування зневоднення проводиться у 2 етапи [24]: </em></strong><strong><em>1 етап (власне</em></strong> <strong><em>регідратації),</em></strong> який направлений на швидке відновлення запасів втраченої рідини та триває 3-4 години. Необхідний об’єм <strong>води ReO</strong>, на даному етапі, залежить від віку та маси тіла хворого і становить:\r\n<h2>Як слід пити воду RеO?</h2>\r\n<ul>\r\n 	<li>для немовлят та дітей вагою до 30 кг – 50-100 мл/ кг <strong>води ReO </strong>протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг – 2-4 л <strong>води ReO </strong>протягом 4 годин.</li>\r\n</ul>\r\n<strong><em>2 етап (підтримуючий), </em></strong>метою якого є попередження зневоднення. Триває даний етап до виліковування пацієнта. При цьому об’єм <strong>води ReO</strong>, окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких випорожнень і складає:\r\n<ul>\r\n 	<li>якщо маса тіла менше 10 кг – по 60-120 мл води ReO після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10-30 кг – по 120-240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг – стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\n<strong>Ще Цельс казав, що у воді — зцілення і попередження захворювань. Вона зміцнює тіло і зберігає бадьорість духу. Сьогодні вибір правильної води став як ніколи легким. Вода ReO не просто характеризується відмінними смаковими властивостями та легко п’ється, навіть при відчутті нудоти.</strong>\r\n\r\n<strong>Завдяки збалансованому водно-сольовому складу вода ReO забезпечує максимально швидке всмоктування води та електролітів і рятує організм від дегідратації, незалежно від її причини.</strong>\r\n<h2>ЛІТЕРАТУРНІ ДЖЕРЕЛА:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n 	<li>Mayo Water: Essential to your body.Режим доступу: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body</li>\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https:// oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n 	<li>Bouchama A and Knochel JP, Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n 	<li>Taylor K, Jones Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://healio.com/nursing/journals/ jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n 	<li>Lennox Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm. nih.gov/19345549/</li>\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n 	<li>Режим доступу: https://www.mayoclinic.org/ diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669</li>\r\n</ol>','РеО гармонія води та електролітів у пляшці','','publish','open','open','','reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi','','','2021-07-19 17:28:03','2021-07-19 14:28:03','',0,'https://reo.ua/?p=1263',3,'post','',0),(1269,1,'2021-07-19 17:28:03','2021-07-19 14:28:03','<em>«Воді була дана чарівна влада стати </em><em>соком життя на Землі.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nНаш організм — це жива лабораторія, в якій щосекунди виникають сотні складних хімічних реакцій. Їхнє нормальне протікання неможливе без води. Вона бере участь в абсолютно усіх процесах в організмі. Ось кілька найважливіших із них [2]: z регуляція температури тіла;\r\n<ul>\r\n 	<li>зволоження та захист слизових оболонок очей, дихального та шлунково-кишкового трактів;</li>\r\n 	<li>транспорт поживних речовин та кисню до клітин;</li>\r\n 	<li>змащення суглобів;</li>\r\n 	<li>знешкодження та виведення шкідливих речовин печінкою та нирками;</li>\r\n 	<li>розчинення мінералів та поживних речовин для того, щоб тіло могло їх засвоїти.</li>\r\n</ul>\r\n<h3>ЦIКАВИЙ ФАКТ!</h3>\r\nТіло середньостатистичної дорослої людини на 60 % складається з води.\r\n\r\nПри цьому кількість рідини в окремих органах відрізняється. Так, наші.\r\n\r\nВтрата понад 1 % рідини організму послідовно призводить до порушення терморегуляції, зниження працездатності та апетиту. Якщо дегідратація продовжується і дефіцит становить 4 % і більше, виникають труднощі з концентрацією уваги, головні болі, дратівливість, сонливість, підвищується температура тіла та частота дихання [3].\r\n\r\nПрогресуюче зневоднення негативно відображається і на стані серцево-судинної системи. Втрата води супроводжується зростанням частоти серцевих скорочень та розладами артеріального тиску. Легке зневоднення (2 % втрати маси тіла) притупляє чутливість барорецепторів, які відповідають за підтримку тиску в нормі [4]. При зниженні артеріального тиску у серце потрапляє мало крові. В результаті зменшується серцевий викид і до органів надходить менше кисню та поживних речовин [5]. Помірне зневоднення також посилює пролапс мітрального клапана, ймовірно, через нижчий тиск і об›єм наповнення передсердь [6].\r\n\r\nВтрата води у кількості, що перевищує 10 % маси тіла при високій температурі навколишнього середовища, супроводжується серйозним ризиком інсульту, шоку та поліорганної недостатності [8].\r\n\r\nХронічне зневоднення може збільшити ризик розвитку інфекцій, особливо сечовивідних шляхів. В той самий час збільшення об’єму прийнятої рідини супроводжується зменшенням частоти повторних інфекцій [10].\r\n\r\nДекілька досліджень повідомляють про підвищений ризик виникнення раку сечового міхура у осіб, які зазвичай споживають мало води. Так, в одному з досліджень було оцінено загальне добове споживання рідини у 47909 чоловіків. Через 10 років спостереження у тих, хто споживав менше 1,3 л/добу, значно (p = 0,002) зростав ризик виникнення раку сечового міхура порівняно з тими, хто споживав більше 2,5 л/добу [11].\r\n\r\n<strong>ЯКІ БУВАЮТЬ ТИПИ ЗНЕВОДНЕННЯ?</strong>\r\n\r\n<strong><em>Існує кілька форм зневоднення [12]:</em></strong>\r\n<ul>\r\n 	<li><strong><em>Ізотонічне</em></strong>, коли вода і натрій втрачаються разом. крові завжди будуть підвищеними при гіпертонічПричинами ізотонічної втрати води є блювота,   ній дегідратації. Даний стан виникає при лихомандіарея, пітливість, опіки, хвороби нирок, гіпергліці, задишці та нецукровому діабеті.</li>\r\n 	<li> <strong><em>Гіпотонічне</em></strong>, при якому організм втрачає більше кемія та гіпоальдостеронізм.</li>\r\n 	<li><strong><em>Гіпертонічне</em></strong>, коли втрати води перевищують натрію, ніж води. Найчастіше це пов’язано з виковтрати натрію. Натрій та осмолярність сироватки ристанням сечогінних препаратів.</li>\r\n</ul>\r\n<h2>У КОГО НАЙЧАСТІШЕ ВИНИКАЄ ЗНЕВОДНЕННЯ?</h2>\r\nАбсолютно ніхто не застрахований від дегідратації, однак у деяких ситуаціях та у певних груп пацієнтів даний стан зустрічається частіше та може супроводжуватися важкими ускладненнями.\r\n<h2>Діти</h2>\r\nДегідратація є однією з частих причин захворюваності та смертності немовлят та маленьких дітей у всьому світі.\r\n\r\nБільшість випадків зневоднення у дітей є наслідком гострого гастроентериту. В загальному, немовлята та маленькі діти особливо схильні до діареї та зневоднення.\r\n\r\nПричиною цього є вищий рівень метаболізму, неможливість повідомити про свої потреби або самостійно випити води. Іншими причинами зневоднення у дітей можуть бути діабетичний кетоацидоз (ДКА), нецукровий діабет, ацетонемічний синдром, опіки, сонячний та тепловий удари, надмірне потовиділення [13].\r\n<h2>Люди літнього віку</h2>\r\nУ будь-якої дорослої людини дегідратація може розвинутися на фоні гіперглікемії. Дегідратація може бути як причиною захворювання, так і її наслідком.\r\n\r\nУ людей похилого віку вірогідність розвитку дегідратації на 20–30 % вища, ніж у популяції молодого та середнього віку. Це пов’язано зі зменшенням фізичної активності, меншою чутливістю до спраги, цукровим діабетом та захворюваннями нирок [14, 15].\r\n<h2>Вагітні</h2>\r\nБільше половини вагітних страждають від нудоти та блювання, які зазвичай починаються на 4 і зникають на 16-му тижні вагітності.\r\n\r\nУ 1 з 200 жінок стан прогресує до нестримного блювання вагітних (hyperemesis gravidarum), який характеризується тривалою та сильною нудотою і блюванням, зневодненням та втратою ваги [16].\r\n<h2>Спортсмени та люди, які займаються фізичною працею</h2>\r\nПід час фізичних вправ підвищення метаболізму викликає підви-\r\n\r\nщення температури тіла. Для того, щоб вберегти тіло від перегрівання, наш організм починає активно випаровувати воду, що і викликає зневоднення [17].\r\n<h2>Пацієнти з лихоманкою</h2>\r\nПідвищення температури тіла змушує нашу шкіру та легені посилено випаровувати воду. Крім того, лихоманка часто супроводжується втратою апетиту, відповідно, організм перестає отримувати рідину з продуктами харчування [18].\r\n<h2>Хворі з діареєю та блюванням</h2>\r\nГастроентерит — найчастіша причина зневоднення у світі. Якщо він супроводжується вираженим блюванням та діареєю, зневоднення може прогресувати дуже стрімко [19, 20].\r\n<h2>Люди у стані алкогольної інтоксикації</h2>\r\nДегідратація є однією із причин, яка викликає симптоми похмілля після вживання алкоголю. Результати досліджень підтвердили, що прийом достатньої кількості рідини прискорює відновлення після безсонної вечірки [22].\r\n<h2>ЯК ЗРОЗУМІТИ, ЩО У ВАС ЗНЕВОДНЕННЯ?</h2>\r\nОзнаки та симптоми зневоднення можуть відрізнятися в залежності від віку. <strong><em>Так, у немовлят або ма</em></strong><strong><em>леньких дітей дегідратація проявляється [23]:</em></strong>\r\n<ul>\r\n 	<li>сухістю слизових ротової порожнини та язика;</li>\r\n 	<li>відсутністю сліз при плачі;</li>\r\n 	<li>сухістю підгузників протягом 3 і більше годин;</li>\r\n 	<li>запалістю очей, щік, тім’ячка;</li>\r\n 	<li>в’ялістю або дратівливістю.</li>\r\n</ul>\r\nДорослі скаржаться на сильну спрагу, рідше сечовипускання і потемніння сечі, втому, запамороченість та затуманеність в голові.\r\n<h2>ЯК ЛІКУВАТИ ЗНЕВОДНЕННЯ?</h2>\r\nОсновою лікування зневоднення будь-якої причини є оральна регідратаційна терапія (ОРТ). Для того, щоб полегшити всмоктування води, ідеальний розчин для регідратації має містити мікроелементи в правильних пропорціях, найважливішим з яких є натрій. Натрій та інші мікроелементи можуть пасивно транспортуватися рідиною з просвіту кишечника в кров’яне русло. У ряді досліджень доведено, що швидка пероральна регідратація відповідним розчином є такою ж ефективною, як внутрішньовенне інфузійне введення розчинів. При цьому регідратація водно-сольовими розчинами через рот не інвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nВода для медичних цілей, яка має збалансований водно-електролітний склад для проведення пероральної регідратації та ефективність і безпеку, підтверджену багаторічним досвідом використання в умовах реальної клінічної практики, представлена на ринку України фармацевтичною компанією <strong>ЮРІЯ ФАРМ </strong>під брендовою назвою <strong>RеO</strong>.\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зневодненням та інтоксикацією організму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях у дітей;</li>\r\n 	<li>токсикозі вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідратаційної терапії (ОРТ), використовуючи <strong>воду</strong> <strong>RеO</strong>. Блювота, як правило, не є протипоказанням до ОРТ, окрім випадків кишкової непрохідності та гострого живота.\r\n\r\nПри гострих кишкових інфекціях та інших розладах, які супроводжуються блюванням і діареєю, особливо у дітей, дефіцит рідини слід поповнювати протягом 4 годин. <strong>Воду RеO </strong>слід вводити у невеликих обсягах дуже часто, щоб мінімізувати роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей <strong>ReO </strong>щохвилини добре переноситься. По мірі відновлення водних запасів організму, блювання часто зменшується і можуть використовуватися більші обсяги рідини [18].\r\n\r\n<strong><em>Лікування зневоднення проводиться у 2 етапи [24]: </em></strong><strong><em>1 етап (власне</em></strong> <strong><em>регідратації),</em></strong> який направлений на швидке відновлення запасів втраченої рідини та триває 3-4 години. Необхідний об’єм <strong>води ReO</strong>, на даному етапі, залежить від віку та маси тіла хворого і становить:\r\n<h2>Як слід пити воду RеO?</h2>\r\n<ul>\r\n 	<li>для немовлят та дітей вагою до 30 кг – 50-100 мл/ кг <strong>води ReO </strong>протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг – 2-4 л <strong>води ReO </strong>протягом 4 годин.</li>\r\n</ul>\r\n<strong><em>2 етап (підтримуючий), </em></strong>метою якого є попередження зневоднення. Триває даний етап до виліковування пацієнта. При цьому об’єм <strong>води ReO</strong>, окрім віку та маси хворого, залежить від кількості епізодів блювання та рідких випорожнень і складає:\r\n<ul>\r\n 	<li>якщо маса тіла менше 10 кг – по 60-120 мл води ReO після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10-30 кг – по 120-240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг – стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\n<strong>Ще Цельс казав, що у воді — зцілення і попередження захворювань. Вона зміцнює тіло і зберігає бадьорість духу. Сьогодні вибір правильної води став як ніколи легким. Вода ReO не просто характеризується відмінними смаковими властивостями та легко п’ється, навіть при відчутті нудоти.</strong>\r\n\r\n<strong>Завдяки збалансованому водно-сольовому складу вода ReO забезпечує максимально швидке всмоктування води та електролітів і рятує організм від дегідратації, незалежно від її причини.</strong>\r\n<h2>ЛІТЕРАТУРНІ ДЖЕРЕЛА:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n 	<li>Mayo Water: Essential to your body.Режим доступу: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body</li>\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https:// oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n 	<li>Bouchama A and Knochel JP, Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n 	<li>Taylor K, Jones Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://healio.com/nursing/journals/ jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n 	<li>Lennox Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm. nih.gov/19345549/</li>\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n 	<li>Режим доступу: https://www.mayoclinic.org/ diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669</li>\r\n</ol>','РеО гармонія води та електролітів у пляшці','','inherit','closed','closed','','1263-revision-v1','','','2021-07-19 17:28:03','2021-07-19 14:28:03','',1263,'https://reo.ua/?p=1269',0,'revision','',0),(1264,1,'2021-07-19 17:25:37','2021-07-19 14:25:37','<em>«Воді була дана чарівна влада стати </em><em>соком життя на Землі.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nНаш організм — це жива лабораторія, в якій щосекунди виникають сотні складних хімічних реакцій. Їхнє нормальне протікання неможливе без води. Вона бере участь в абсолютно усіх процесах в організмі. Ось кілька найважливіших із них [2]: z регуляція температури тіла;\r\n<ul>\r\n 	<li>зволоження та захист слизових оболонок очей, дихального та шлунково-кишкового трактів;</li>\r\n 	<li>транспорт поживних речовин та кисню до клітин;</li>\r\n 	<li>змащення суглобів;</li>\r\n 	<li>знешкодження та виведення шкідливих речовин печінкою та нирками;</li>\r\n 	<li>розчинення мінералів та поживних речовин для того, щоб тіло могло їх засвоїти.</li>\r\n</ul>\r\n<h3>ЦIКАВИЙ ФАКТ!</h3>\r\nТіло середньостатистичної дорослої людини на 60 % складається з води.\r\n\r\nПри цьому кількість рідини в окремих органах відрізняється. Так, наші.\r\n\r\nВтрата понад 1 % рідини організ- му послідовно призводить до по- рушення терморегуляції, знижен- ня працездатності та апетиту. Якщо дегідратація продовжується і дефі- цит становить 4 % і більше, виника- ють труднощі з концентрацією ува- ги, головні болі, дратівливість, сон- ливість, підвищується температура тіла та частота дихання [3].\r\n\r\nПрогресуюче зневоднення нега- тивно відображається і на стані сер- цево-судинної системи. Втрата води супроводжується зростанням ча- стоти серцевих скорочень та роз- ладами артеріального тиску. Легке зневоднення (2 % втрати маси тіла) притупляє чутливість барорецеп- торів, які відповідають за підтрим- ку тиску в нормі [4]. При зниженні артеріального тиску у серце потра- пляє мало крові. В результаті змен- шується серцевий викид і до ор- ганів надходить менше кисню та по- живних речовин [5]. Помірне зне- воднення також посилює пролапс мітрального клапана, ймовірно, через нижчий тиск і об›єм наповнення передсердь [6].\r\n\r\nВтрата води у кількості, що пе- ревищує 10 % маси тіла при високій температурі навколишнього середо- вища, супроводжується серйозним ризиком інсульту, шоку та поліор- ганної недостатності [8].\r\n\r\nХронічне зневоднення може збільшити ризик розвитку інфек- цій, особливо сечовивідних шляхів. В той самий час збільшення об’єму прийнятої рідини супроводжуєть- ся зменшенням частоти повторних інфекцій [10].\r\n\r\nДекілька досліджень повідомля- ють про підвищений ризик виник- нення раку сечового міхура у осіб, які зазвичай споживають мало води. Так, в одному з досліджень було оцінено загальне добове споживання рідини у 47909 чоловіків. Через 10 років спо- стереження у тих, хто споживав мен- ше 1,3 л/добу, значно (p = 0,002) зро- став ризик виникнення раку сечово- го міхура порівняно з тими, хто спо- живав більше 2,5 л/добу [11].\r\n\r\n<strong>ЯКІ БУВАЮТЬ ТИПИ ЗНЕВОДНЕННЯ?</strong>\r\n\r\n<strong><em>Існує кілька форм зневоднення [12]:</em></strong>\r\n<ul>\r\n 	<li><strong><em>Ізотонічне</em></strong>, коли вода і натрій втрачаються разом. крові завжди будуть підвищеними при гіпертоніч- Причинами ізотонічної втрати води є блювота,   ній дегідратації. Даний стан виникає при лихоман- діарея, пітливість, опіки, хвороби нирок, гіперглі- ці, задишці та нецукровому діабеті.</li>\r\n 	<li> <strong><em>Гіпотонічне</em></strong>, при якому організм втрачає більше кемія та гіпоальдостеронізм.</li>\r\n 	<li><strong><em>Гіпертонічне</em></strong>, коли втрати води перевищують натрію, ніж води. Найчастіше це пов’язано з вико- втрати натрію. Натрій та осмолярність сироватки ристанням сечогінних препаратів.</li>\r\n</ul>\r\n<h2>У КОГО НАЙЧАСТІШЕ ВИНИКАЄ ЗНЕВОДНЕННЯ?</h2>\r\nАбсолютно ніхто не застрахований від дегідратації, однак у деяких ситуаціях та у певних груп пацієнтів даний стан зустрічається частіше та може супроводжуватися важкими ускладненнями.\r\n<h2>Діти</h2>\r\nДегідратація є однією з частих причин захворюваності та смерт- ності немовлят та маленьких дітей у всьому світі.\r\n\r\nБільшість випадків зневоднен- ня у дітей є наслідком гострого га- строентериту. В загальному, не- мовлята та маленькі діти особли- во схильні до діареї та зневоднення.\r\n\r\nПричиною цього є вищий рівень метаболізму, неможливість пові- домити про свої потреби або само- стійно випити води. Іншими при- чинами зневоднення у дітей мо- жуть бути діабетичний кетоацидоз (ДКА), нецукровий діабет, ацето- немічний синдром, опіки, соняч- ний та тепловий удари, надмірне потовиділення [13].\r\n<h2>Люди літнього віку</h2>\r\nУ будь-якої дорослої людини де- гідратація може розвинутися на фоні гіперглікемії. Дегідратація може бути як причиною захворю- вання, так і її наслідком.\r\n\r\nУ людей похилого віку віро- гідність розвитку дегідратації на 20–30 % вища, ніж у популяції мо- лодого та середнього віку. Це пов’я- зано зі зменшенням фізичної актив- ності, меншою чутливістю до спра- ги, цукровим діабетом та захворю- ваннями нирок [14, 15].\r\n<h2>Вагітні</h2>\r\nБільше половини вагітних стра- ждають від нудоти та блювання, які зазвичай починаються на 4 і зника- ють на 16-му тижні вагітності.\r\n\r\nУ 1 з 200 жінок стан прогресує до нестримного блювання вагітних (hyperemesis gravidarum), який ха- рактеризується тривалою та силь- ною нудотою і блюванням, зневод- ненням та втратою ваги [16].\r\n<h2>Спортсмени та люди, які займаються фізичною працею</h2>\r\nПід час фізичних вправ підви- щення метаболізму викликає підви-\r\n\r\nщення температури тіла. Для того, щоб вберегти тіло від перегріван- ня, наш організм починає активно випаровувати воду, що і викликає зневоднення [17].\r\n<h2>Пацієнти з лихоманкою</h2>\r\nПідвищення температури тіла змушує нашу шкіру та легені поси- лено випаровувати воду. Крім того, лихоманка часто супроводжуєть- ся втратою апетиту, відповідно, ор- ганізм перестає отримувати рідину з продуктами харчування [18].\r\n<h2>Хворі з діареєю та блюванням</h2>\r\nГастроентерит — найчастіша причина зневоднення у світі. Якщо він супроводжується вираженим блюванням та діареєю, зневоднен- ня може прогресувати дуже стрім- ко [19, 20].\r\n<h2>Люди у стані алкогольної інтоксикації</h2>\r\nДегідратація є однією із причин, яка викликає симптоми похмілля після вживання алкоголю. Резуль- тати досліджень підтвердили, що прийом достатньої кількості рідини прискорює відновлення після без- сонної вечірки [22].\r\n<h2>ЯК ЗРОЗУМІТИ, ЩО У ВАС ЗНЕВОДНЕННЯ?</h2>\r\nОзнаки та симптоми зневоднення можуть відріз- нятися в залежності від віку. <strong><em>Так, у немовлят або ма- </em></strong><strong><em>леньких дітей дегідратація проявляється [23]:</em></strong>\r\n<ul>\r\n 	<li>сухістю слизових ротової порожнини та язика;</li>\r\n 	<li>відсутністю сліз при плачі;</li>\r\n 	<li>сухістю підгузників протягом 3 і більше годин;</li>\r\n 	<li>запалістю очей, щік, тім’ячка;</li>\r\n 	<li>в’ялістю або дратівливістю.</li>\r\n</ul>\r\nДорослі скаржаться на сильну спрагу, рідше се- човипускання і потемніння сечі, втому, запаморо- ченість та затуманеність в голові.\r\n<h2>ЯК ЛІКУВАТИ ЗНЕВОДНЕННЯ?</h2>\r\nОсновою лікування зневоднення будь-якої причини є оральна регідра- таційна терапія (ОРТ). Для того, щоб полегшити всмоктування води, іде- альний розчин для регідратації має містити мікроелементи в правильних пропорціях, найважливішим з яких є натрій. Натрій та інші мікроелемен- ти можуть пасивно транспортуватися рідиною з просвіту кишечника в кров’яне русло. У ряді досліджень доведено, що швидка пероральна ре- гідратація відповідним розчином є такою ж ефективною, як внутрішньо- венне інфузійне введення розчинів. При цьому регідратація водно-сольо- вими розчинами через рот не інвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nВода для медичних цілей, яка має збалансований водно-електролітний склад для проведення пероральної регідратації та ефективність і безпе- ку, підтверджену багаторічним досвідом використання в умовах реальної клінічної практики, представлена на ринку України фармацевтичною ком- панією <strong>ЮРІЯ ФАРМ </strong>під брендовою назвою <strong>RеO</strong>.\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією ор- ганізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях у дітей;</li>\r\n 	<li>токсикозі вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідрата- ційної терапії (ОРТ), використовуючи <strong>воду</strong> <strong>RеO</strong>. Блюво- та, як правило, не є протипоказанням до ОРТ, окрім ви- падків кишкової непрохідності та гострого живота.\r\n\r\nПри гострих кишкових інфекціях та інших розла- дах, які супроводжуються блюванням і діареєю, осо- бливо у дітей, дефіцит рідини слід поповнювати про- тягом 4 годин. <strong>Воду RеO </strong>слід вводити у невеликих об- сягах дуже часто, щоб мінімізувати роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей <strong>ReO </strong>щохвилини добре переноситься. По мірі відновлення водних запасів організму, блю- вання часто зменшується і можуть використовувати- ся більші обсяги рідини [18].\r\n\r\n<strong><em>Лікування зневоднення проводиться у 2 етапи [24]: </em></strong><strong><em>1 етап (власне</em></strong> <strong><em>регідратації),</em></strong> який направле- ний на швидке відновлення запасів втраченої рідини та триває 3-4 години. Необхідний об’єм <strong>води ReO</strong>, на даному етапі, залежить від віку та маси тіла хворого і становить:\r\n<h2>Як слід пити воду RеO?</h2>\r\n<ul>\r\n 	<li>для немовлят та дітей вагою до 30 кг – 50-100 мл/ кг <strong>води ReO </strong>протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг – 2-4 л <strong>води ReO </strong>протягом 4 годин.</li>\r\n</ul>\r\n<strong><em>2 етап (підтримуючий), </em></strong>метою якого є поперед- ження зневоднення. Триває даний етап до вилікову- вання пацієнта. При цьому об’єм <strong>води ReO</strong>, окрім віку та маси хворого, залежить від кількості епізодів блю- вання та рідких випорожнень і складає:\r\n<ul>\r\n 	<li>якщо маса тіла менше 10 кг – по 60-120 мл води ReO після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10-30 кг – по 120-240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг – стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\n<strong>Ще Цельс казав, що у воді — зцілення і попередження захворювань. Вона зміцнює тіло і зберігає бадьорість духу. Сьогодні вибір правильної води став як ніколи легким. Вода ReO не просто характеризується відмінними смаковими властивостями та легко п’ється, навіть при відчутті нудоти.</strong>\r\n\r\n<strong>Завдяки збалансованому водно-сольовому складу вода ReO забезпечує максимально швидке всмоктування води та електролітів і рятує організм від дегідратації, незалежно від її причини.</strong>\r\n<h2>ЛІТЕРАТУРНІ ДЖЕРЕЛА:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. 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J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">https://journals.physiology.org/doi/full/10.1152/</a> <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-</a> <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">2003&amp;rfr_id=ori %3Arid %3Acrossref.org</a></li>\r\n 	<li>Lennox Huang. Dehydration. Режим доступу: <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">https://emedicine.</a> <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">medscape.com/article/906999-overview#a7</a></li>\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060- PMID: 10836917. Режим доступу: <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">https://www.acpjournals.</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</a></li>\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm. nih.gov/19345549/</li>\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">https://pubmed.ncbi.nlm.nih.</a> <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">gov/26611203/</a></li>\r\n 	<li>Режим доступу: https://<a href=\"http://www.mayoclinic.org/\">www.mayoclinic.org/</a> diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669</li>\r\n</ol>','РеО гармонія води та електролітів у пляшці','','inherit','closed','closed','','1263-revision-v1','','','2021-07-19 17:25:37','2021-07-19 14:25:37','',1263,'https://reo.ua/?p=1264',0,'revision','',0),(1265,1,'2021-07-19 17:26:00','2021-07-19 14:26:00','','РеО гармонія води та електролітів у пляшці','','inherit','open','closed','','reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi','','','2021-07-19 17:26:00','2021-07-19 14:26:00','',1263,'https://reo.ua/wp-content/uploads/2021/07/reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi.pdf',0,'attachment','application/pdf',0),(1266,1,'2021-07-19 17:26:00','2021-07-19 14:26:00','','РеО гармонія води та електролітів у пляшці','','inherit','open','closed','','reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi-2','','','2021-07-19 17:26:00','2021-07-19 14:26:00','',1317,'https://reo.ua/wp-content/uploads/2021/07/reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi.pdf',0,'attachment','application/pdf',0),(1267,1,'2021-07-19 17:26:08','2021-07-19 14:26:08','<em>«Воді була дана чарівна влада стати </em><em>соком життя на Землі.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nНаш організм — це жива лабораторія, в якій щосекунди виникають сотні складних хімічних реакцій. Їхнє нормальне протікання неможливе без води. Вона бере участь в абсолютно усіх процесах в організмі. Ось кілька найважливіших із них [2]: z регуляція температури тіла;\r\n<ul>\r\n 	<li>зволоження та захист слизових оболонок очей, дихального та шлунково-кишкового трактів;</li>\r\n 	<li>транспорт поживних речовин та кисню до клітин;</li>\r\n 	<li>змащення суглобів;</li>\r\n 	<li>знешкодження та виведення шкідливих речовин печінкою та нирками;</li>\r\n 	<li>розчинення мінералів та поживних речовин для того, щоб тіло могло їх засвоїти.</li>\r\n</ul>\r\n<h3>ЦIКАВИЙ ФАКТ!</h3>\r\nТіло середньостатистичної дорослої людини на 60 % складається з води.\r\n\r\nПри цьому кількість рідини в окремих органах відрізняється. Так, наші.\r\n\r\nВтрата понад 1 % рідини організ- му послідовно призводить до по- рушення терморегуляції, знижен- ня працездатності та апетиту. Якщо дегідратація продовжується і дефі- цит становить 4 % і більше, виника- ють труднощі з концентрацією ува- ги, головні болі, дратівливість, сон- ливість, підвищується температура тіла та частота дихання [3].\r\n\r\nПрогресуюче зневоднення нега- тивно відображається і на стані сер- цево-судинної системи. Втрата води супроводжується зростанням ча- стоти серцевих скорочень та роз- ладами артеріального тиску. Легке зневоднення (2 % втрати маси тіла) притупляє чутливість барорецеп- торів, які відповідають за підтрим- ку тиску в нормі [4]. При зниженні артеріального тиску у серце потра- пляє мало крові. В результаті змен- шується серцевий викид і до ор- ганів надходить менше кисню та по- живних речовин [5]. Помірне зне- воднення також посилює пролапс мітрального клапана, ймовірно, через нижчий тиск і об›єм наповнення передсердь [6].\r\n\r\nВтрата води у кількості, що пе- ревищує 10 % маси тіла при високій температурі навколишнього середо- вища, супроводжується серйозним ризиком інсульту, шоку та поліор- ганної недостатності [8].\r\n\r\nХронічне зневоднення може збільшити ризик розвитку інфек- цій, особливо сечовивідних шляхів. В той самий час збільшення об’єму прийнятої рідини супроводжуєть- ся зменшенням частоти повторних інфекцій [10].\r\n\r\nДекілька досліджень повідомля- ють про підвищений ризик виник- нення раку сечового міхура у осіб, які зазвичай споживають мало води. Так, в одному з досліджень було оцінено загальне добове споживання рідини у 47909 чоловіків. Через 10 років спо- стереження у тих, хто споживав мен- ше 1,3 л/добу, значно (p = 0,002) зро- став ризик виникнення раку сечово- го міхура порівняно з тими, хто спо- живав більше 2,5 л/добу [11].\r\n\r\n<strong>ЯКІ БУВАЮТЬ ТИПИ ЗНЕВОДНЕННЯ?</strong>\r\n\r\n<strong><em>Існує кілька форм зневоднення [12]:</em></strong>\r\n<ul>\r\n 	<li><strong><em>Ізотонічне</em></strong>, коли вода і натрій втрачаються разом. крові завжди будуть підвищеними при гіпертоніч- Причинами ізотонічної втрати води є блювота,   ній дегідратації. Даний стан виникає при лихоман- діарея, пітливість, опіки, хвороби нирок, гіперглі- ці, задишці та нецукровому діабеті.</li>\r\n 	<li> <strong><em>Гіпотонічне</em></strong>, при якому організм втрачає більше кемія та гіпоальдостеронізм.</li>\r\n 	<li><strong><em>Гіпертонічне</em></strong>, коли втрати води перевищують натрію, ніж води. Найчастіше це пов’язано з вико- втрати натрію. Натрій та осмолярність сироватки ристанням сечогінних препаратів.</li>\r\n</ul>\r\n<h2>У КОГО НАЙЧАСТІШЕ ВИНИКАЄ ЗНЕВОДНЕННЯ?</h2>\r\nАбсолютно ніхто не застрахований від дегідратації, однак у деяких ситуаціях та у певних груп пацієнтів даний стан зустрічається частіше та може супроводжуватися важкими ускладненнями.\r\n<h2>Діти</h2>\r\nДегідратація є однією з частих причин захворюваності та смерт- ності немовлят та маленьких дітей у всьому світі.\r\n\r\nБільшість випадків зневоднен- ня у дітей є наслідком гострого га- строентериту. В загальному, не- мовлята та маленькі діти особли- во схильні до діареї та зневоднення.\r\n\r\nПричиною цього є вищий рівень метаболізму, неможливість пові- домити про свої потреби або само- стійно випити води. Іншими при- чинами зневоднення у дітей мо- жуть бути діабетичний кетоацидоз (ДКА), нецукровий діабет, ацето- немічний синдром, опіки, соняч- ний та тепловий удари, надмірне потовиділення [13].\r\n<h2>Люди літнього віку</h2>\r\nУ будь-якої дорослої людини де- гідратація може розвинутися на фоні гіперглікемії. Дегідратація може бути як причиною захворю- вання, так і її наслідком.\r\n\r\nУ людей похилого віку віро- гідність розвитку дегідратації на 20–30 % вища, ніж у популяції мо- лодого та середнього віку. Це пов’я- зано зі зменшенням фізичної актив- ності, меншою чутливістю до спра- ги, цукровим діабетом та захворю- ваннями нирок [14, 15].\r\n<h2>Вагітні</h2>\r\nБільше половини вагітних стра- ждають від нудоти та блювання, які зазвичай починаються на 4 і зника- ють на 16-му тижні вагітності.\r\n\r\nУ 1 з 200 жінок стан прогресує до нестримного блювання вагітних (hyperemesis gravidarum), який ха- рактеризується тривалою та силь- ною нудотою і блюванням, зневод- ненням та втратою ваги [16].\r\n<h2>Спортсмени та люди, які займаються фізичною працею</h2>\r\nПід час фізичних вправ підви- щення метаболізму викликає підви-\r\n\r\nщення температури тіла. Для того, щоб вберегти тіло від перегріван- ня, наш організм починає активно випаровувати воду, що і викликає зневоднення [17].\r\n<h2>Пацієнти з лихоманкою</h2>\r\nПідвищення температури тіла змушує нашу шкіру та легені поси- лено випаровувати воду. Крім того, лихоманка часто супроводжуєть- ся втратою апетиту, відповідно, ор- ганізм перестає отримувати рідину з продуктами харчування [18].\r\n<h2>Хворі з діареєю та блюванням</h2>\r\nГастроентерит — найчастіша причина зневоднення у світі. Якщо він супроводжується вираженим блюванням та діареєю, зневоднен- ня може прогресувати дуже стрім- ко [19, 20].\r\n<h2>Люди у стані алкогольної інтоксикації</h2>\r\nДегідратація є однією із причин, яка викликає симптоми похмілля після вживання алкоголю. Резуль- тати досліджень підтвердили, що прийом достатньої кількості рідини прискорює відновлення після без- сонної вечірки [22].\r\n<h2>ЯК ЗРОЗУМІТИ, ЩО У ВАС ЗНЕВОДНЕННЯ?</h2>\r\nОзнаки та симптоми зневоднення можуть відріз- нятися в залежності від віку. <strong><em>Так, у немовлят або ма- </em></strong><strong><em>леньких дітей дегідратація проявляється [23]:</em></strong>\r\n<ul>\r\n 	<li>сухістю слизових ротової порожнини та язика;</li>\r\n 	<li>відсутністю сліз при плачі;</li>\r\n 	<li>сухістю підгузників протягом 3 і більше годин;</li>\r\n 	<li>запалістю очей, щік, тім’ячка;</li>\r\n 	<li>в’ялістю або дратівливістю.</li>\r\n</ul>\r\nДорослі скаржаться на сильну спрагу, рідше се- човипускання і потемніння сечі, втому, запаморо- ченість та затуманеність в голові.\r\n<h2>ЯК ЛІКУВАТИ ЗНЕВОДНЕННЯ?</h2>\r\nОсновою лікування зневоднення будь-якої причини є оральна регідра- таційна терапія (ОРТ). Для того, щоб полегшити всмоктування води, іде- альний розчин для регідратації має містити мікроелементи в правильних пропорціях, найважливішим з яких є натрій. Натрій та інші мікроелемен- ти можуть пасивно транспортуватися рідиною з просвіту кишечника в кров’яне русло. У ряді досліджень доведено, що швидка пероральна ре- гідратація відповідним розчином є такою ж ефективною, як внутрішньо- венне інфузійне введення розчинів. При цьому регідратація водно-сольо- вими розчинами через рот не інвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\r\n\r\nВода для медичних цілей, яка має збалансований водно-електролітний склад для проведення пероральної регідратації та ефективність і безпе- ку, підтверджену багаторічним досвідом використання в умовах реальної клінічної практики, представлена на ринку України фармацевтичною ком- панією <strong>ЮРІЯ ФАРМ </strong>під брендовою назвою <strong>RеO</strong>.\r\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\r\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією ор- ганізму, зокрема:\r\n<ul>\r\n 	<li>фізичних навантаженнях;</li>\r\n 	<li>перебуванні в умовах жаркого клімату;</li>\r\n 	<li>алкогольній інтоксикації;</li>\r\n 	<li>лихоманці;</li>\r\n 	<li>отруєннях;</li>\r\n 	<li>діареї;</li>\r\n 	<li>гострих кишкових інфекціях у дітей;</li>\r\n 	<li>токсикозі вагітних.</li>\r\n</ul>\r\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідрата- ційної терапії (ОРТ), використовуючи <strong>воду</strong> <strong>RеO</strong>. Блюво- та, як правило, не є протипоказанням до ОРТ, окрім ви- падків кишкової непрохідності та гострого живота.\r\n\r\nПри гострих кишкових інфекціях та інших розла- дах, які супроводжуються блюванням і діареєю, осо- бливо у дітей, дефіцит рідини слід поповнювати про- тягом 4 годин. <strong>Воду RеO </strong>слід вводити у невеликих об- сягах дуже часто, щоб мінімізувати роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей <strong>ReO </strong>щохвилини добре переноситься. По мірі відновлення водних запасів організму, блю- вання часто зменшується і можуть використовувати- ся більші обсяги рідини [18].\r\n\r\n<strong><em>Лікування зневоднення проводиться у 2 етапи [24]: </em></strong><strong><em>1 етап (власне</em></strong> <strong><em>регідратації),</em></strong> який направле- ний на швидке відновлення запасів втраченої рідини та триває 3-4 години. Необхідний об’єм <strong>води ReO</strong>, на даному етапі, залежить від віку та маси тіла хворого і становить:\r\n<h2>Як слід пити воду RеO?</h2>\r\n<ul>\r\n 	<li>для немовлят та дітей вагою до 30 кг – 50-100 мл/ кг <strong>води ReO </strong>протягом 4 годин;</li>\r\n 	<li>для дорослих та підлітків масою тіла більше 30 кг – 2-4 л <strong>води ReO </strong>протягом 4 годин.</li>\r\n</ul>\r\n<strong><em>2 етап (підтримуючий), </em></strong>метою якого є поперед- ження зневоднення. Триває даний етап до вилікову- вання пацієнта. При цьому об’єм <strong>води ReO</strong>, окрім віку та маси хворого, залежить від кількості епізодів блю- вання та рідких випорожнень і складає:\r\n<ul>\r\n 	<li>якщо маса тіла менше 10 кг – по 60-120 мл води ReO після кожного епізоду діареї чи блювання;</li>\r\n 	<li>маса тіла 10-30 кг – по 120-240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\r\n 	<li>підлітки та дорослі масою тіла більше 30 кг – стільки рідини, скільки вони бажають випити.</li>\r\n</ul>\r\n<strong>Ще Цельс казав, що у воді — зцілення і попередження захворювань. Вона зміцнює тіло і зберігає бадьорість духу. Сьогодні вибір правильної води став як ніколи легким. Вода ReO не просто характеризується відмінними смаковими властивостями та легко п’ється, навіть при відчутті нудоти.</strong>\r\n\r\n<strong>Завдяки збалансованому водно-сольовому складу вода ReO забезпечує максимально швидке всмоктування води та електролітів і рятує організм від дегідратації, незалежно від її причини.</strong>\r\n<h2>ЛІТЕРАТУРНІ ДЖЕРЕЛА:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: <a href=\"https://www.efbw.org/index.php?id=46\">https://www.efbw.org/index.php?id=46</a></li>\r\n 	<li>Mayo Water: Essential to your body.Режим доступу: <a href=\"https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body\">https://</a> <a href=\"https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body\">www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/</a> <a href=\"https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body\">water-essential-to-your-body</a></li>\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: <a href=\"https://academic.oup.com/nutritionreviews/article/61/8/261/1920531\">https://</a> <a href=\"https://academic.oup.com/nutritionreviews/article/61/8/261/1920531\">oup.com/nutritionreviews/article/61/8/261/1920531</a></li>\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n 	<li>Bouchama A and Knochel JP, Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: <a href=\"https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">https://www.nejm.org/</a> <a href=\"https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.</a> <a href=\"https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">org&amp;rfr_dat=cr_pub %20 %200pubmed</a></li>\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Life- threatening hypernatraemic dehydration in breastfed Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим досту- пу: <a href=\"https://europepmc.org/article/med/10228189\">https://europepmc.org/article/med/10228189</a></li>\r\n 	<li>Taylor K, Jones Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK555956/\">https://www.ncbi.nlm.nih.gov/books/NBK555956/</a></li>\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK436022/\">https://www.ncbi.nlm.nih.gov/books/NBK436022/</a></li>\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://<a href=\"http://www.healio.com/nursing/journals/\">healio.com/nursing/journals/</a> jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n 	<li>Режим доступу: <a href=\"https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm%3Apubmed\">https://agsjournals.onlinelibrary.wiley.com/doi/</a> <a href=\"https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm%3Apubmed\">abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</a></li>\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/\">https://www.ncbi.nlm.nih.gov/pmc/</a> <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/\">articles/PMC3959188/</a></li>\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">https://journals.physiology.org/doi/full/10.1152/</a> <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-</a> <a href=\"https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub%2B%2B0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org\">2003&amp;rfr_id=ori %3Arid %3Acrossref.org</a></li>\r\n 	<li>Lennox Huang. Dehydration. Режим доступу: <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">https://emedicine.</a> <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">medscape.com/article/906999-overview#a7</a></li>\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060- PMID: 10836917. Режим доступу: <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">https://www.acpjournals.</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</a></li>\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm. nih.gov/19345549/</li>\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">https://pubmed.ncbi.nlm.nih.</a> <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">gov/26611203/</a></li>\r\n 	<li>Режим доступу: https://<a href=\"http://www.mayoclinic.org/\">www.mayoclinic.org/</a> diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669</li>\r\n</ol>','РеО гармонія води та електролітів у пляшці','','inherit','closed','closed','','1263-revision-v1','','','2021-07-19 17:26:08','2021-07-19 14:26:08','',1263,'https://reo.ua/?p=1267',0,'revision','',0),(1268,1,'2021-07-19 17:27:16','2021-07-19 14:27:16','<em>«Воді була дана чарівна влада стати </em><em>соком життя на Землі.»</em>\n<em>Леонардо Да Вінчі</em>\n\nНаш організм — це жива лабораторія, в якій щосекунди виникають сотні складних хімічних реакцій. Їхнє нормальне протікання неможливе без води. Вона бере участь в абсолютно усіх процесах в організмі. Ось кілька найважливіших із них [2]: z регуляція температури тіла;\n<ul>\n 	<li>зволоження та захист слизових оболонок очей, дихального та шлунково-кишкового трактів;</li>\n 	<li>транспорт поживних речовин та кисню до клітин;</li>\n 	<li>змащення суглобів;</li>\n 	<li>знешкодження та виведення шкідливих речовин печінкою та нирками;</li>\n 	<li>розчинення мінералів та поживних речовин для того, щоб тіло могло їх засвоїти.</li>\n</ul>\n<h3>ЦIКАВИЙ ФАКТ!</h3>\nТіло середньостатистичної дорослої людини на 60 % складається з води.\n\nПри цьому кількість рідини в окремих органах відрізняється. Так, наші.\n\nВтрата понад 1 % рідини організ- му послідовно призводить до по- рушення терморегуляції, знижен- ня працездатності та апетиту. Якщо дегідратація продовжується і дефі- цит становить 4 % і більше, виника- ють труднощі з концентрацією ува- ги, головні болі, дратівливість, сон- ливість, підвищується температура тіла та частота дихання [3].\n\nПрогресуюче зневоднення нега- тивно відображається і на стані сер- цево-судинної системи. Втрата води супроводжується зростанням ча- стоти серцевих скорочень та роз- ладами артеріального тиску. Легке зневоднення (2 % втрати маси тіла) притупляє чутливість барорецеп- торів, які відповідають за підтрим- ку тиску в нормі [4]. При зниженні артеріального тиску у серце потра- пляє мало крові. В результаті змен- шується серцевий викид і до ор- ганів надходить менше кисню та по- живних речовин [5]. Помірне зне- воднення також посилює пролапс мітрального клапана, ймовірно, через нижчий тиск і об›єм наповнення передсердь [6].\n\nВтрата води у кількості, що пе- ревищує 10 % маси тіла при високій температурі навколишнього середо- вища, супроводжується серйозним ризиком інсульту, шоку та поліор- ганної недостатності [8].\n\nХронічне зневоднення може збільшити ризик розвитку інфек- цій, особливо сечовивідних шляхів. В той самий час збільшення об’єму прийнятої рідини супроводжуєть- ся зменшенням частоти повторних інфекцій [10].\n\nДекілька досліджень повідомля- ють про підвищений ризик виник- нення раку сечового міхура у осіб, які зазвичай споживають мало води. Так, в одному з досліджень було оцінено загальне добове споживання рідини у 47909 чоловіків. Через 10 років спо- стереження у тих, хто споживав мен- ше 1,3 л/добу, значно (p = 0,002) зро- став ризик виникнення раку сечово- го міхура порівняно з тими, хто спо- живав більше 2,5 л/добу [11].\n\n<strong>ЯКІ БУВАЮТЬ ТИПИ ЗНЕВОДНЕННЯ?</strong>\n\n<strong><em>Існує кілька форм зневоднення [12]:</em></strong>\n<ul>\n 	<li><strong><em>Ізотонічне</em></strong>, коли вода і натрій втрачаються разом. крові завжди будуть підвищеними при гіпертоніч- Причинами ізотонічної втрати води є блювота,   ній дегідратації. Даний стан виникає при лихоман- діарея, пітливість, опіки, хвороби нирок, гіперглі- ці, задишці та нецукровому діабеті.</li>\n 	<li> <strong><em>Гіпотонічне</em></strong>, при якому організм втрачає більше кемія та гіпоальдостеронізм.</li>\n 	<li><strong><em>Гіпертонічне</em></strong>, коли втрати води перевищують натрію, ніж води. Найчастіше це пов’язано з вико- втрати натрію. Натрій та осмолярність сироватки ристанням сечогінних препаратів.</li>\n</ul>\n<h2>У КОГО НАЙЧАСТІШЕ ВИНИКАЄ ЗНЕВОДНЕННЯ?</h2>\nАбсолютно ніхто не застрахований від дегідратації, однак у деяких ситуаціях та у певних груп пацієнтів даний стан зустрічається частіше та може супроводжуватися важкими ускладненнями.\n<h2>Діти</h2>\nДегідратація є однією з частих причин захворюваності та смерт- ності немовлят та маленьких дітей у всьому світі.\n\nБільшість випадків зневоднен- ня у дітей є наслідком гострого га- строентериту. В загальному, не- мовлята та маленькі діти особли- во схильні до діареї та зневоднення.\n\nПричиною цього є вищий рівень метаболізму, неможливість пові- домити про свої потреби або само- стійно випити води. Іншими при- чинами зневоднення у дітей мо- жуть бути діабетичний кетоацидоз (ДКА), нецукровий діабет, ацето- немічний синдром, опіки, соняч- ний та тепловий удари, надмірне потовиділення [13].\n<h2>Люди літнього віку</h2>\nУ будь-якої дорослої людини де- гідратація може розвинутися на фоні гіперглікемії. Дегідратація може бути як причиною захворю- вання, так і її наслідком.\n\nУ людей похилого віку віро- гідність розвитку дегідратації на 20–30 % вища, ніж у популяції мо- лодого та середнього віку. Це пов’я- зано зі зменшенням фізичної актив- ності, меншою чутливістю до спра- ги, цукровим діабетом та захворю- ваннями нирок [14, 15].\n<h2>Вагітні</h2>\nБільше половини вагітних стра- ждають від нудоти та блювання, які зазвичай починаються на 4 і зника- ють на 16-му тижні вагітності.\n\nУ 1 з 200 жінок стан прогресує до нестримного блювання вагітних (hyperemesis gravidarum), який ха- рактеризується тривалою та силь- ною нудотою і блюванням, зневод- ненням та втратою ваги [16].\n<h2>Спортсмени та люди, які займаються фізичною працею</h2>\nПід час фізичних вправ підви- щення метаболізму викликає підви-\n\nщення температури тіла. Для того, щоб вберегти тіло від перегріван- ня, наш організм починає активно випаровувати воду, що і викликає зневоднення [17].\n<h2>Пацієнти з лихоманкою</h2>\nПідвищення температури тіла змушує нашу шкіру та легені поси- лено випаровувати воду. Крім того, лихоманка часто супроводжуєть- ся втратою апетиту, відповідно, ор- ганізм перестає отримувати рідину з продуктами харчування [18].\n<h2>Хворі з діареєю та блюванням</h2>\nГастроентерит — найчастіша причина зневоднення у світі. Якщо він супроводжується вираженим блюванням та діареєю, зневоднен- ня може прогресувати дуже стрім- ко [19, 20].\n<h2>Люди у стані алкогольної інтоксикації</h2>\nДегідратація є однією із причин, яка викликає симптоми похмілля після вживання алкоголю. Резуль- тати досліджень підтвердили, що прийом достатньої кількості рідини прискорює відновлення після без- сонної вечірки [22].\n<h2>ЯК ЗРОЗУМІТИ, ЩО У ВАС ЗНЕВОДНЕННЯ?</h2>\nОзнаки та симптоми зневоднення можуть відріз- нятися в залежності від віку. <strong><em>Так, у немовлят або ма- </em></strong><strong><em>леньких дітей дегідратація проявляється [23]:</em></strong>\n<ul>\n 	<li>сухістю слизових ротової порожнини та язика;</li>\n 	<li>відсутністю сліз при плачі;</li>\n 	<li>сухістю підгузників протягом 3 і більше годин;</li>\n 	<li>запалістю очей, щік, тім’ячка;</li>\n 	<li>в’ялістю або дратівливістю.</li>\n</ul>\nДорослі скаржаться на сильну спрагу, рідше се- човипускання і потемніння сечі, втому, запаморо- ченість та затуманеність в голові.\n<h2>ЯК ЛІКУВАТИ ЗНЕВОДНЕННЯ?</h2>\nОсновою лікування зневоднення будь-якої причини є оральна регідра- таційна терапія (ОРТ). Для того, щоб полегшити всмоктування води, іде- альний розчин для регідратації має містити мікроелементи в правильних пропорціях, найважливішим з яких є натрій. Натрій та інші мікроелемен- ти можуть пасивно транспортуватися рідиною з просвіту кишечника в кров’яне русло. У ряді досліджень доведено, що швидка пероральна ре- гідратація відповідним розчином є такою ж ефективною, як внутрішньо- венне інфузійне введення розчинів. При цьому регідратація водно-сольо- вими розчинами через рот не інвазивна та не супроводжується низкою побічних реакцій, які можуть виникнути на фоні інфузійної терапії.\n\nВода для медичних цілей, яка має збалансований водно-електролітний склад для проведення пероральної регідратації та ефективність і безпе- ку, підтверджену багаторічним досвідом використання в умовах реальної клінічної практики, представлена на ринку України фармацевтичною ком- панією <strong>ЮРІЯ ФАРМ </strong>під брендовою назвою <strong>RеO</strong>.\n<h2>Коли слід пити воду для медичних цілей ReO?</h2>\n<strong>Вода ReO </strong>рекомендується при станах, що супроводжуються зне- водненням та інтоксикацією ор- ганізму, зокрема:\n<ul>\n 	<li>фізичних навантаженнях;</li>\n 	<li>перебуванні в умовах жаркого клімату;</li>\n 	<li>алкогольній інтоксикації;</li>\n 	<li>лихоманці;</li>\n 	<li>отруєннях;</li>\n 	<li>діареї;</li>\n 	<li>гострих кишкових інфекціях у дітей;</li>\n 	<li>токсикозі вагітних.</li>\n</ul>\nЛегке або помірне зневоднення зазвичай можна ефективно вилікувати за допомогою оральної регідрата- ційної терапії (ОРТ), використовуючи <strong>воду</strong> <strong>RеO</strong>. Блюво- та, як правило, не є протипоказанням до ОРТ, окрім ви- падків кишкової непрохідності та гострого живота.\n\nПри гострих кишкових інфекціях та інших розла- дах, які супроводжуються блюванням і діареєю, осо- бливо у дітей, дефіцит рідини слід поповнювати про- тягом 4 годин. <strong>Воду RеO </strong>слід вводити у невеликих об- сягах дуже часто, щоб мінімізувати роздуття шлунку та рефлекторну блювоту. Як правило, 5 мл води для медичних цілей <strong>ReO </strong>щохвилини добре переноситься. По мірі відновлення водних запасів організму, блю- вання часто зменшується і можуть використовувати- ся більші обсяги рідини [18].\n\n<strong><em>Лікування зневоднення проводиться у 2 етапи [24]: </em></strong><strong><em>1 етап (власне</em></strong> <strong><em>регідратації),</em></strong> який направле- ний на швидке відновлення запасів втраченої рідини та триває 3-4 години. Необхідний об’єм <strong>води ReO</strong>, на даному етапі, залежить від віку та маси тіла хворого і становить:\n<h2>Як слід пити воду RеO?</h2>\n<ul>\n 	<li>для немовлят та дітей вагою до 30 кг – 50-100 мл/ кг <strong>води ReO </strong>протягом 4 годин;</li>\n 	<li>для дорослих та підлітків масою тіла більше 30 кг – 2-4 л <strong>води ReO </strong>протягом 4 годин.</li>\n</ul>\n<strong><em>2 етап (підтримуючий), </em></strong>метою якого є поперед- ження зневоднення. Триває даний етап до вилікову- вання пацієнта. При цьому об’єм <strong>води ReO</strong>, окрім віку та маси хворого, залежить від кількості епізодів блю- вання та рідких випорожнень і складає:\n<ul>\n 	<li>якщо маса тіла менше 10 кг – по 60-120 мл води ReO після кожного епізоду діареї чи блювання;</li>\n 	<li>маса тіла 10-30 кг – по 120-240 мл <strong>води ReO </strong>після кожного епізоду діареї чи блювання.</li>\n 	<li>підлітки та дорослі масою тіла більше 30 кг – стільки рідини, скільки вони бажають випити.</li>\n</ul>\n<strong>Ще Цельс казав, що у воді — зцілення і попередження захворювань. Вона зміцнює тіло і зберігає бадьорість духу. Сьогодні вибір правильної води став як ніколи легким. Вода ReO не просто характеризується відмінними смаковими властивостями та легко п’ється, навіть при відчутті нудоти.</strong>\n\n<strong>Завдяки збалансованому водно-сольовому складу вода ReO забезпечує максимально швидке всмоктування води та електролітів і рятує організм від дегідратації, незалежно від її причини.</strong>\n<h2>ЛІТЕРАТУРНІ ДЖЕРЕЛА:</h2>\n<ol>\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\n 	<li>Mayo Water: Essential to your body.Режим доступу: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body</li>\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https:// oup.com/nutritionreviews/article/61/8/261/1920531</li>\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\n 	<li>Aufderheide S, Lax D and Goldberg SJ, Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB, Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\n 	<li>Bouchama A and Knochel JP, Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Life- threatening hypernatraemic dehydration in breastfed Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC2083010/</li>\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим досту- пу: https://europepmc.org/article/med/10228189</li>\n 	<li>Taylor K, Jones Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://healio.com/nursing/journals/ jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\n 	<li>Режим доступу: <a href=\"https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm%3Apubmed\">https://agsjournals.onlinelibrary.wiley.com/doi/</a>abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\n 	<li>Lennox Huang. Dehydration. Режим доступу: <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">https://emedicine.</a> <a href=\"https://emedicine.medscape.com/article/906999-overview#a7\">medscape.com/article/906999-overview#a7</a></li>\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060- PMID: 10836917. Режим доступу: <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">https://www.acpjournals.</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-</a> <a href=\"https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</a></li>\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm. nih.gov/19345549/</li>\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">https://pubmed.ncbi.nlm.nih.</a> <a href=\"https://pubmed.ncbi.nlm.nih.gov/26611203/\">gov/26611203/</a></li>\n 	<li>Режим доступу: https://<a href=\"http://www.mayoclinic.org/\">www.mayoclinic.org/</a> diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 65,12 (2017): e45-e80. doi:10.1093/cid/cix669</li>\n</ol>','РеО гармонія води та електролітів у пляшці','','inherit','closed','closed','','1263-autosave-v1','','','2021-07-19 17:27:16','2021-07-19 14:27:16','',1263,'https://reo.ua/?p=1268',0,'revision','',0),(1270,1,'2021-07-20 10:59:19','2021-07-20 07:59:19','','Замовити','','inherit','closed','closed','','282-revision-v1','','','2021-07-20 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09:49:04','',8,'https://reo.ua/?p=1315',0,'revision','',0),(1316,1,'2021-08-02 13:46:22','2021-08-02 10:46:22','','Главная','','inherit','closed','closed','','176-revision-v1','','','2021-08-02 13:46:22','2021-08-02 10:46:22','',176,'https://reo.ua/?p=1316',0,'revision','',0),(1317,1,'2021-07-19 17:25:37','2021-07-19 14:25:37','<em>«Воде была дана волшебная власть стать соком жизни на Земле.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nВода играет ключевую роль в жизни человека.\r\n\r\nКаждая система организма, начиная от клетки и заканчивая жизненно\r\n\r\nважными органами, не способна работать без воды.\r\n<h2>Для чего организму требуется столько воды?</h2>\r\nНаш организм – это живая лаборатория, в которой каждую секунду возникают сотни сложных химических реакций. Их нормальное протекания невозможно без воды. Она участвует в абсолютно всех процессах в организме. Вот несколько наиболее важных из них [2]:\r\n<ul>\r\n 	<li>регуляция температуры тела;</li>\r\n 	<li>увлажнение и защита слизистых оболочек глаз, дыхательного и желудочно-кишечного трактов;</li>\r\n 	<li>транспортировка питательных веществ и кислорода к клеткам;</li>\r\n 	<li>смазка суставов;</li>\r\n 	<li>обезвреживание и выведение вредных веществ печенью и почками;</li>\r\n 	<li>растворения минералов и питательных веществ для того, чтобы тело могло их усвоить.</li>\r\n</ul>\r\n<h2>ЭТО ВАЖНО!</h2>\r\nПри потере воды в количестве, превышающей 8% от общей массы тела, может наступить смерть [3].\r\n\r\n***\r\n\r\nЧеловеческий организм не может накапливать и хранить воду. Мы постоянно теряем ее через кожу, легкие, почки и кишечник.\r\n\r\nВосстановление потерянной жидкости и надлежащая гидратация являются залогами здоровья и функционирования организма [1].\r\n<h2>Интересный ФАКТ!</h2>\r\nТело среднестатистического взрослого человека на 60% состоит из воды.\r\n\r\nПри этом количество жидкости в отдельных органах отличается. Так, наши кости состоят из воды лишь на треть, тогда как легкие – на 83% [1].\r\n<h2>ЧТО ПРОИСХОДИТ С ОРГАНИЗМОМ ПРИ ОБЕЗВОЖИВАНИИ?</h2>\r\nПотеря более 1% жидкости организмом последовательно приводит к нарушению терморегуляции, снижению работоспособности и аппетита. Если дегидратация продолжается и дефицит составляет 4% и более, возникают трудности с концентрацией внимания, головные боли, раздражительность, сонливость, повышается температура тела и частота дыхания [3].\r\n\r\nПрогрессирующее обезвоживание негативно отражается и на состоянии сердечно-сосудистой системы. Потеря воды сопровождается ростом частоты сердечных сокращений и расстройствами артериального давления. Легкое обезвоживание (2% потери массы тела) притупляет чувствительность барорецепторов, которые отвечают за поддержку давления в норме [4].\r\n\r\nПри снижении артериального давления в сердце попадает мало крови. В результате уменьшается сердечный выброс и к органам поступает меньше кислорода и питательных веществ. [5]. Умеренное обезвоживание также усиливает пролапс митрального клапана, вероятно, из-за низкого давления и объема наполнения предсердий [6].\r\n\r\nПотеря воды в количестве, превышающей 10% массы тела при высокой температуре окружающей среды, сопровождается серьезным риском инсульта, шока и полиорганной недостаточности [8].\r\n\r\nХроническое обезвоживание может увеличить риск развития инфекций, особенно мочевыводящих путей. В то же время увеличение объема принятой жидкости сопровождается уменьшением частоты повторных инфекций [10].\r\n\r\nНесколько исследований сообщают о повышенном риске возникновения рака мочевого пузыря у людей, которые обычно потребляют мало воды.\r\n\r\nТак, в одном из исследований было оценено общее суточное потребление жидкости у 47909 мужчин. Через 10 лет наблюдения у тех, кто потреблял меньше 1,3 л/сут., значительно (p = 0,002) увеличивался риск возникновения рака мочевого пузыря по сравнению с теми, кто потреблял более 2,5 л/сут. [11].\r\n<h2>Какие бывают типы обезвоживания?</h2>\r\nСуществует несколько форм обезвоживания [12]:\r\n<ul>\r\n 	<li>Изотоническая, когда вода и натрий теряются вместе.</li>\r\n 	<li>Причинами изотонической потери воды являются рвота, диарея, потливость, ожоги, болезни почек, гипергликемия и гипоальдостеронизм.</li>\r\n 	<li>Гипертоническая, когда потери воды превышают</li>\r\n 	<li>потери натрия. Натрий и осмолярность сыворотки крови всегда будут повышенными при гипертонической дегидратации. Это состояние возникает при лихорадке, одышке и несахарном диабете.</li>\r\n 	<li>Гипотоническая, при которой организм теряет больше натрия, чем воды. Чаще всего это связано с приемом мочегонных препаратов.</li>\r\n</ul>\r\n<h2>У КОГО ЧАЩЕ ВОЗНИКАЕТ ОБЕЗВОЖИВАНИЕ?</h2>\r\nАбсолютно никто не застрахован от дегидратации, однако в некоторых\r\n\r\nситуациях и у определенных групп пациентов это состояние встречается чаще и может сопровождаться тяжелыми осложнениями.\r\n<h2>Дети</h2>\r\nДегидратация является одной из частых причин заболеваемости и смертности младенцев и маленьких детей во всем мире.\r\n\r\nБольшинство случаев обезвоживания у детей являются следствием острого гастроэнтерита.\r\n\r\nМладенцы и маленькие дети особенно склонны к диарее и обезвоживанию.\r\n\r\nПричиной этого является высокий уровень метаболизма, невозможность сообщить о своих потребностях или самостоятельно попить воды. Другими причинами обезвоживания у детей могут быть диабетический кетоацидоз\r\n\r\n(ДКА), несахарный диабет, ацетонемический синдром, ожоги, солнечный и тепловой удары, чрезмерное потоотделение [13].\r\n<h2>Люди пожилого возраста</h2>\r\nУ любого взрослого человека дегидратация может развиться на фоне гипергликемии.\r\n\r\nДегидратация может быть как причиной заболевания, так и ее следствием.\r\n\r\nУ пожилых людей вероятность развития дегидратации на 2 0-30% выше, чем в популяции молодого и среднего возраста.\r\n\r\nЭто связано с уменьшением физической активности, меньшей чувствительностью к жажде, сахарным диабетом и заболеваниями почек [14, 15].\r\n<h2>Беременные</h2>\r\nБолее половины беременных страдают от тошноты и рвоты, которые обычно начинаются на 4-й и исчезают на 16-й неделе беременности.\r\n\r\nУ 1 из 200 женщин состояние прогрессирует до неукротимой рвоты беременных (Hyperemesis gravidarum). Это состояние характеризуется длительной и сильной тошнотой и рвотой, обезвоживанием и потерей веса [16].\r\n<h2>Спортсмены и люди, которые занимаются физическим трудом</h2>\r\nВо время физических упражнений повышенный метаболизм вызывает повышение температуры тела. Для того, чтобы уберечь тело от перегревания, наш организм начинает активно испарять воду и вызывает обезвоживание [17].\r\n<h2>Пациенты с лихорадкой</h2>\r\nПовышение температуры тела заставляет нашу кожу и легкие усилено испарять воду. Кроме того, лихорадка часто сопровождается потерей аппетита, соответственно, организм перестает получать жидкость с продуктами питания [18].\r\n<h2>Больные с диареей и рвотой</h2>\r\nГастроэнтерит – самая частая причина обезвоживания в мире.\r\n\r\nЕсли он сопровождается выраженным рвотой и диареей, обезвоживание может прогрессировать очень стремительно [19, 20].\r\n<h2>Люди в состоянии алкогольной интоксикации</h2>\r\nДегидратация является одной из причин, которая вызывает симптомы похмелья после употребления алкоголя.\r\n\r\nРезультаты исследований подтвердили, что прием достаточного количества жидкости ускоряет восстановление после бессонной вечеринки [22].\r\n<h2>Это важно!</h2>\r\nЗа данными неспециализированной прессы, 75% американцев хронически обезвожены.\r\n\r\nРаспространенность дегидратации среди пациентов пожилого возраста колеблется в пределах 17%-28% [12].\r\n<h2>ВАЖНО!</h2>\r\nРотавирус является самой распространенной в мире причиной дегидратации и тяжелой диареи у младенцев и детей раннего возраста [21].\r\n<h2>Интересный ФАКТ!</h2>\r\nПричина тошноты и рвоты во время беременности точно неизвестна, но она может быть обусловлена ​​повышением концентрации хорионического гонадотропина в организме женщины [16].\r\n<h2>Как понять, что у Вас обезвоживание?</h2>\r\nПризнаки и симптомы обезвоживания могут отличаться в зависимости от возраста. Так, у младенцев или маленьких детей дегидратация проявляется [23]:\r\n<ul>\r\n 	<li>сухостью слизистых ротовой полости и языка;</li>\r\n 	<li>отсутствием слез при плаче;</li>\r\n 	<li>сухостью подгузников в течение 3 и больше часов;</li>\r\n 	<li>впалостью глаз, щек, темечка;</li>\r\n 	<li>вялостью или раздражительностью.</li>\r\n</ul>\r\nВзрослые жалуются на сильную жажду, редкие мочеиспускания и потемнение мочи, усталость, головокружение и затуманенность в голове.\r\n<h2>Как лечить обезвоживание?</h2>\r\nОсновой лечения обезвоживания любой причины является оральная регидратационная терапия (ОРТ). Для того, чтобы облегчить всасывание воды, идеальный раствор для регидратации должен содержать микроэлементы в правильных пропорциях, важнейшим из которых является натрий. Натрий и другие микроэлементы могут пассивно транспортироваться жидкостью из просвета кишечника в кровяное русло. В ряде исследований доказано, что быстрая пероральная регидратация соответствующим раствором является такой же эффективной, как внутривенное инфузионное введение растворов. При этом регидратация водно-солевыми растворами через рот не инвазивная и не сопровождается рядом побочных реакций, которые могут возникнуть на фоне инфузионной терапии. Вода для медицинских целей ReO от фармацевтической компании «Юрия-Фарм» имеет сбалансированный водно-электролитный состав для проведения пероральной реидратации, эффективна и безопасна. Это подтверждено многолетним опытом использования в условиях реальной клинической практики.\r\n<h2>Когда следует пить воду для медицинских целей ReO?</h2>\r\nВода ReO рекомендуется при состояниях, которые сопровождаются обезвоживанием и интоксикацией организма, в частности:\r\n<ul>\r\n 	<li>физических нагрузках;</li>\r\n 	<li>пребывании в условиях жаркого климата;</li>\r\n 	<li>лкогольной интоксикации;</li>\r\n 	<li>лихорадке;</li>\r\n 	<li>отравлениях;</li>\r\n 	<li>диарее;</li>\r\n 	<li>острых кишечных инфекциях у детей;</li>\r\n 	<li>токсикозе беременных.</li>\r\n</ul>\r\n<h2>Как следует пить воду РеО?</h2>\r\nЛегкое или умеренное обезвоживание обычно можно эффективно вылечить с помощью оральной регидратационной терапии (ОРТ), используя воду RеO. Рвота, как правило, не является противопоказанием к ОРТ, кроме случаев кишечной непроходимости и острого живота. При острых кишечных инфекциях и других расстройствах, которые сопровождаются рвотой и диареей, особенно у детей, дефицит жидкости следует восполнять в течение 4 часов. Воду RеO следует вводить в небольших объемах очень часто, чтобы минимизировать растягивание желудка и рефлекторную рвоту. Как правило, 5 мл воды для медицинских целей ReO ежеминутно переносятся хорошо. По мере возобновления водных запасов организма рвота часто уменьшается, поэтому могут быть использованы большие объемы жидкости [18].\r\n<h2>Лечение обезвоживания проводится в 2 этапа [24]:</h2>\r\n<ul>\r\n 	<li>1 этап – регидратация. Он направлен на быстрое возобновление запасов потерянной жидкости и длится 3-4 часа. Необходимый объем воды ReO зависит от возраста и массы тела больного и составляет:</li>\r\n</ul>\r\n- для младенцев и детей весом до 30 кг – 50-100 мл/кг воды РеО в течение 4 часов;\r\n\r\n- для взрослых и подростков весом более 30 кг – 2-4 л воды РеО в течение 4 часов.\r\n<ul>\r\n 	<li>2 этап – поддерживающий. Цель этого этапа – предотвратить обезвоживание. Длится данный этап до выздоровления пациента. При этом объем воды ReO, кроме возраста и массы больного, зависит от количества эпизодов рвоты и жидкого стула и составляет:</li>\r\n</ul>\r\n- по 60-120 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела менее 10 кг;\r\n- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\r\n\r\nПодростки и взрослые массой тела больше 30 кг могут пить столько жидкости, сколько они желают.\r\n\r\nЕще Цельс говорил, что в воде – исцеление и предупреждение заболеваний. Она укрепляет тело и хранит бодрость духа. Сегодня выбор правильной воды стал как никогда легким. Вода ReO не просто характеризуется отличными вкусовыми свойствами, но также ее легко пить даже при ощущении тошноты. Благодаря сбалансированному водно-солевому составу вода ReO обеспечивает максимально быстрое всасывание воды и электролитов и спасает организм от дегидратации независимо от ее причины.\r\n<h2>Литературные источники:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n</ol>\r\n<ol start=\"2\">\r\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\r\n</ol>\r\n<ol start=\"3\">\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n</ol>\r\n<ol start=\"4\">\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n</ol>\r\n<ol start=\"5\">\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n</ol>\r\n<ol start=\"6\">\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n</ol>\r\n<ol start=\"7\">\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\r\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"9\">\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n</ol>\r\n<ol start=\"10\">\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n</ol>\r\n<ol start=\"11\">\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n</ol>\r\n<ol start=\"12\">\r\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n</ol>\r\n<ol start=\"13\">\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n</ol>\r\n<ol start=\"14\">\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n</ol>\r\n<ol start=\"15\">\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factorscontributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n</ol>\r\n<ol start=\"94\">\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n</ol>\r\n<ol start=\"16\">\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n</ol>\r\n<ol start=\"17\">\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n</ol>\r\n<ol start=\"18\">\r\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n</ol>\r\n<ol start=\"19\">\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"20\">\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine Committee. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19345549/</li>\r\n</ol>\r\n<ol start=\"21\">\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN. Clinical and laboratory assessment of dehydration severity in children withacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n</ol>\r\n<ol start=\"22\">\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n</ol>\r\n<ol start=\"23\">\r\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n</ol>\r\n<ol start=\"24\">\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases</li>\r\n</ol>','РеО гармония воды и электролитов в бутылке','','publish','open','open','','reo-garmoniya-vody-i-elektrolitov-v-butylke','','','2021-08-02 17:04:52','2021-08-02 14:04:52','',0,'https://reo.ua/bez-kategorii/reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi/',2,'post','',0),(1318,1,'2021-08-02 17:03:41','2021-08-02 14:03:41','<em>«Воде была дана волшебная власть стать соком жизни на Земле.»</em>\n<em>Леонардо Да Вінчі</em>\n\nВода играет ключевую роль в жизни человека.\n\nКаждая система организма, начиная от клетки и заканчивая жизненно\n\nважными органами, не способна работать без воды.\n<h2>Для чего организму требуется столько воды?</h2>\nНаш организм – это живая лаборатория, в которой каждую секунду возникают сотни сложных химических реакций. Их нормальное протекания невозможно без воды. Она участвует в абсолютно всех процессах в организме. Вот несколько наиболее важных из них [2]:\n<ul>\n 	<li>регуляция температуры тела;</li>\n 	<li>увлажнение и защита слизистых оболочек глаз, дыхательного и желудочно-кишечного трактов;</li>\n 	<li>транспортировка питательных веществ и кислорода к клеткам;</li>\n 	<li>смазка суставов;</li>\n 	<li>обезвреживание и выведение вредных веществ печенью и почками;</li>\n 	<li>растворения минералов и питательных веществ для того, чтобы тело могло их усвоить.</li>\n</ul>\n<h2>ЭТО ВАЖНО!</h2>\nПри потере воды в количестве, превышающей 8% от общей массы тела, может наступить смерть [3].\n\n***\n\nЧеловеческий организм не может накапливать и хранить воду. Мы постоянно теряем ее через кожу, легкие, почки и кишечник.\n\nВосстановление потерянной жидкости и надлежащая гидратация являются залогами здоровья и функционирования организма [1].\n<h2>Интересный ФАКТ!</h2>\nТело среднестатистического взрослого человека на 60% состоит из воды.\n\nПри этом количество жидкости в отдельных органах отличается. Так, наши кости состоят из воды лишь на треть, тогда как легкие – на 83% [1].\n<h2>ЧТО ПРОИСХОДИТ С ОРГАНИЗМОМ ПРИ ОБЕЗВОЖИВАНИИ?</h2>\nПотеря более 1% жидкости организмом последовательно приводит к нарушению терморегуляции, снижению работоспособности и аппетита. Если дегидратация продолжается и дефицит составляет 4% и более, возникают трудности с концентрацией внимания, головные боли, раздражительность, сонливость, повышается температура тела и частота дыхания [3].\n\nПрогрессирующее обезвоживание негативно отражается и на состоянии сердечно-сосудистой системы. Потеря воды сопровождается ростом частоты сердечных сокращений и расстройствами артериального давления. Легкое обезвоживание (2% потери массы тела) притупляет чувствительность барорецепторов, которые отвечают за поддержку давления в норме [4].\n\nПри снижении артериального давления в сердце попадает мало крови. В результате уменьшается сердечный выброс и к органам поступает меньше кислорода и питательных веществ. [5]. Умеренное обезвоживание также усиливает пролапс митрального клапана, вероятно, из-за низкого давления и объема наполнения предсердий [6].\n\nПотеря воды в количестве, превышающей 10% массы тела при высокой температуре окружающей среды, сопровождается серьезным риском инсульта, шока и полиорганной недостаточности [8].\n\nХроническое обезвоживание может увеличить риск развития инфекций, особенно мочевыводящих путей. В то же время увеличение объема принятой жидкости сопровождается уменьшением частоты повторных инфекций [10].\n\nНесколько исследований сообщают о повышенном риске возникновения рака мочевого пузыря у людей, которые обычно потребляют мало воды.\n\nТак, в одном из исследований было оценено общее суточное потребление жидкости у 47909 мужчин. Через 10 лет наблюдения у тех, кто потреблял меньше 1,3 л/сут., значительно (p = 0,002) увеличивался риск возникновения рака мочевого пузыря по сравнению с теми, кто потреблял более 2,5 л/сут. [11].\n<h2>Какие бывают типы обезвоживания?</h2>\nСуществует несколько форм обезвоживания [12]:\n<ul>\n 	<li>Изотоническая, когда вода и натрий теряются вместе.</li>\n 	<li>Причинами изотонической потери воды являются рвота, диарея, потливость, ожоги, болезни почек, гипергликемия и гипоальдостеронизм.</li>\n 	<li>Гипертоническая, когда потери воды превышают</li>\n 	<li>потери натрия. Натрий и осмолярность сыворотки крови всегда будут повышенными при гипертонической дегидратации. Это состояние возникает при лихорадке, одышке и несахарном диабете.</li>\n 	<li>Гипотоническая, при которой организм теряет больше натрия, чем воды. Чаще всего это связано с приемом мочегонных препаратов.</li>\n</ul>\n<h2>У КОГО ЧАЩЕ ВОЗНИКАЕТ ОБЕЗВОЖИВАНИЕ?</h2>\nАбсолютно никто не застрахован от дегидратации, однако в некоторых\n\nситуациях и у определенных групп пациентов это состояние встречается чаще и может сопровождаться тяжелыми осложнениями.\n<h2>Дети</h2>\nДегидратация является одной из частых причин заболеваемости и смертности младенцев и маленьких детей во всем мире.\n\nБольшинство случаев обезвоживания у детей являются следствием острого гастроэнтерита.\n\nМладенцы и маленькие дети особенно склонны к диарее и обезвоживанию.\n\nПричиной этого является высокий уровень метаболизма, невозможность сообщить о своих потребностях или самостоятельно попить воды. Другими причинами обезвоживания у детей могут быть диабетический кетоацидоз\n\n(ДКА), несахарный диабет, ацетонемический синдром, ожоги, солнечный и тепловой удары, чрезмерное потоотделение [13].\n<h2>Люди пожилого возраста</h2>\nУ любого взрослого человека дегидратация может развиться на фоне гипергликемии.\n\nДегидратация может быть как причиной заболевания, так и ее следствием.\n\nУ пожилых людей вероятность развития дегидратации на 2 0-30% выше, чем в популяции молодого и среднего возраста.\n\nЭто связано с уменьшением физической активности, меньшей чувствительностью к жажде, сахарным диабетом и заболеваниями почек [14, 15].\n<h2>Беременные</h2>\nБолее половины беременных страдают от тошноты и рвоты, которые обычно начинаются на 4-й и исчезают на 16-й неделе беременности.\n\nУ 1 из 200 женщин состояние прогрессирует до неукротимой рвоты беременных (Hyperemesis gravidarum). Это состояние характеризуется длительной и сильной тошнотой и рвотой, обезвоживанием и потерей веса [16].\n<h2>Спортсмены и люди, которые занимаются физическим трудом</h2>\nВо время физических упражнений повышенный метаболизм вызывает повышение температуры тела. Для того, чтобы уберечь тело от перегревания, наш организм начинает активно испарять воду и вызывает обезвоживание [17].\n<h2>Пациенты с лихорадкой</h2>\nПовышение температуры тела заставляет нашу кожу и легкие усилено испарять воду. Кроме того, лихорадка часто сопровождается потерей аппетита, соответственно, организм перестает получать жидкость с продуктами питания [18].\n<h2>Больные с диареей и рвотой</h2>\nГастроэнтерит – самая частая причина обезвоживания в мире.\n\nЕсли он сопровождается выраженным рвотой и диареей, обезвоживание может прогрессировать очень стремительно [19, 20].\n<h2>Люди в состоянии алкогольной интоксикации</h2>\nДегидратация является одной из причин, которая вызывает симптомы похмелья после употребления алкоголя.\n\nРезультаты исследований подтвердили, что прием достаточного количества жидкости ускоряет восстановление после бессонной вечеринки [22].\n<h2>Это важно!</h2>\nЗа данными неспециализированной прессы, 75% американцев хронически обезвожены.\n\nРаспространенность дегидратации среди пациентов пожилого возраста колеблется в пределах 17%-28% [12].\n<h2>ВАЖНО!</h2>\nРотавирус является самой распространенной в мире причиной дегидратации и тяжелой диареи у младенцев и детей раннего возраста [21].\n<h2>Интересный ФАКТ!</h2>\nПричина тошноты и рвоты во время беременности точно неизвестна, но она может быть обусловлена ​​повышением концентрации хорионического гонадотропина в организме женщины [16].\n<h2>Как понять, что у Вас обезвоживание?</h2>\nПризнаки и симптомы обезвоживания могут отличаться в зависимости от возраста. Так, у младенцев или маленьких детей дегидратация проявляется [23]:\n<ul>\n 	<li>сухостью слизистых ротовой полости и языка;</li>\n 	<li>отсутствием слез при плаче;</li>\n 	<li>сухостью подгузников в течение 3 и больше часов;</li>\n 	<li>впалостью глаз, щек, темечка;</li>\n 	<li>вялостью или раздражительностью.</li>\n</ul>\nВзрослые жалуются на сильную жажду, редкие мочеиспускания и потемнение мочи, усталость, головокружение и затуманенность в голове.\n<h2>Как лечить обезвоживание?</h2>\nОсновой лечения обезвоживания любой причины является оральная регидратационная терапия (ОРТ). Для того, чтобы облегчить всасывание воды, идеальный раствор для регидратации должен содержать микроэлементы в правильных пропорциях, важнейшим из которых является натрий. Натрий и другие микроэлементы могут пассивно транспортироваться жидкостью из просвета кишечника в кровяное русло. В ряде исследований доказано, что быстрая пероральная регидратация соответствующим раствором является такой же эффективной, как внутривенное инфузионное введение растворов. При этом регидратация водно-солевыми растворами через рот не инвазивная и не сопровождается рядом побочных реакций, которые могут возникнуть на фоне инфузионной терапии. Вода для медицинских целей ReO от фармацевтической компании «Юрия-Фарм» имеет сбалансированный водно-электролитный состав для проведения пероральной реидратации, эффективна и безопасна. Это подтверждено многолетним опытом использования в условиях реальной клинической практики.\n<h2>Когда следует пить воду для медицинских целей ReO?</h2>\nВода ReO рекомендуется при состояниях, которые сопровождаются обезвоживанием и интоксикацией организма, в частности:\n<ul>\n 	<li>физических нагрузках;</li>\n 	<li>пребывании в условиях жаркого климата;</li>\n 	<li>лкогольной интоксикации;</li>\n 	<li>лихорадке;</li>\n 	<li>отравлениях;</li>\n 	<li>диарее;</li>\n 	<li>острых кишечных инфекциях у детей;</li>\n 	<li>токсикозе беременных.</li>\n</ul>\n<h2>Как следует пить воду РеО?</h2>\nЛегкое или умеренное обезвоживание обычно можно эффективно вылечить с помощью оральной регидратационной терапии (ОРТ), используя воду RеO. Рвота, как правило, не является противопоказанием к ОРТ, кроме случаев кишечной непроходимости и острого живота. При острых кишечных инфекциях и других расстройствах, которые сопровождаются рвотой и диареей, особенно у детей, дефицит жидкости следует восполнять в течение 4 часов. Воду RеO следует вводить в небольших объемах очень часто, чтобы минимизировать растягивание желудка и рефлекторную рвоту. Как правило, 5 мл воды для медицинских целей ReO ежеминутно переносятся хорошо. По мере возобновления водных запасов организма рвота часто уменьшается, поэтому могут быть использованы большие объемы жидкости [18].\n<h2>Лечение обезвоживания проводится в 2 этапа [24]:</h2>\n<ul>\n 	<li>1 этап – регидратация. Он направлен на быстрое возобновление запасов потерянной жидкости и длится 3-4 часа. Необходимый объем воды ReO зависит от возраста и массы тела больного и составляет:</li>\n</ul>\n- для младенцев и детей весом до 30 кг – 50-100 мл/кг воды РеО в течение 4 часов;\n\n- для взрослых и подростков весом более 30 кг – 2-4 л воды РеО в течение 4 часов.\n<ul>\n 	<li>2 этап – поддерживающий. Цель этого этапа – предотвратить обезвоживание. Длится данный этап до выздоровления пациента. При этом объем воды ReO, кроме возраста и массы больного, зависит от количества эпизодов рвоты и жидкого стула и составляет:</li>\n</ul>\n- по 60-120 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела менее 10 кг;\n- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\n\nПодростки и взрослые массой тела больше 30 кг могут пить столько жидкости, сколько они желают.\n\nЕще Цельс говорил, что в воде – исцеление и предупреждение заболеваний. Она укрепляет тело и хранит бодрость духа. Сегодня выбор правильной воды стал как никогда легким. Вода ReO не просто характеризуется отличными вкусовыми свойствами, но также ее легко пить даже при ощущении тошноты. Благодаря сбалансированному водно-солевому составу вода ReO обеспечивает максимально быстрое всасывание воды и электролитов и спасает организм от дегидратации независимо от ее причины.\n<h2>Литературные источники:</h2>\n<ol>\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\n</ol>\n<ol start=\"2\">\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\n</ol>\n<ol start=\"3\">\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\n</ol>\n<ol start=\"4\">\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\n</ol>\n<ol start=\"5\">\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\n</ol>\n<ol start=\"6\">\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\n</ol>\n<ol start=\"7\">\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\n</ol>\n<ol start=\"8\">\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\n</ol>\n<ol start=\"9\">\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\n</ol>\n<ol start=\"10\">\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\n</ol>\n<ol start=\"11\">\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\n</ol>\n<ol start=\"12\">\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\n</ol>\n<ol start=\"13\">\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-</li>\n</ol>\n. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/\n<ol start=\"14\">\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep</li>\n</ol>\n01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/\n\njgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/\n\ndehydration-in-the-older-adult\n<ol start=\"15\">\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors</li>\n</ol>\ncontributing to dehydration in nursing homes: inadequate staffing and\n\nlack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-\n<ol start=\"94\">\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/</li>\n</ol>\nabs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed\n<ol start=\"16\">\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical</li>\n</ol>\nevidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/\n\narticles/PMC3959188/\n<ol start=\"17\">\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the</li>\n</ol>\nrestoration and maintenance of fluid balance after exercise-induced\n\ndehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi:\n\n10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906.\n\nРежим доступу: https://journals.physiology.org/doi/full/10.1152/\n\njapplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-\n\n2003&amp;rfr_id=ori %3Arid %3Acrossref.org\n<ol start=\"18\">\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.</li>\n</ol>\nmedscape.com/article/906999-overview#a7\n<ol start=\"19\">\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med.</li>\n</ol>\n2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-\n<ol start=\"8\">\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.</li>\n</ol>\norg/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-\n\n2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed\n<ol start=\"20\">\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric</li>\n</ol>\nEmergency Medicine Committee. The management of children with\n\ngastroenteritis and dehydration in the emergency department. J Emerg\n\nMed. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.\n\nnih.gov/19345549/\n<ol start=\"21\">\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN.</li>\n</ol>\nClinical and laboratory assessment of dehydration severity in children with\n\nacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим\n\nдоступу: https://pubmed.ncbi.nlm.nih.gov/19487761/\n<ol start=\"22\">\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus —</li>\n</ol>\nGlobal research density equalizing mapping and gender analysis. Vaccine.\n\n2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.\n\ngov/26611203/\n<ol start=\"23\">\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/</li>\n</ol>\ndiseases-conditions/dehydration/symptoms-causes/syc-20354086\n<ol start=\"24\">\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America</li>\n</ol>\nClinical Practice Guidelines for the Diagnosis and Management of\n\nInfectious Diarrhea.” Clinical infectious diseases : an official publication\n\nof the Infectious Diseases','РеО гармония воды и электролитов в бутылке','','inherit','closed','closed','','1317-autosave-v1','','','2021-08-02 17:03:41','2021-08-02 14:03:41','',1317,'https://reo.ua/?p=1318',0,'revision','',0),(1319,1,'2021-08-02 17:04:52','2021-08-02 14:04:52','<em>«Воде была дана волшебная власть стать соком жизни на Земле.»</em>\r\n<em>Леонардо Да Вінчі</em>\r\n\r\nВода играет ключевую роль в жизни человека.\r\n\r\nКаждая система организма, начиная от клетки и заканчивая жизненно\r\n\r\nважными органами, не способна работать без воды.\r\n<h2>Для чего организму требуется столько воды?</h2>\r\nНаш организм – это живая лаборатория, в которой каждую секунду возникают сотни сложных химических реакций. Их нормальное протекания невозможно без воды. Она участвует в абсолютно всех процессах в организме. Вот несколько наиболее важных из них [2]:\r\n<ul>\r\n 	<li>регуляция температуры тела;</li>\r\n 	<li>увлажнение и защита слизистых оболочек глаз, дыхательного и желудочно-кишечного трактов;</li>\r\n 	<li>транспортировка питательных веществ и кислорода к клеткам;</li>\r\n 	<li>смазка суставов;</li>\r\n 	<li>обезвреживание и выведение вредных веществ печенью и почками;</li>\r\n 	<li>растворения минералов и питательных веществ для того, чтобы тело могло их усвоить.</li>\r\n</ul>\r\n<h2>ЭТО ВАЖНО!</h2>\r\nПри потере воды в количестве, превышающей 8% от общей массы тела, может наступить смерть [3].\r\n\r\n***\r\n\r\nЧеловеческий организм не может накапливать и хранить воду. Мы постоянно теряем ее через кожу, легкие, почки и кишечник.\r\n\r\nВосстановление потерянной жидкости и надлежащая гидратация являются залогами здоровья и функционирования организма [1].\r\n<h2>Интересный ФАКТ!</h2>\r\nТело среднестатистического взрослого человека на 60% состоит из воды.\r\n\r\nПри этом количество жидкости в отдельных органах отличается. Так, наши кости состоят из воды лишь на треть, тогда как легкие – на 83% [1].\r\n<h2>ЧТО ПРОИСХОДИТ С ОРГАНИЗМОМ ПРИ ОБЕЗВОЖИВАНИИ?</h2>\r\nПотеря более 1% жидкости организмом последовательно приводит к нарушению терморегуляции, снижению работоспособности и аппетита. Если дегидратация продолжается и дефицит составляет 4% и более, возникают трудности с концентрацией внимания, головные боли, раздражительность, сонливость, повышается температура тела и частота дыхания [3].\r\n\r\nПрогрессирующее обезвоживание негативно отражается и на состоянии сердечно-сосудистой системы. Потеря воды сопровождается ростом частоты сердечных сокращений и расстройствами артериального давления. Легкое обезвоживание (2% потери массы тела) притупляет чувствительность барорецепторов, которые отвечают за поддержку давления в норме [4].\r\n\r\nПри снижении артериального давления в сердце попадает мало крови. В результате уменьшается сердечный выброс и к органам поступает меньше кислорода и питательных веществ. [5]. Умеренное обезвоживание также усиливает пролапс митрального клапана, вероятно, из-за низкого давления и объема наполнения предсердий [6].\r\n\r\nПотеря воды в количестве, превышающей 10% массы тела при высокой температуре окружающей среды, сопровождается серьезным риском инсульта, шока и полиорганной недостаточности [8].\r\n\r\nХроническое обезвоживание может увеличить риск развития инфекций, особенно мочевыводящих путей. В то же время увеличение объема принятой жидкости сопровождается уменьшением частоты повторных инфекций [10].\r\n\r\nНесколько исследований сообщают о повышенном риске возникновения рака мочевого пузыря у людей, которые обычно потребляют мало воды.\r\n\r\nТак, в одном из исследований было оценено общее суточное потребление жидкости у 47909 мужчин. Через 10 лет наблюдения у тех, кто потреблял меньше 1,3 л/сут., значительно (p = 0,002) увеличивался риск возникновения рака мочевого пузыря по сравнению с теми, кто потреблял более 2,5 л/сут. [11].\r\n<h2>Какие бывают типы обезвоживания?</h2>\r\nСуществует несколько форм обезвоживания [12]:\r\n<ul>\r\n 	<li>Изотоническая, когда вода и натрий теряются вместе.</li>\r\n 	<li>Причинами изотонической потери воды являются рвота, диарея, потливость, ожоги, болезни почек, гипергликемия и гипоальдостеронизм.</li>\r\n 	<li>Гипертоническая, когда потери воды превышают</li>\r\n 	<li>потери натрия. Натрий и осмолярность сыворотки крови всегда будут повышенными при гипертонической дегидратации. Это состояние возникает при лихорадке, одышке и несахарном диабете.</li>\r\n 	<li>Гипотоническая, при которой организм теряет больше натрия, чем воды. Чаще всего это связано с приемом мочегонных препаратов.</li>\r\n</ul>\r\n<h2>У КОГО ЧАЩЕ ВОЗНИКАЕТ ОБЕЗВОЖИВАНИЕ?</h2>\r\nАбсолютно никто не застрахован от дегидратации, однако в некоторых\r\n\r\nситуациях и у определенных групп пациентов это состояние встречается чаще и может сопровождаться тяжелыми осложнениями.\r\n<h2>Дети</h2>\r\nДегидратация является одной из частых причин заболеваемости и смертности младенцев и маленьких детей во всем мире.\r\n\r\nБольшинство случаев обезвоживания у детей являются следствием острого гастроэнтерита.\r\n\r\nМладенцы и маленькие дети особенно склонны к диарее и обезвоживанию.\r\n\r\nПричиной этого является высокий уровень метаболизма, невозможность сообщить о своих потребностях или самостоятельно попить воды. Другими причинами обезвоживания у детей могут быть диабетический кетоацидоз\r\n\r\n(ДКА), несахарный диабет, ацетонемический синдром, ожоги, солнечный и тепловой удары, чрезмерное потоотделение [13].\r\n<h2>Люди пожилого возраста</h2>\r\nУ любого взрослого человека дегидратация может развиться на фоне гипергликемии.\r\n\r\nДегидратация может быть как причиной заболевания, так и ее следствием.\r\n\r\nУ пожилых людей вероятность развития дегидратации на 2 0-30% выше, чем в популяции молодого и среднего возраста.\r\n\r\nЭто связано с уменьшением физической активности, меньшей чувствительностью к жажде, сахарным диабетом и заболеваниями почек [14, 15].\r\n<h2>Беременные</h2>\r\nБолее половины беременных страдают от тошноты и рвоты, которые обычно начинаются на 4-й и исчезают на 16-й неделе беременности.\r\n\r\nУ 1 из 200 женщин состояние прогрессирует до неукротимой рвоты беременных (Hyperemesis gravidarum). Это состояние характеризуется длительной и сильной тошнотой и рвотой, обезвоживанием и потерей веса [16].\r\n<h2>Спортсмены и люди, которые занимаются физическим трудом</h2>\r\nВо время физических упражнений повышенный метаболизм вызывает повышение температуры тела. Для того, чтобы уберечь тело от перегревания, наш организм начинает активно испарять воду и вызывает обезвоживание [17].\r\n<h2>Пациенты с лихорадкой</h2>\r\nПовышение температуры тела заставляет нашу кожу и легкие усилено испарять воду. Кроме того, лихорадка часто сопровождается потерей аппетита, соответственно, организм перестает получать жидкость с продуктами питания [18].\r\n<h2>Больные с диареей и рвотой</h2>\r\nГастроэнтерит – самая частая причина обезвоживания в мире.\r\n\r\nЕсли он сопровождается выраженным рвотой и диареей, обезвоживание может прогрессировать очень стремительно [19, 20].\r\n<h2>Люди в состоянии алкогольной интоксикации</h2>\r\nДегидратация является одной из причин, которая вызывает симптомы похмелья после употребления алкоголя.\r\n\r\nРезультаты исследований подтвердили, что прием достаточного количества жидкости ускоряет восстановление после бессонной вечеринки [22].\r\n<h2>Это важно!</h2>\r\nЗа данными неспециализированной прессы, 75% американцев хронически обезвожены.\r\n\r\nРаспространенность дегидратации среди пациентов пожилого возраста колеблется в пределах 17%-28% [12].\r\n<h2>ВАЖНО!</h2>\r\nРотавирус является самой распространенной в мире причиной дегидратации и тяжелой диареи у младенцев и детей раннего возраста [21].\r\n<h2>Интересный ФАКТ!</h2>\r\nПричина тошноты и рвоты во время беременности точно неизвестна, но она может быть обусловлена ​​повышением концентрации хорионического гонадотропина в организме женщины [16].\r\n<h2>Как понять, что у Вас обезвоживание?</h2>\r\nПризнаки и симптомы обезвоживания могут отличаться в зависимости от возраста. Так, у младенцев или маленьких детей дегидратация проявляется [23]:\r\n<ul>\r\n 	<li>сухостью слизистых ротовой полости и языка;</li>\r\n 	<li>отсутствием слез при плаче;</li>\r\n 	<li>сухостью подгузников в течение 3 и больше часов;</li>\r\n 	<li>впалостью глаз, щек, темечка;</li>\r\n 	<li>вялостью или раздражительностью.</li>\r\n</ul>\r\nВзрослые жалуются на сильную жажду, редкие мочеиспускания и потемнение мочи, усталость, головокружение и затуманенность в голове.\r\n<h2>Как лечить обезвоживание?</h2>\r\nОсновой лечения обезвоживания любой причины является оральная регидратационная терапия (ОРТ). Для того, чтобы облегчить всасывание воды, идеальный раствор для регидратации должен содержать микроэлементы в правильных пропорциях, важнейшим из которых является натрий. Натрий и другие микроэлементы могут пассивно транспортироваться жидкостью из просвета кишечника в кровяное русло. В ряде исследований доказано, что быстрая пероральная регидратация соответствующим раствором является такой же эффективной, как внутривенное инфузионное введение растворов. При этом регидратация водно-солевыми растворами через рот не инвазивная и не сопровождается рядом побочных реакций, которые могут возникнуть на фоне инфузионной терапии. Вода для медицинских целей ReO от фармацевтической компании «Юрия-Фарм» имеет сбалансированный водно-электролитный состав для проведения пероральной реидратации, эффективна и безопасна. Это подтверждено многолетним опытом использования в условиях реальной клинической практики.\r\n<h2>Когда следует пить воду для медицинских целей ReO?</h2>\r\nВода ReO рекомендуется при состояниях, которые сопровождаются обезвоживанием и интоксикацией организма, в частности:\r\n<ul>\r\n 	<li>физических нагрузках;</li>\r\n 	<li>пребывании в условиях жаркого климата;</li>\r\n 	<li>лкогольной интоксикации;</li>\r\n 	<li>лихорадке;</li>\r\n 	<li>отравлениях;</li>\r\n 	<li>диарее;</li>\r\n 	<li>острых кишечных инфекциях у детей;</li>\r\n 	<li>токсикозе беременных.</li>\r\n</ul>\r\n<h2>Как следует пить воду РеО?</h2>\r\nЛегкое или умеренное обезвоживание обычно можно эффективно вылечить с помощью оральной регидратационной терапии (ОРТ), используя воду RеO. Рвота, как правило, не является противопоказанием к ОРТ, кроме случаев кишечной непроходимости и острого живота. При острых кишечных инфекциях и других расстройствах, которые сопровождаются рвотой и диареей, особенно у детей, дефицит жидкости следует восполнять в течение 4 часов. Воду RеO следует вводить в небольших объемах очень часто, чтобы минимизировать растягивание желудка и рефлекторную рвоту. Как правило, 5 мл воды для медицинских целей ReO ежеминутно переносятся хорошо. По мере возобновления водных запасов организма рвота часто уменьшается, поэтому могут быть использованы большие объемы жидкости [18].\r\n<h2>Лечение обезвоживания проводится в 2 этапа [24]:</h2>\r\n<ul>\r\n 	<li>1 этап – регидратация. Он направлен на быстрое возобновление запасов потерянной жидкости и длится 3-4 часа. Необходимый объем воды ReO зависит от возраста и массы тела больного и составляет:</li>\r\n</ul>\r\n- для младенцев и детей весом до 30 кг – 50-100 мл/кг воды РеО в течение 4 часов;\r\n\r\n- для взрослых и подростков весом более 30 кг – 2-4 л воды РеО в течение 4 часов.\r\n<ul>\r\n 	<li>2 этап – поддерживающий. Цель этого этапа – предотвратить обезвоживание. Длится данный этап до выздоровления пациента. При этом объем воды ReO, кроме возраста и массы больного, зависит от количества эпизодов рвоты и жидкого стула и составляет:</li>\r\n</ul>\r\n- по 60-120 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела менее 10 кг;\r\n- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\r\n\r\nПодростки и взрослые массой тела больше 30 кг могут пить столько жидкости, сколько они желают.\r\n\r\nЕще Цельс говорил, что в воде – исцеление и предупреждение заболеваний. Она укрепляет тело и хранит бодрость духа. Сегодня выбор правильной воды стал как никогда легким. Вода ReO не просто характеризуется отличными вкусовыми свойствами, но также ее легко пить даже при ощущении тошноты. Благодаря сбалансированному водно-солевому составу вода ReO обеспечивает максимально быстрое всасывание воды и электролитов и спасает организм от дегидратации независимо от ее причины.\r\n<h2>Литературные источники:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n</ol>\r\n<ol start=\"2\">\r\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\r\n</ol>\r\n<ol start=\"3\">\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n</ol>\r\n<ol start=\"4\">\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n</ol>\r\n<ol start=\"5\">\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n</ol>\r\n<ol start=\"6\">\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n</ol>\r\n<ol start=\"7\">\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\r\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"9\">\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n</ol>\r\n<ol start=\"10\">\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n</ol>\r\n<ol start=\"11\">\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n</ol>\r\n<ol start=\"12\">\r\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n</ol>\r\n<ol start=\"13\">\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n</ol>\r\n<ol start=\"14\">\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n</ol>\r\n<ol start=\"15\">\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factorscontributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n</ol>\r\n<ol start=\"94\">\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n</ol>\r\n<ol start=\"16\">\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n</ol>\r\n<ol start=\"17\">\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n</ol>\r\n<ol start=\"18\">\r\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n</ol>\r\n<ol start=\"19\">\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"20\">\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine Committee. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19345549/</li>\r\n</ol>\r\n<ol start=\"21\">\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN. Clinical and laboratory assessment of dehydration severity in children withacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n</ol>\r\n<ol start=\"22\">\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n</ol>\r\n<ol start=\"23\">\r\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n</ol>\r\n<ol start=\"24\">\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases</li>\r\n</ol>','РеО гармония воды и электролитов в бутылке','','inherit','closed','closed','','1317-revision-v1','','','2021-08-02 17:04:52','2021-08-02 14:04:52','',1317,'https://reo.ua/?p=1319',0,'revision','',0),(1320,1,'2021-08-03 10:31:28','2021-08-03 07:31:28','','Главная','','inherit','closed','closed','','176-revision-v1','','','2021-08-03 10:31:28','2021-08-03 07:31:28','',176,'https://reo.ua/?p=1320',0,'revision','',0),(1321,1,'2021-08-03 10:39:55','2021-08-03 07:39:55','','logo-ukr','','inherit','open','closed','','logo-ukr','','','2021-08-03 10:39:55','2021-08-03 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placeholder \"Телефон рақамингиз*\"]</div>\r\n</div>\r\n<div class=\"col-md-6\">\r\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Исмингиз*\"]</div>\r\n</div>\r\n</div>\r\n<div class=\"form-group\">[text* adress class:form-control placeholder \"Етказиб бериш манзили*\"]</div>\r\n<div class=\"form-group agree\">[checkbox* agree \"\"] Мен <a href=\"/uz/terms-of-use/\" target=\"_blank\" rel=\"noopener\">Махфийлик сиёсати</a> билан розиман.</div>\r\n<div class=\"form-group align-right\">[submit class:butn class:order-butn \"Буюртмани расмийлаштириш\"]</div>\r\n<div class=\"form-group requaired\"><p>* Юлдузча билан белгиланган жойлар тўлдирилиши шарт.</p></div>\n1\nНовый заказ (ReO)\nsend@reo.ua\nSanzhar.Tursunov@uf.ua, tetiana.filipchuk@uf.ua\n<p><strong>Количество:</strong> [products]</p>\r\n<p><strong>Имя:</strong> [nname]</p>\r\n<p><strong>Телефон:</strong> [tel]</p>\r\n<p><strong>Адрес доставки:</strong> [adress]</p>\n\n\n1\n1\n\n[_site_title] \"[your-subject]\"\n[_site_title] <wordpress@reo.tonic-adv.com>\n[your-email]\nСообщение:\r\n[your-message]\r\n\r\n-- \r\nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\nReply-To: [_site_admin_email]\n\n\n\nХабарингиз учун раҳмат. У муваффақиятли юборилди\nХабарни юборишда хатолик юз берди. Илтимос, кейинроқ қайта уриниб кўринг\nБир ёки бир неча майдонда нотўғри маълумотлар мавжуд. Уларни текшириб, қайтадан уриниб кўринг\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nХабарни юборишдан олдин сиз шартларни қабул қилишингиз лозим\nТўлдирилиши шарт бўлган майдон\nМайдон жуда узун\nМайдон жуда қисқа\nПри загрузке файла произошла неизвестная ошибка.\nВам не разрешено загружать файлы этого типа.\nФайл слишком большой.\nПри загрузке файла произошла ошибка.\nФормат даты некорректен.\nВведённая дата слишком далеко в прошлом.\nВведённая дата слишком далеко в будущем.\nФормат числа некорректен.\nЧисло меньше минимально допустимого.\nЧисло больше максимально допустимого.\nНеверный ответ на проверочный вопрос.\nЭлектрон манзил нотўғри киритилган\nURL манзил нотўғри киритилган\nТелефон рақами нотўғри киритилган','Форма заказа (уз)','','publish','closed','closed','','forma-zakaza-ru_copy','','','2022-06-30 10:55:24','2022-06-30 07:55:24','',0,'https://reo.ua/?post_type=wpcf7_contact_form&#038;p=1382',0,'wpcf7_contact_form','',0),(1736,1,'2021-08-31 14:57:10','2021-08-31 11:57:10','<h2>“GD-Pharm” МЧЖ нинг Хорижий корхонаси</h2>','Контактлар','','inherit','closed','closed','','1401-revision-v1','','','2021-08-31 14:57:10','2021-08-31 11:57:10','',1401,'https://reo.ua/?p=1736',0,'revision','',0),(1384,1,'2021-08-27 15:36:50','2021-08-27 12:36:50','<div class=\"title\"><h3>Бизга ёзинг</h3></div>\r\n<div class=\"form-group\">[text* nname class:form-control placeholder \"Исмингиз*\"]</div>\r\n<div class=\"form-group\">[email* email class:form-control placeholder \"E-mail*\"]</div>\r\n<div class=\"form-group\">[tel* tel class:form-control placeholder \"Телефон рақамингиз*\"]</div>\r\n<div class=\"form-group\">[textarea mailtext class:form-control placeholder \"Хабар\"]</div>\r\n<div class=\"form-group agree\">[checkbox* agree \"\"] Мен <a href=\"/uz/terms-of-use/\" target=\"_blank\" rel=\"noopener\">Махфийлик сиёсати</a> билан розиман.</div>\r\n<div class=\"form-group align-right\">[submit class:butn \"Бекор қилиш\"]</div>\r\n<div class=\"form-group requaired\"><p>* Юлдузча билан белгиланган жойлар тўлдирилиши шарт.</p></div>\n1\nОбратная связь\nsend@reo.ua\nSanzhar.Tursunov@uf.ua, tetiana.filipchuk@uf.ua\n<p><strong>Имя:</strong> [nname]</p>\r\n<p><strong>Email:</strong> [email]</p>\r\n<p><strong>Телефон:</strong> [tel]</p>\r\n<p><strong>Сообщение:</strong> [mailtext]</p>\n\n\n1\n1\n\n[_site_title] \"[your-subject]\"\n[_site_title] <wordpress@reo.tonic-adv.com>\n[your-email]\nСообщение:\r\n[your-message]\r\n\r\n-- \r\nЭто сообщение отправлено с сайта [_site_title] ([_site_url])\nReply-To: [_site_admin_email]\n\n\n\nХабарингиз учун раҳмат. У муваффақиятли юборилди\nХабарни юборишда хатолик юз берди. Илтимос, кейинроқ қайта уриниб кўринг\nБир ёки бир неча майдонда нотўғри маълумотлар мавжуд. Уларни текшириб, қайтадан уриниб кўринг\nПри отправке сообщения произошла ошибка. Пожалуйста, попробуйте ещё раз позже.\nХабарни юборишдан олдин сиз шартларни қабул қилишингиз лозим\nТўлдирилиши шарт бўлган майдон\nМайдон жуда узун\nМайдон жуда қисқа\nПри загрузке файла произошла неизвестная ошибка.\nВам не разрешено загружать файлы этого типа.\nФайл слишком большой.\nПри загрузке файла произошла ошибка.\nФормат даты некорректен.\nВведённая дата слишком далеко в прошлом.\nВведённая дата слишком далеко в будущем.\nФормат числа некорректен.\nЧисло меньше минимально допустимого.\nЧисло больше максимально допустимого.\nНеверный ответ на проверочный вопрос.\nЭлектрон манзил нотўғри киритилган\nURL манзил нотўғри киритилган\nТелефон рақами нотўғри киритилган','Обратная связь (уз)','','publish','closed','closed','','obratnaya-svyaz-ru_copy-2','','','2022-06-30 10:55:35','2022-06-30 07:55:35','',0,'https://reo.ua/?post_type=wpcf7_contact_form&#038;p=1384',0,'wpcf7_contact_form','',0),(1571,1,'2021-08-28 15:33:12','2021-08-28 12:33:12','','Ишлаб чиқарувчи','','inherit','closed','closed','','1403-revision-v1','','','2021-08-28 15:33:12','2021-08-28 12:33:12','',1403,'https://reo.ua/?p=1571',0,'revision','',0),(1385,1,'2021-06-15 11:49:30','2021-06-15 08:49:30','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – <strong>Политика</strong>) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Махфийлик сиёсати','','publish','closed','closed','','terms-of-use','','','2022-09-15 18:16:33','2022-09-15 15:16:33','',0,'https://reo.ua/terms-of-use/',12,'page','',0),(1386,1,'2021-08-27 15:39:27','2021-08-27 12:39:27','Добро пожаловать на reo.ua.\r\nДанный сайт является собственностью ООО \"Юрия-фарм\". ООО \"Юрия-фарм\" - компания, зарегистрированная в Киеве, Украина, с головным офисом в Киеве, Украина, регистрационный номер компании: 30109129 (далее - мы, наш, нас), который управляет данным Веб-сайтом (далее - \"Веб-сайт).\r\n\r\nНам очень важно защитить ваши персональные данные. Мы обязуемся защищать приватность лиц, посещающих наш Веб-сайт и использующих наши онлайн-инструменты. В данной Политике конфиденциальности мы хотим рассказать вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что вы принимаете данную Политику конфиденциальности в случае просмотра Веб-сайта или его использования иным образом, независимо от того, попросят ли вас дать дополнительное разрешение во время использования Веб-сайта. Ознакомление с данной Политикой конфиденциальности является исключительно вашей ответственностью.\r\n<h2>1. Информация, которую мы собираем</h2>\r\n1.1. Во время использования Веб-сайта, вы можете принять решение о предоставлении нам определенной информации о вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и пр. Видами персональной информации, которую вы можете нам предоставить, могут быть, без ограничения, контактная информация (адрес, электронная почта, номер телефона, факса), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт вы не обязаны предоставлять перечисленные ниже персональные данные, однако в таком случае некоторые функции могут быть вам недоступны.\r\n\r\n1.2. Сразу после того, как вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для вашей идентификации, например, номер домена, IP адрес вашего компьютера, вид используемого вами браузера, операционной системы и платформы, техническая информация, информация о географическом местонахождении во время посещения Вебсайта (длительность нахождения, просматриваемые продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги вами и пр.). Мы можем использовать такую информацию по отдельности или в совокупности, для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Правовое основание такой обработки - наши законные интересы для мониторинга и улучшения нашего Веб-сайта и услуг.\r\n<h2>2. Обработка персональной информации</h2>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать вашу информацию, которая указана в вашем профиле на нашем Веб-сайте. Данные профиля могут содержать ваше имя, адрес, номер телефона, электронного адреса, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах моложе 18 лет. Данные профиля могут быть обработаны для предоставления вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания вашего личного профиля и управления ним, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общения с вами. Правовое основание такой обработки - наши законные интересы для надлежащего управления нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, которую вы публикуете на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию из вашего запроса о товарах и/или услугах. Данные запроса могут быть обработаны с целю предложения, маркетинга и продажи соответствующих товаров и/или услуг вам и для обработки ваших отдельных запросов. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, в том числе контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, работодателя, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления наших взаимоотношений с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления вам рекомендаций, рекламирования наших товаров и услуг клиентам. Правовым основанием такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставляемую вами информацию с целью подписания вас на наши электронные рассылки и/или информационные письма. Данные об уведомлениях могут обрабатываться с целью отправки вам соответствующих уведомлений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалов. После того, как вы подпишетесь на новостную рассылку на нашем Веб-сайте, мы направим вам сообщение по указанному электронному адресу для подтверждения. Если вы не подведите подписку, она будет автоматически удалена. Вы можете в любой момент отозвать свое согласие на получение нашей новостной рассылки. Чтобы отписаться от рассылки, перейдите по ссылке, предоставленной во всех информационных рассылках, напишите нам электронное письмо по адресу, указанному в разделе 12 \"Как с нами связаться\" или позвоните по телефону +38 (044) 246-83-83. Правовое основание такой обработки - надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать ваши персональные данные, изложенным в этом разделе, мы также можем обрабатывать ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц.\r\n<h2>3. Предоставление ваших персональных данных другим лицам</h2>\r\nМы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для совершения действий, описанных в данном разделе.\r\n\r\n3.1. Мы можем разгласить ваши персональные данные любому участнику нашей группы компаний (то есть дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных данной политикой.\r\n\r\n3.2. Мы можем разгласить ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<u>Пример использования персональных данных нашими поставщиками услуг:</u>\r\n<ul>\r\n 	<li>мы передаем вашу персональную информацию поставщикам услуг, помогающим нам в деятельности, связанной с маркетингом и анализом данных, чтобы уведомлять вас и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять вам уведомления рекламного характера. Нашими поставщиками маркетинговых услуг и данных являются “Google Analytics”, “Contact Form 7”, “AddThis”. Политика конфиденциальности наших поставщиков услуг доступна на их соответствующих Веб-сайтах.\r\nМы не анализируем таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона.</li>\r\n</ul>\r\n3.3. В дополнение отдельным случаям разглашения, изложенным в этом разделе, мы также можем разглашать ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном производстве или в административном порядке, либо в порядке досудебного решения спора.\r\n<h2>4. Передача ваших персональных данных за границу</h2>\r\nВ данном разделе мы предоставляем информацию о случаях, в которых персональные данные могут передаваться в страны за пределы Европейской экономической зоны (ЕЭЗ).\r\n\r\n4.1. Мы делимся вашими персональными данными с нашими контрагентами за пределами Европейской экономической зоны (ЕЭЗ) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача в такие страны будет защищена надлежащими средствами защиты, а именно стандартными пунктами о защите данных, принятыми или утвержденными Европейской Комиссией.\r\n\r\n4.2. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: Mirohost.net). Передача на хостинги будет защищена надлежащими средствами защиты, а именно стандартными пунктами о защите данных, принятыми или утвержденными Европейской Комиссией.\r\n\r\n4.3. Если вы заходите на данный Веб-сайт в стране, отличной от страны нахождения нашего сервера, коммуникация между нами может привести к передаче информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, вы соглашаетесь на такую передачу. Даже если в вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать вашу информацию подлежащей защите, предусмотренной данной Политикой конфиденциальности.\r\n<h2>5. Сохранение и удаление персональных данных</h2>\r\nВ данном разделе описана политика и процедура сохранения данных, обеспечивающая соблюдение нами юридических обязательств относительно сохранения и удаления персональных данных.\r\n\r\n5.1. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. Таким образом, мы больше не требуем информацию в формате, по которому можно идентифицировать вашу личность, например, если мы храним информацию для аналитических и исследовательских целей или с целью передачи информации, мы удаляем все персональные данные о вас.\r\n\r\n5.2. Ваши персональные данные хранятся в течение минимального периода - 1 рабочий день после принятия данной Политики конфиденциальности, а также в течение максимального периода 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n5.3. Несмотря на изложенные выше положения данного раздела 6, мы сохраняем ваши персональные данные, если такое сохранение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты ваших жизненно важных интересов или жизненно важных интересов других физических лиц.\r\n<h2>6. Изменения и дополнения</h2>\r\n6.1. Мы можем периодически обновлять данную политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n6.2. Мы можем в любой момент изменить или дополнить данную Политику конфиденциальности на наше усмотрение. Такие изменения вступают в силу сразу же после опубликования уведомления об изменении или дополнении на данном сайте. Мы также можем уведомлять вас об изменениях конфиденциальности личных данных при помощи других средств, в частности по электронной почте. Продолжая использовать Веб-сайт, вы подтверждаете согласие с условиями Политики конфиденциальности с соответствующими изменениями и дополнениями.\r\n<h2>7. Ваши права и обязанности</h2>\r\nВ данном разделе мы дадим краткую справку о ваших правах по законодательству о защите данных. Некоторые права являются комплексными и не все подробности включены в нашу справку. Таким образом, вам следует ознакомиться с соответствующими законами и руководствами регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n7.1. Вы имеете право на исправление любых неправильных персональных данных о вас и, с учетом целей обработки, на дополнение неполных персональных данных о вас.\r\n\r\n7.2. В некоторых случаях вы имеете право удалить ваши персональные данные без излишней задержки. К таким случаям относятся: персональные данные, которые уже не нужны для тех целей, для которых они собирались или обрабатывались иным образом; отмена вами согласия на обработку данных, требующую согласия; если вы против обработки данных в соответствии с определенными нормами законодательства о защите данных; обработка непосредственно для маркетинговых целей; незаконная обработка персональных данных. При этом существуют исключения из права на удаление данных. Общее исключение предусматривает необходимость обработки для реализации свободы высказывания и права на информацию; соблюдение предусмотренного законом обязательства; предъявления, реализации или защиты законных претензий.\r\n\r\n7.3. В некоторых случаях вы имеете право ограничить обработку ваших персональных данных. К таким случаям относятся: отрицание вами точности персональных данных; обработка была осуществлена незаконным путем, однако вы против удаления данных; нам уже не нужны персональные данные для целей, в которых они обрабатывались, но вам понадобились персональные данные для предъявления, реализации или защиты законных претензий; вы против обработки, до проверки такого протеста. Если обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем осуществлять ее обработку иным путем: по вашему согласию, для предъявления, реализации или защиты законных претензий; для защиты прав других физических или юридических лиц; по другим причинам, связанным с важными общественными интересами.\r\n\r\n7.4. Чтобы помочь нам защитить вашу приватность: завершите сеанс на Веб-сайте после завершения работы с ним; предоставьте нам правдивую, точную и полную информацию; не используйте Веб-сайт, если вы моложе 18 лет; не предоставляйте нам информацию о ком-либо другом, если у вас нет на это разрешения.\r\n\r\n7.5. Если вы хотите узнать больше о том, какую именно информацию о вас мы храним, включая изменения или запросы на удаление, вы имеете право подать Запрос субъекта персональных данных. Вы можете подать запрос по электронной почте <a href=\"mailto:info@uf.ua\">info@uf.ua</a>. Просим обратить Ваше внимание на то, что мы должны будем исключить некоторую информацию как часть вашего запроса, например, для защиты приватности других лиц или если у нас есть законные или иные причины исключать такую информацию.\r\n\r\n7.6. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<h2>8. Файлы Cookie</h2>\r\n8.1. Сookie - это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузеру и который хранится в браузере. Затем идентификатор направляется обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n8.2. Файлы сookie могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем, после закрытия браузера.\r\n<h2>9. Сookie, которые мы используем</h2>\r\n9.1. Мы используем cookie в следующих целях: аутентификация - мы используем cookie для вашей идентификации во время посещения вами Веб-сайта и навигации по нему; статус - мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином; персонализация - мы используем cookie, чтобы хранить информацию о ваших предпочтениях и персонализировать Веб-сайт под ваши нужды; безопасность - мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом; реклама - мы используем cookie, чтобы показывать рекламу, которая может быть вам интересна; анализ - мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг; согласие - мы используем cookie, чтобы хранить ваши предпочтения относительно использования cookie для более обширных целей.\r\n<h2>10. Сookie, используемые нашими поставщиками услуг</h2>\r\n10.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере во время посещения Веб-сайта.\r\n\r\n10.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта при помощи cookie. Собираемая информация, касающаяся нашего Веб-сайта используется для создания отчетов об использовании нашего Веб-сайта. Политика конфиденциальности Google доступна по ссылке: <a href=\"https://www.google.com/policies/privacy\" target=\"_blank\" rel=\"nofollow noopener\">https://www.google.com/policies/privacy</a>.\r\n\r\n10.3. Сookies от Analytics помогает нам понять сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривали определенные страницы на нашем сайте. Несмотря на то, что cookiе аналитики позволяют нам собирать определенную информацию о посещенных вами страницах или о том, сколько раз вы заходили на сайт, мы не можем использовать это чтобы узнать ваши данные, например, имя или адрес.\r\n<h2>11. Управление файлами Cookie</h2>\r\n11.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n11.2. Все популярные браузеры (Chrome, Internet Explorer, Firefox, Opera и Safari) позволяют менять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как найти информацию о контролирующих файлах cookie\" на веб-сайте Информационных комиссий <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"nofollow noopener\">https://ico.org.uk/for-the-public/online/cookies</a>.\r\n<h2>12. Как с нами связаться</h2>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\n\r\nТел./факс: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:info@uf.ua\">info@uf.ua</a>\r\n\r\nБудем рады вас приветствовать! Мы очень ценим ваши отзывы, комментарии или предложения - они помогают нам улучшать качество нашей работы.\r\n\r\nСпасибо что выбрали reo.ua\r\n<p style=\"text-align: right;\">Дата вступления в силу: 24 мая 2018 года.</p>','Махфийлик сиёсати','','inherit','closed','closed','','1385-revision-v1','','','2021-08-27 15:39:27','2021-08-27 12:39:27','',1385,'https://reo.ua/?p=1386',0,'revision','',0),(1387,1,'2021-07-02 14:18:49','2021-07-02 11:18:49','<p style=\"text-align: center;\">Тиббий мақсадлар учун РеО сувини шаҳрингиз дорихоналаридан харид қилишингиз мумкин:</p>','Қаердан харид қилиш мумкин','','publish','closed','closed','','%d2%9baerdan-harid-%d2%9bilish-mumkin','','','2021-08-31 10:08:47','2021-08-31 07:08:47','',0,'https://reo.ua/de-pridbati/',6,'page','',0),(1388,1,'2021-07-27 10:24:49','2021-07-27 07:24:49','','silpo','','inherit','open','closed','','silpo-3','','','2021-07-27 10:24:49','2021-07-27 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16:04:53','2021-08-27 13:04:53','','olampharm','','inherit','open','closed','','olampharm-2','','','2021-08-27 16:04:53','2021-08-27 13:04:53','',776,'https://reo.ua/wp-content/uploads/2021/08/olampharm.jpg',0,'attachment','image/jpeg',0),(1464,1,'2021-08-27 16:04:53','2021-08-27 13:04:53','','olampharm','','inherit','open','closed','','olampharm-2','','','2021-08-27 16:04:53','2021-08-27 13:04:53','',747,'https://reo.ua/wp-content/uploads/2021/08/olampharm.jpg',0,'attachment','image/jpeg',0),(1465,1,'2021-08-27 16:04:57','2021-08-27 13:04:57','<p style=\"text-align: center;\">Воду для медицинских целей РЭО можно приобрести в аптеках и магазинах вашего города:</p>','қаердан сотиб олиш мумкин','','inherit','closed','closed','','1387-revision-v1','','','2021-08-27 16:04:57','2021-08-27 13:04:57','',1387,'https://reo.ua/?p=1465',0,'revision','',0),(1466,1,'2021-06-25 10:39:27','2021-06-25 07:39:27','Одамда тана ҳарорати доимий даражада (ҳарорат мувозанати) сақланиб туради ва тана ҳароратининг ҳар қандай пасайиши ёки кўтарилиши касалликдан далолат бўлиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\"><img class=\"aligncenter wp-image-1695\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\" alt=\"\" width=\"924\" height=\"622\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Одамда ҳарорат мувозанатини сақлаб туриш</strong></p>\r\n&nbsp;\r\n\r\nҲароратнинг кўтарилиши (иситма)  бир қатор инфекцион ва ноинфекцион сабабларнинг оқибати бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg\"><img class=\"aligncenter wp-image-1698 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2-1024x508.jpg\" alt=\"\" width=\"1024\" height=\"508\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Иситма сабаблари</strong></p>\r\n&nbsp;\r\n\r\nТана ҳароратининг 37 °С дан кўтарилиши ошган ҳарорат ҳисобланади, 39,5 °С дан ошиши хавфли ҳарорат саналади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\"><img class=\"aligncenter wp-image-1701\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\" alt=\"\" width=\"825\" height=\"478\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Тана ҳароратининг ошиш даражалари</strong></p>\r\n&nbsp;\r\n\r\nЮқори температура кўпинча мушак ва бўғимлардаги оғриқлар, кучли тер босиши, юрак тез уриши ва ҳоказолар билан бирга кечади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg\"><img class=\"aligncenter wp-image-1704\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4-1024x887.jpg\" alt=\"\" width=\"670\" height=\"581\" /></a>\r\n<p style=\"text-align: center;\"><strong>4-расм. Ҳарорат кўтарилиши билан бирга кечувчи белгилар</strong></p>\r\n&nbsp;\r\n<h2>Ҳарорат кўтарилганида қандай ҳолларда врачга мурожаат қилиш зарур?</h2>\r\n<ul>\r\n 	<li>Кучайиб бораётган тошма</li>\r\n 	<li>Бош айланиши</li>\r\n 	<li>Қайт қилиш</li>\r\n 	<li>Нафас сиқиши</li>\r\n 	<li>Сийишдаги оғриқлар</li>\r\n 	<li>Қорин оғриғи</li>\r\n 	<li>Иякни кўкракка боса олмаслик</li>\r\n 	<li>Кучли бош оғриғи</li>\r\n 	<li>Талваса хуружлари</li>\r\n</ul>\r\n<h2>Сув ва юқори ҳарорат ўртасида қандай боғлиқлик бор?</h2>\r\nСув катта иссиқлик сиғими кўрсаткичига  эга, бу  атроф муҳит совуқ ёки иссиқлигида тана ҳароратини бир маромда сақлаб туришга ёрдам беради. Сувнинг тер билан бирга буғланиши тананинг анча миқдордаги иссиқликни йўқотишига имкон беради.\r\n\r\nТана ҳарорати кўтарилганида меъёридан ортиқ тер ажралиб чиқади, шунингдек нафас олиш тезлашади, оқибатда кўп миқдорда суюқлик йўқотилади. Шунинг учун сувсизланиш ривожлангунча бу йўқотишнинг ўрнини тўлдириш мақсадга мувофиқ бўлади.\r\n<h2>Тана ҳарорати кўтарилганда нима қилиш керак?</h2>\r\nҲарорат кўтарилиши организмнинг ҳимоя механизми ҳисобланади, у вируслар ва бактерияларнинг кўпайишини тўхтатади. Шунинг учун  38,5 °С дан юқори бўлмаган температурани пасайтирмаслик керак. Совуқ компресслардан фойдаланиш ҳароратни дориларсиз пасайтиришнинг мақбул усули ҳисобланади. Шунингдек тегишли гидратация ҳам зарур, чунки сувсизланган танада ҳароратнинг тез пасайиш эҳтимоли камроқ бўлади.\r\n\r\nАгар ҳароратнинг сезиларли кўтарилиш сабабига таъсир қилиб бўлмаса, нохуш симптомлар (бош ва мушаклар оғриғи) ни дорилар ёрдамида камайтириш зарур. Бу мақсадда, одатда, ибупрофен ва парацетамолдан фойдаланилади.\r\n<h2>Қанча суюқлик ичиш зарур?</h2>\r\nТана ҳарорати қанчалик юқори бўлса, суюқлик йўқотилиши ҳам шунчалик катта бўлади. Сувсизланиш ҳарорат кўтарилишининг ёқимсиз ва хавфли белгиларини (масалан, юрак уриш сонининг ошиши каби) кучайтириши мумкинлиги сабабли ҳам ўз вақтида йўқотилган суюқлик ўрнини тўлдириш  зарур. Бундан ташқари, кўп суюқлик ичиш диурезни ва буйрак орқали токсинлар ва ҳужайраларнинг парчаланиш маҳсулотлари чиқарилишини оширади. Шунинг учун  ҳарорат кўтарилганда бир кунда камида 10 стакан сув ичиш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nҲарорат кўтарилганида тер билан нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун ҳам  йўқотилган суюқликни таркибида электролитлар: натрий, калий, магний бўлган махсус ичимликлар билан тўлдириш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун RеО суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. РеО таркибида консервантлар, бўёқлар йўқ, шунингдек у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг м</strong><strong>увозанат</strong><strong>лаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳарорат кўтарилганда РеО сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёқлар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга ва уни ҳатто кўнгил айниб турганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Тана ҳарорати кўтарилганида нима қилиш ва нима қилмаслик керак?','','publish','open','open','','tana-%d2%b3arorati-k%d1%9etarilganida-nima-%d2%9bilish-va-nima-%d2%9bilmaslik-kerak','','','2021-08-31 13:14:35','2021-08-31 10:14:35','',0,'https://reo.ua/uncategorized-uz/chto-nuzhno-i-ne-nuzhno-delat-pri-povyshenii-temperatury-tela/',35,'post','',0),(1467,1,'2021-06-25 10:34:16','2021-06-25 07:34:16','','infograph-11','','inherit','open','closed','','infograph-11-2-2','','','2021-06-25 10:34:16','2021-06-25 07:34:16','',1466,'https://reo.ua/wp-content/uploads/2021/06/infograph-11.jpg',0,'attachment','image/jpeg',0),(1468,1,'2021-07-07 12:08:22','2021-07-07 09:08:22','','повышении температуры тела','','inherit','open','closed','','povyshenii-temperatury-tela-2','','','2021-07-07 12:08:22','2021-07-07 09:08:22','',1466,'https://reo.ua/wp-content/uploads/2021/06/povyshenii-temperatury-tela.jpg',0,'attachment','image/jpeg',0),(1469,1,'2021-08-31 13:13:20','2021-08-31 10:13:20','Одамда тана ҳарорати доимий даражада (ҳарорат мувозанати) сақланиб туради ва тана ҳароратининг ҳар қандай пасайиши ёки кўтарилиши касалликдан далолат бўлиши мумкин.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\"><img class=\"aligncenter wp-image-1695\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\" alt=\"\" width=\"924\" height=\"622\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>1-расм. Одамда ҳарорат мувозанатини сақлаб туриш</strong></p>\n&nbsp;\n\nҲароратнинг кўтарилиши (иситма)  бир қатор инфекцион ва ноинфекцион сабабларнинг оқибати бўлиши мумкин.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg\"><img class=\"aligncenter wp-image-1698 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2-1024x508.jpg\" alt=\"\" width=\"1024\" height=\"508\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>2-расм. Иситма сабаблари</strong></p>\n&nbsp;\n\nТана ҳароратининг 37 °С дан кўтарилиши ошган ҳарорат ҳисобланади, 39,5 °С дан ошиши хавфли ҳарорат саналади.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\"><img class=\"aligncenter wp-image-1701\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\" alt=\"\" width=\"825\" height=\"478\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>3-расм. Тана ҳароратининг ошиш даражалари</strong></p>\n&nbsp;\n\nЮқори температура кўпинча мушак ва бўғимлардаги оғриқлар, кучли тер босиши, юрак тез уриши ва ҳоказолар билан бирга кечади.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg\"><img class=\"aligncenter wp-image-1704 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4-1024x887.jpg\" alt=\"\" width=\"1024\" height=\"887\" data-wp-editing=\"1\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\n<p style=\"text-align: center;\"><strong>4-расм. Ҳарорат кўтарилиши билан бирга кечувчи белгилар</strong></p>\n&nbsp;\n<h2>Ҳарорат кўтарилганида қандай ҳолларда врачга мурожаат қилиш зарур?</h2>\n<ul>\n 	<li>Кучайиб бораётган тошма</li>\n 	<li>Бош айланиши</li>\n 	<li>Қайт қилиш</li>\n 	<li>Нафас сиқиши</li>\n 	<li>Сийишдаги оғриқлар</li>\n 	<li>Қорин оғриғи</li>\n 	<li>Иякни кўкракка боса олмаслик</li>\n 	<li>Кучли бош оғриғи</li>\n 	<li>Талваса хуружлари</li>\n</ul>\n<h2>Сув ва юқори ҳарорат ўртасида қандай боғлиқлик бор?</h2>\nСув катта иссиқлик сиғими кўрсаткичига  эга, бу  атроф муҳит совуқ ёки иссиқлигида тана ҳароратини бир маромда сақлаб туришга ёрдам беради. Сувнинг тер билан бирга буғланиши тананинг анча миқдордаги иссиқликни йўқотишига имкон беради.\n\nТана ҳарорати кўтарилганида меъёридан ортиқ тер ажралиб чиқади, шунингдек нафас олиш тезлашади, оқибатда кўп миқдорда суюқлик йўқотилади. Шунинг учун сувсизланиш ривожлангунча бу йўқотишнинг ўрнини тўлдириш мақсадга мувофиқ бўлади.\n<h2>Тана ҳарорати кўтарилганда нима қилиш керак?</h2>\nҲарорат кўтарилиши организмнинг ҳимоя механизми ҳисобланади, у вируслар ва бактерияларнинг кўпайишини тўхтатади. Шунинг учун  38,5 °С дан юқори бўлмаган температурани пасайтирмаслик керак. Совуқ компресслардан фойдаланиш ҳароратни дориларсиз пасайтиришнинг мақбул усули ҳисобланади. Шунингдек тегишли гидратация ҳам зарур, чунки сувсизланган танада ҳароратнинг тез пасайиш эҳтимоли камроқ бўлади.\n\nАгар ҳароратнинг сезиларли кўтарилиш сабабига таъсир қилиб бўлмаса, нохуш симптомлар (бош ва мушаклар оғриғи) ни дорилар ёрдамида камайтириш зарур. Бу мақсадда, одатда, ибупрофен ва парацетамолдан фойдаланилади.\n<h2>Қанча суюқлик ичиш зарур?</h2>\nТана ҳарорати қанчалик юқори бўлса, суюқлик йўқотилиши ҳам шунчалик катта бўлади. Сувсизланиш ҳарорат кўтарилишининг ёқимсиз ва хавфли белгиларини (масалан, юрак уриш сонининг ошиши каби) кучайтириши мумкинлиги сабабли ҳам ўз вақтида йўқотилган суюқлик ўрнини тўлдириш  зарур. Бундан ташқари, кўп суюқлик ичиш диурезни ва буйрак орқали токсинлар ва ҳужайраларнинг парчаланиш маҳсулотлари чиқарилишини оширади. Шунинг учун  ҳарорат кўтарилганда бир кунда камида 10 стакан сув ичиш керак.\n<h2>Нима ичиш зарур?</h2>\nҲарорат кўтарилганида тер билан нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун ҳам  йўқотилган суюқликни таркибида электролитлар: натрий, калий, магний бўлган махсус ичимликлар билан тўлдириш мақсадга мувофиқ.\n<h2>Тиббий мақсадлар учун RеО суви</h2>\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. РеО таркибида консервантлар, бўёқлар йўқ, шунингдек у ёқимли таъмга эга.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг м</strong><strong>увозанат</strong><strong>лаштирилган таркиби</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Таркиби</strong></th>\n<th width=\"50%\"><strong>Миқдори</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Карбонат кислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Ҳарорат кўтарилганда РеО сувининг афзалликлари:</h2>\n<ul>\n 	<li>мувозанатлаштирилган таркибга эга;</li>\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\n 	<li>таркибида консервантлар, бўёқлар ва углеводлар йўқ;</li>\n 	<li>ёқимли таъмга эга ва уни ҳатто кўнгил айниб турганда ҳам ичиш осон;</li>\n 	<li>сувсизланиш белгиларини бартараф этади.</li>\n</ul>\n<h2>Адабиётлар рўйхати</h2>\n<ol>\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\n</ol>','Тана ҳарорати кўтарилганида нима қилиш ва нима қилмаслик керак?','','inherit','closed','closed','','1466-autosave-v1','','','2021-08-31 13:13:20','2021-08-31 10:13:20','',1466,'https://reo.ua/?p=1469',0,'revision','',0),(1707,1,'2021-08-31 13:13:34','2021-08-31 10:13:34','Одамда тана ҳарорати доимий даражада (ҳарорат мувозанати) сақланиб туради ва тана ҳароратининг ҳар қандай пасайиши ёки кўтарилиши касалликдан далолат бўлиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\"><img class=\"aligncenter wp-image-1695\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\" alt=\"\" width=\"924\" height=\"622\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Одамда ҳарорат мувозанатини сақлаб туриш</strong></p>\r\n&nbsp;\r\n\r\nҲароратнинг кўтарилиши (иситма)  бир қатор инфекцион ва ноинфекцион сабабларнинг оқибати бўлиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg\"><img class=\"aligncenter wp-image-1698 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2-1024x508.jpg\" alt=\"\" width=\"1024\" height=\"508\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>2-расм. Иситма сабаблари</strong></p>\r\n&nbsp;\r\n\r\nТана ҳароратининг 37 °С дан кўтарилиши ошган ҳарорат ҳисобланади, 39,5 °С дан ошиши хавфли ҳарорат саналади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\"><img class=\"aligncenter wp-image-1701\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\" alt=\"\" width=\"825\" height=\"478\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>3-расм. Тана ҳароратининг ошиш даражалари</strong></p>\r\n&nbsp;\r\n\r\nЮқори температура кўпинча мушак ва бўғимлардаги оғриқлар, кучли тер босиши, юрак тез уриши ва ҳоказолар билан бирга кечади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg\"><img class=\"aligncenter wp-image-1704\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4-1024x887.jpg\" alt=\"\" width=\"670\" height=\"581\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>4-расм. Ҳарорат кўтарилиши билан бирга кечувчи белгилар</strong></p>\r\n&nbsp;\r\n<h2>Ҳарорат кўтарилганида қандай ҳолларда врачга мурожаат қилиш зарур?</h2>\r\n<ul>\r\n 	<li>Кучайиб бораётган тошма</li>\r\n 	<li>Бош айланиши</li>\r\n 	<li>Қайт қилиш</li>\r\n 	<li>Нафас сиқиши</li>\r\n 	<li>Сийишдаги оғриқлар</li>\r\n 	<li>Қорин оғриғи</li>\r\n 	<li>Иякни кўкракка боса олмаслик</li>\r\n 	<li>Кучли бош оғриғи</li>\r\n 	<li>Талваса хуружлари</li>\r\n</ul>\r\n<h2>Сув ва юқори ҳарорат ўртасида қандай боғлиқлик бор?</h2>\r\nСув катта иссиқлик сиғими кўрсаткичига  эга, бу  атроф муҳит совуқ ёки иссиқлигида тана ҳароратини бир маромда сақлаб туришга ёрдам беради. Сувнинг тер билан бирга буғланиши тананинг анча миқдордаги иссиқликни йўқотишига имкон беради.\r\n\r\nТана ҳарорати кўтарилганида меъёридан ортиқ тер ажралиб чиқади, шунингдек нафас олиш тезлашади, оқибатда кўп миқдорда суюқлик йўқотилади. Шунинг учун сувсизланиш ривожлангунча бу йўқотишнинг ўрнини тўлдириш мақсадга мувофиқ бўлади.\r\n<h2>Тана ҳарорати кўтарилганда нима қилиш керак?</h2>\r\nҲарорат кўтарилиши организмнинг ҳимоя механизми ҳисобланади, у вируслар ва бактерияларнинг кўпайишини тўхтатади. Шунинг учун  38,5 °С дан юқори бўлмаган температурани пасайтирмаслик керак. Совуқ компресслардан фойдаланиш ҳароратни дориларсиз пасайтиришнинг мақбул усули ҳисобланади. Шунингдек тегишли гидратация ҳам зарур, чунки сувсизланган танада ҳароратнинг тез пасайиш эҳтимоли камроқ бўлади.\r\n\r\nАгар ҳароратнинг сезиларли кўтарилиш сабабига таъсир қилиб бўлмаса, нохуш симптомлар (бош ва мушаклар оғриғи) ни дорилар ёрдамида камайтириш зарур. Бу мақсадда, одатда, ибупрофен ва парацетамолдан фойдаланилади.\r\n<h2>Қанча суюқлик ичиш зарур?</h2>\r\nТана ҳарорати қанчалик юқори бўлса, суюқлик йўқотилиши ҳам шунчалик катта бўлади. Сувсизланиш ҳарорат кўтарилишининг ёқимсиз ва хавфли белгиларини (масалан, юрак уриш сонининг ошиши каби) кучайтириши мумкинлиги сабабли ҳам ўз вақтида йўқотилган суюқлик ўрнини тўлдириш  зарур. Бундан ташқари, кўп суюқлик ичиш диурезни ва буйрак орқали токсинлар ва ҳужайраларнинг парчаланиш маҳсулотлари чиқарилишини оширади. Шунинг учун  ҳарорат кўтарилганда бир кунда камида 10 стакан сув ичиш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nҲарорат кўтарилганида тер билан нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун ҳам  йўқотилган суюқликни таркибида электролитлар: натрий, калий, магний бўлган махсус ичимликлар билан тўлдириш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун RеО суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. РеО таркибида консервантлар, бўёқлар йўқ, шунингдек у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг м</strong><strong>увозанат</strong><strong>лаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳарорат кўтарилганда РеО сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёқлар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга ва уни ҳатто кўнгил айниб турганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Тана ҳарорати кўтарилганида нима қилиш ва нима қилмаслик керак?','','inherit','closed','closed','','1466-revision-v1','','','2021-08-31 13:13:34','2021-08-31 10:13:34','',1466,'https://reo.ua/?p=1707',0,'revision','',0),(1470,1,'2021-08-27 17:27:24','2021-08-27 14:27:24','Одамда тана ҳарорати доимий даражада (ҳарорат мувозанати) сақланиб туради ва тана ҳароратининг ҳар қандай пасайиши ёки кўтарилиши касалликдан далолат бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru.jpg\"><img class=\"aligncenter wp-image-637\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-30-ru-1024x687.jpg\" alt=\"\" width=\"924\" height=\"620\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Одамда ҳарорат мувозанатини сақлаб туриш</strong></p>\r\n&nbsp;\r\n\r\nҲароратнинг кўтарилиши (иситма)  бир қатор инфекцион ва ноинфекцион сабабларнинг оқибати бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png\"><img class=\"aligncenter size-large wp-image-1098\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1-1024x557.png\" alt=\"\" width=\"1024\" height=\"557\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Иситма сабаблари</strong></p>\r\n&nbsp;\r\n\r\nТана ҳароратининг 37 °С дан кўтарилиши ошган ҳарорат ҳисобланади, 39,5 °С дан ошиши хавфли ҳарорат саналади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4.png\"><img class=\"aligncenter size-large wp-image-1019\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_4-1024x546.png\" alt=\"\" width=\"1024\" height=\"546\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Тана ҳароратининг ошиш даражалари</strong></p>\r\n&nbsp;\r\n\r\nЮқори температура кўпинча мушак ва бўғимлардаги оғриқлар, кучли тер босиши, юрак тез уриши ва ҳоказолар билан бирга кечади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\"><img class=\"aligncenter wp-image-649\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-33-ru.jpg\" alt=\"\" width=\"570\" height=\"585\" /></a>\r\n<p style=\"text-align: center;\"><strong>4-расм. Ҳарорат кўтарилиши билан бирга кечувчи белгилар</strong></p>\r\n&nbsp;\r\n<h2>Ҳарорат кўтарилганида қандай ҳолларда врачга мурожаат қилиш зарур?</h2>\r\n<ul>\r\n 	<li>Кучайиб бораётган тошма</li>\r\n 	<li>Бош айланиши</li>\r\n 	<li>Қайт қилиш</li>\r\n 	<li>Нафас сиқиши</li>\r\n 	<li>Сийишдаги оғриқлар</li>\r\n 	<li>Қорин оғриғи</li>\r\n 	<li>Иякни кўкракка боса олмаслик</li>\r\n 	<li>Кучли бош оғриғи</li>\r\n 	<li>Талваса хуружлари</li>\r\n</ul>\r\n<h2>Сув ва юқори ҳарорат ўртасида қандай боғлиқлик бор?</h2>\r\nСув катта иссиқлик сиғими кўрсаткичига  эга, бу  атроф муҳит совуқ ёки иссиқлигида тана ҳароратини бир маромда сақлаб туришга ёрдам беради. Сувнинг тер билан бирга буғланиши тананинг анча миқдордаги иссиқликни йўқотишига имкон беради.\r\n\r\nТана ҳарорати кўтарилганида меъёридан ортиқ тер ажралиб чиқади, шунингдек нафас олиш тезлашади, оқибатда кўп миқдорда суюқлик йўқотилади. Шунинг учун сувсизланиш ривожлангунча бу йўқотишнинг ўрнини тўлдириш мақсадга мувофиқ бўлади.\r\n<h2>Тана ҳарорати кўтарилганда нима қилиш керак?</h2>\r\nҲарорат кўтарилиши организмнинг ҳимоя механизми ҳисобланади, у вируслар ва бактерияларнинг кўпайишини тўхтатади. Шунинг учун  38,5 °С дан юқори бўлмаган температурани пасайтирмаслик керак. Совуқ компресслардан фойдаланиш ҳароратни дориларсиз пасайтиришнинг мақбул усули ҳисобланади. Шунингдек тегишли гидратация ҳам зарур, чунки сувсизланган танада ҳароратнинг тез пасайиш эҳтимоли камроқ бўлади.\r\n\r\nАгар ҳароратнинг сезиларли кўтарилиш сабабига таъсир қилиб бўлмаса, нохуш симптомлар (бош ва мушаклар оғриғи) ни дорилар ёрдамида камайтириш зарур. Бу мақсадда, одатда, ибупрофен ва парацетамолдан фойдаланилади.\r\n<h2>Қанча суюқлик ичиш зарур?</h2>\r\nТана ҳарорати қанчалик юқори бўлса, суюқлик йўқотилиши ҳам шунчалик катта бўлади. Сувсизланиш ҳарорат кўтарилишининг ёқимсиз ва хавфли белгиларини (масалан, юрак уриш сонининг ошиши каби) кучайтириши мумкинлиги сабабли ҳам ўз вақтида йўқотилган суюқлик ўрнини тўлдириш  зарур. Бундан ташқари, кўп суюқлик ичиш диурезни ва буйрак орқали токсинлар ва ҳужайраларнинг парчаланиш маҳсулотлари чиқарилишини оширади. Шунинг учун  ҳарорат кўтарилганда бир кунда камида 10 стакан сув ичиш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nҲарорат кўтарилганида тер билан нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун ҳам  йўқотилган суюқликни таркибида электролитлар: натрий, калий, магний бўлган махсус ичимликлар билан тўлдириш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун RеО суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. РеО таркибида консервантлар, бўёқлар йўқ, шунингдек у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг м</strong><strong>увозанат</strong><strong>лаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳарорат кўтарилганда РеО сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёқлар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга ва уни ҳатто кўнгил айниб турганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Тана ҳарорати кўтарилганида нима қилиш ва нима қилмаслик керак?','','inherit','closed','closed','','1466-revision-v1','','','2021-08-27 17:27:24','2021-08-27 14:27:24','',1466,'https://reo.ua/?p=1470',0,'revision','',0),(1471,1,'2021-06-25 10:35:09','2021-06-25 07:35:09','','infograph-12','','inherit','open','closed','','infograph-12','','','2021-06-25 10:35:09','2021-06-25 07:35:09','',1466,'https://reo.ua/wp-content/uploads/2021/06/infograph-12.jpg',0,'attachment','image/jpeg',0),(1472,1,'2021-06-25 10:35:45','2021-06-25 07:35:45','','infograph-13','','inherit','open','closed','','infograph-13','','','2021-06-25 10:35:45','2021-06-25 07:35:45','',1466,'https://reo.ua/wp-content/uploads/2021/06/infograph-13.jpg',0,'attachment','image/jpeg',0),(1473,1,'2021-06-25 10:36:45','2021-06-25 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Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\r\n\r\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\"><img class=\"aligncenter wp-image-1686\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\" alt=\"\" width=\"1024\" height=\"505\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n\r\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\r\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\"><img class=\"aligncenter wp-image-1689\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\r\n&nbsp;\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\r\n<h2>Нима ичиш керак?</h2>\r\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th><strong>Таркиби</strong></th>\r\n<th><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\r\n<ul>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','publish','open','open','','nima-uchun-%d2%b3arorat-k%d1%9etarilganida-k%d1%9ep-suyu%d2%9blik-ichish-zarur','','','2021-08-31 13:05:57','2021-08-31 10:05:57','',0,'https://reo.ua/uncategorized-uz/pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature/',39,'post','',0),(1494,1,'2021-06-24 14:42:42','2021-06-24 11:42:42','','infograph-5','','inherit','open','closed','','infograph-5-2-2','','','2021-06-24 14:42:42','2021-06-24 11:42:42','',1493,'https://reo.ua/wp-content/uploads/2021/06/infograph-5.jpg',0,'attachment','image/jpeg',0),(1495,1,'2021-07-07 12:14:57','2021-07-07 09:14:57','','Почему необходимо много пить при повышенной температуре','','inherit','open','closed','','pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature-2-2','','','2021-07-07 12:14:57','2021-07-07 09:14:57','',1493,'https://reo.ua/wp-content/uploads/2021/06/pochemu-neobhodimo-mnogo-pit-pri-povyshennoj-temperature.jpg',0,'attachment','image/jpeg',0),(1496,1,'2021-08-31 13:04:39','2021-08-31 10:04:39','Иситма  – бу иссиқликни бошқариш маркази ишидаги ўзгаришлар оқибатида тана ҳароратининг кўтарилишидир. Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\n\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\"><img class=\"aligncenter wp-image-1686\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\" alt=\"\" width=\"1024\" height=\"505\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\n&nbsp;\n\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\"><img class=\"aligncenter size-full wp-image-1689\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\" alt=\"\" width=\"1182\" height=\"745\" data-wp-editing=\"1\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png\"><img class=\"aligncenter size-large wp-image-1115\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1024x661.png\" alt=\"\" width=\"1024\" height=\"661\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\n&nbsp;\n<h2>Қанча суюқлик ичиш керак?</h2>\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\n<h2>Нима ичиш керак?</h2>\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\n<h2>Тиббий мақсадлар учун ReO суви</h2>\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\n</tr>\n<tr>\n<th><strong>Таркиби</strong></th>\n<th><strong>Миқдори</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Карбонат кислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\n<ul>\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\n</ul>\n<h2>Адабиётлар рўйхати</h2>\n<ol>\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','inherit','closed','closed','','1493-autosave-v1','','','2021-08-31 13:04:39','2021-08-31 10:04:39','',1493,'https://reo.ua/?p=1496',0,'revision','',0),(1692,1,'2021-08-31 13:04:50','2021-08-31 10:04:50','Иситма  – бу иссиқликни бошқариш маркази ишидаги ўзгаришлар оқибатида тана ҳароратининг кўтарилишидир. Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\r\n\r\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\"><img class=\"aligncenter wp-image-1686\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\" alt=\"\" width=\"1024\" height=\"505\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n\r\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\r\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\"><img class=\"aligncenter wp-image-1689\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\r\n&nbsp;\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\r\n<h2>Нима ичиш керак?</h2>\r\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th><strong>Таркиби</strong></th>\r\n<th><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\r\n<ul>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','inherit','closed','closed','','1493-revision-v1','','','2021-08-31 13:04:50','2021-08-31 10:04:50','',1493,'https://reo.ua/?p=1692',0,'revision','',0),(1497,1,'2021-08-27 17:37:24','2021-08-27 14:37:24','Иситма  – бу иссиқликни бошқариш маркази ишидаги ўзгаришлар оқибатида тана ҳароратининг кўтарилишидир. Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\r\n\r\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png\"><img class=\"aligncenter size-large wp-image-1025\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1-1024x534.png\" alt=\"\" width=\"1024\" height=\"534\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n\r\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\r\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png\"><img class=\"aligncenter size-large wp-image-1115\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1024x661.png\" alt=\"\" width=\"1024\" height=\"661\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\r\n&nbsp;\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\r\n<h2>Нима ичиш керак?</h2>\r\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th><strong>Таркиби</strong></th>\r\n<th><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\r\n<ul>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','inherit','closed','closed','','1493-revision-v1','','','2021-08-27 17:37:24','2021-08-27 14:37:24','',1493,'https://reo.ua/?p=1497',0,'revision','',0),(1498,1,'2021-06-24 14:45:07','2021-06-24 11:45:07','','infograph-6','','inherit','open','closed','','infograph-6','','','2021-06-24 14:45:07','2021-06-24 11:45:07','',1493,'https://reo.ua/wp-content/uploads/2021/06/infograph-6.jpg',0,'attachment','image/jpeg',0),(1499,1,'2021-06-29 18:34:55','2021-06-29 15:34:55','','infograph-11-ua','','inherit','open','closed','','infograph-11-ua-2','','','2021-06-29 18:34:55','2021-06-29 15:34:55','',1493,'https://reo.ua/wp-content/uploads/2021/06/infograph-11-ua-1.jpg',0,'attachment','image/jpeg',0),(1500,1,'2021-07-09 10:09:13','2021-07-09 07:09:13','','Web_REO_T3 при повышенной температуре_1','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_1-2','','','2021-07-09 10:09:13','2021-07-09 07:09:13','',1493,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_1.png',0,'attachment','image/png',0),(1501,1,'2021-07-13 17:41:12','2021-07-13 14:41:12','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3-2','','','2021-07-13 17:41:12','2021-07-13 14:41:12','',1493,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3.png',0,'attachment','image/png',0),(1502,1,'2021-07-13 17:41:27','2021-07-13 14:41:27','','Web_REO_T3 при повышенной температуре_3','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_3-2-2','','','2021-07-13 17:41:27','2021-07-13 14:41:27','',1493,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png',0,'attachment','image/png',0),(1503,1,'2021-07-13 17:41:48','2021-07-13 14:41:48','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4-2','','','2021-07-13 17:41:48','2021-07-13 14:41:48','',1493,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png',0,'attachment','image/png',0),(1504,1,'2021-07-13 17:42:46','2021-07-13 14:42:46','','Web_REO_T3 при повышенной температуре_4','','inherit','open','closed','','web_reo_t3-pri-povyshennoj-temperature_4','','','2021-07-13 17:42:46','2021-07-13 14:42:46','',1493,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1.png',0,'attachment','image/png',0),(1505,1,'2021-06-29 17:06:44','2021-06-29 14:06:44','Алкоголли ичимликлар сийдик ҳайдаш таъсирига эга, улар суиистеъмол қилинганида дегидратацияга олиб келади. Ҳаддан ортиқ алкоголь ичишдан кейинги қусиш ҳам суюқлик ва тузлар йўқотилишига олиб келиши мумкин. Айнан сувсизланиш ичкиликдан кейинги карахтлик симптомлари – бош оғриғи, бош айланиши ва чанқоқлик пайдо бўлишининг асосий сабабларидан бири ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Ичкиликдан кейинги карахтликда нима қилиш керак?</h2>\r\nАфсуски, алкоголдан кейинги карахтликни тез ва таъсирчан усул билан бартараф этишнинг имкони йўқ, чунки этил спиртининг заҳарли маҳсулотлари парчаланиши ва организмдан чиқарилиши вақт талаб қилади. Шунга қарамай, ўз организмингизга карахтлик синдромини енгишга ёрдам беришингиз мумкин. Қуйидаги чораларни қўллаб кўрса бўлади:\r\n<ul>\r\n 	<li>бутун кун мобайнида кўпроқ суюқлик ичинг, таркибида электролит (туз)лар бўлган суюқликларни ичиш мақсадга мувофиқ;</li>\r\n 	<li>тўйиб ухлаб олиш зарур;</li>\r\n 	<li>бош оғриғидан рецепсиз бериладиган препаратни қабул қилинг;</li>\r\n 	<li>таркибида кофеин бўлган ичимликларни суиистеъмол қилманг, чунки улар  сувсизланишни кучайтиради ва ошқозон шиллиқ қаватига таъсир қилади</li>\r\n 	<li>ҳаддан ортиқ қуёш нуридан қочинг;</li>\r\n 	<li>ошқозон шиллиқ қаватига таъсир қилмасдан қондаги қанд даражасини кўтариш учун оддий овқат (тост, крекерлар) ни истеъмол қилинг.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nИчкиликдан кейинги карахтликда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Умуман олганда бу ичилган алкоголь миқдори ва унинг ўткирлигига боғлиқ. Карахтлик белгилари мавжудлигида алкоголь суиистеъмол қилингандан кейинги бутун кун давомида бир неча дақиқа оралатиб 1-2 қултумдан сув ичиб туриш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nАлкоголли ичимликлар  организмда сув-туз мувозанатини бузади, бунинг оқибатида бош оғриғи, ҳолсизлик ва серзардалик юз беради. Бу мувозанатни тиклаш учун таркибида электролитлар – натрий, калий, магний, кальций бўлган ичимликларни истеъмол қилиш мақсадга мувофиқ. Бу юқорида санаб ўтилган белгиларни бартараф этишни тезлаштиради. Оддий сув ва газланган ширин ичимликлар таркибида электролитлар жуда паст концентрацияларда бўлади, шунинг учун сув-туз мувозанатини тўлиқ тиклай олмайди.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nReO суви «Юрия-Фарм» корпорацияси томонидан тиббий мақсадлар, хусусан организмнинг сув-туз мувозанатини тиклаш ва сақлаб туриш учун махсус ишлаб чиқилган. ReO сувининг мувозанатлаштирилган таркиби организм йўқотган электролитларни тўлдириш имконини беради, сорбитол эса ҳужайраларга энергия беради. Ёқимли нимшўр мазаси туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам кичик порцияларда ҳўплаб ичса бўлади.\r\n<h2>Карахтликда қачон врачга мурожаат қилиш керак ?</h2>\r\nИчкиликдан кейинги карахтлик – бу  бор-йўғи аксарият ҳолларда бир сутка ичида ўз-ўзидан ўтиб кетадиган  ёқимсиз белгилар мажмуидир. Алкоголдан заҳарланиш – бу бошқа гап, у ҳатто одамнинг ҳаётига хавф солиши мумкин. Агар сизда ва бошқа одамларда қуйидаги белгилар пайдо бўлса врачга мурожаат қилинг:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>талвасалар;</li>\r\n 	<li>тана ҳароратининг пасайиши;</li>\r\n 	<li>секинлашган ёки доимий бўлмаган нафас олиш.</li>\r\n</ul>\r\n<h2>Қандай қилиб ичкиликдан кейинги карахтликнинг олдини олиш мумкин?</h2>\r\nКарахтликни олдини олишнинг энг яхши усули – алкоголь ичишдан тийилиш. Лекин сиз  барибир ичкилик ичишга қарор қилган бўлсангиз, карахтлик синдроми ривожланишининг олдини олиш ёки уни енгиллаштиришнинг бир неча усуллари мавжуд.\r\n<ul>\r\n 	<li>Етарлича  сув ичинг. Алкоголнинг ҳар бир порцияси (25 мл ўткир ичимликлар, 100 мл вино, 259 мл пиво) дан кейин бир стакан  ва уйқу олдидан яна бир стакан қўшимча сув ичишни одат қилинг.</li>\r\n 	<li>Углеводларга бой овқатларни истеъмол қилинг. Жигарранг гуруч ёки макаронлар алкоголнинг ўзлаштирилишини секинлаштириши мумкин.</li>\r\n 	<li>Электролитлар етишмовчилигини тўлдиришга ҳаракат қилинг. Масалан, бананлар ва авокадо таркибида кўп калий, ёнғоқда – магний, тузланган маҳсулотларда – натрий кўп бўлади.</li>\r\n 	<li>Ранги оч ичимликларни танланг, чунки уларда карахтликни кучайтирадиган ферментация маҳсулотлари камроқ бўлади.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Газланган ичимликлардан қочинг, чунки улар алкоголнинг сўрилишини кучайтиради.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg\"><img class=\"aligncenter wp-image-1728 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2-1024x372.jpg\" alt=\"\" width=\"1024\" height=\"372\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Карахтликнинг олдини олиш</strong></p>\r\n\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Алкоголь ичгандан кейинги асоратлар ва у билан бир вақтда кечадиган сувсизланишни қандай енгиш мумкин?','','publish','open','open','','alkogol-ichgandan-kejingi-asoratlar-va-u-bilan-bir-va%d2%9btda-kechadigan-suvsizlanishni-%d2%9bandaj-engish-mumkin','','','2021-08-31 13:29:33','2021-08-31 10:29:33','',0,'https://reo.ua/uncategorized-uz/kak-preodolet-pohmele-i-obezvozhivanie-kotoroe-ego-soprovozhdaet/',12,'post','',0),(1506,1,'2021-06-29 17:04:43','2021-06-29 14:04:43','','infograph41','','inherit','open','closed','','infograph41-2-2-2','','','2021-06-29 17:04:43','2021-06-29 14:04:43','',1505,'https://reo.ua/wp-content/uploads/2021/06/infograph41-1.jpg',0,'attachment','image/jpeg',0),(1507,1,'2021-07-07 11:57:58','2021-07-07 08:57:58','','Как преодолеть похмелье','','inherit','open','closed','','kak-preodolet-pohmele-2-2','','','2021-07-07 11:57:58','2021-07-07 08:57:58','',1505,'https://reo.ua/wp-content/uploads/2021/06/kak-preodolet-pohmele.jpg',0,'attachment','image/jpeg',0),(1508,1,'2021-08-31 13:28:36','2021-08-31 10:28:36','Алкоголли ичимликлар сийдик ҳайдаш таъсирига эга, улар суиистеъмол қилинганида дегидратацияга олиб келади. Ҳаддан ортиқ алкоголь ичишдан кейинги қусиш ҳам суюқлик ва тузлар йўқотилишига олиб келиши мумкин. Айнан сувсизланиш ичкиликдан кейинги карахтлик симптомлари – бош оғриғи, бош айланиши ва чанқоқлик пайдо бўлишининг асосий сабабларидан бири ҳисобланади.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\n\n<h2>Ичкиликдан кейинги карахтликда нима қилиш керак?</h2>\nАфсуски, алкоголдан кейинги карахтликни тез ва таъсирчан усул билан бартараф этишнинг имкони йўқ, чунки этил спиртининг заҳарли маҳсулотлари парчаланиши ва организмдан чиқарилиши вақт талаб қилади. Шунга қарамай, ўз организмингизга карахтлик синдромини енгишга ёрдам беришингиз мумкин. Қуйидаги чораларни қўллаб кўрса бўлади:\n<ul>\n 	<li>бутун кун мобайнида кўпроқ суюқлик ичинг, таркибида электролит (туз)лар бўлган суюқликларни ичиш мақсадга мувофиқ;</li>\n 	<li>тўйиб ухлаб олиш зарур;</li>\n 	<li>бош оғриғидан рецепсиз бериладиган препаратни қабул қилинг;</li>\n 	<li>таркибида кофеин бўлган ичимликларни суиистеъмол қилманг, чунки улар  сувсизланишни кучайтиради ва ошқозон шиллиқ қаватига таъсир қилади</li>\n 	<li>ҳаддан ортиқ қуёш нуридан қочинг;</li>\n 	<li>ошқозон шиллиқ қаватига таъсир қилмасдан қондаги қанд даражасини кўтариш учун оддий овқат (тост, крекерлар) ни истеъмол қилинг.</li>\n</ul>\n<h2>Қанча суюқлик ичиш керак?</h2>\nИчкиликдан кейинги карахтликда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Умуман олганда бу ичилган алкоголь миқдори ва унинг ўткирлигига боғлиқ. Карахтлик белгилари мавжудлигида алкоголь суиистеъмол қилингандан кейинги бутун кун давомида бир неча дақиқа оралатиб 1-2 қултумдан сув ичиб туриш керак.\n<h2>Нима ичиш зарур?</h2>\nАлкоголли ичимликлар  организмда сув-туз мувозанатини бузади, бунинг оқибатида бош оғриғи, ҳолсизлик ва серзардалик юз беради. Бу мувозанатни тиклаш учун таркибида электролитлар – натрий, калий, магний, кальций бўлган ичимликларни истеъмол қилиш мақсадга мувофиқ. Бу юқорида санаб ўтилган белгиларни бартараф этишни тезлаштиради. Оддий сув ва газланган ширин ичимликлар таркибида электролитлар жуда паст концентрацияларда бўлади, шунинг учун сув-туз мувозанатини тўлиқ тиклай олмайди.\n<h2>Тиббий мақсадлар учун ReO суви</h2>\nReO суви «Юрия-Фарм» корпорацияси томонидан тиббий мақсадлар, хусусан организмнинг сув-туз мувозанатини тиклаш ва сақлаб туриш учун махсус ишлаб чиқилган. ReO сувининг мувозанатлаштирилган таркиби организм йўқотган электролитларни тўлдириш имконини беради, сорбитол эса ҳужайраларга энергия беради. Ёқимли нимшўр мазаси туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам кичик порцияларда ҳўплаб ичса бўлади.\n<h2>Карахтликда қачон врачга мурожаат қилиш керак ?</h2>\nИчкиликдан кейинги карахтлик – бу  бор-йўғи аксарият ҳолларда бир сутка ичида ўз-ўзидан ўтиб кетадиган  ёқимсиз белгилар мажмуидир. Алкоголдан заҳарланиш – бу бошқа гап, у ҳатто одамнинг ҳаётига хавф солиши мумкин. Агар сизда ва бошқа одамларда қуйидаги белгилар пайдо бўлса врачга мурожаат қилинг:\n<ul>\n 	<li>онгнинг бузилиши;</li>\n 	<li>талвасалар;</li>\n 	<li>тана ҳароратининг пасайиши;</li>\n 	<li>секинлашган ёки доимий бўлмаган нафас олиш.</li>\n</ul>\n<h2>Қандай қилиб ичкиликдан кейинги карахтликнинг олдини олиш мумкин?</h2>\nКарахтликни олдини олишнинг энг яхши усули – алкоголь ичишдан тийилиш. Лекин сиз  барибир ичкилик ичишга қарор қилган бўлсангиз, карахтлик синдроми ривожланишининг олдини олиш ёки уни енгиллаштиришнинг бир неча усуллари мавжуд.\n<ul>\n 	<li>Етарлича  сув ичинг. Алкоголнинг ҳар бир порцияси (25 мл ўткир ичимликлар, 100 мл вино, 259 мл пиво) дан кейин бир стакан  ва уйқу олдидан яна бир стакан қўшимча сув ичишни одат қилинг.</li>\n 	<li>Углеводларга бой овқатларни истеъмол қилинг. Жигарранг гуруч ёки макаронлар алкоголнинг ўзлаштирилишини секинлаштириши мумкин.</li>\n 	<li>Электролитлар етишмовчилигини тўлдиришга ҳаракат қилинг. Масалан, бананлар ва авокадо таркибида кўп калий, ёнғоқда – магний, тузланган маҳсулотларда – натрий кўп бўлади.</li>\n 	<li>Ранги оч ичимликларни танланг, чунки уларда карахтликни кучайтирадиган ферментация маҳсулотлари камроқ бўлади.</li>\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\n 	<li>Газланган ичимликлардан қочинг, чунки улар алкоголнинг сўрилишини кучайтиради.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg\"><img class=\"aligncenter size-full wp-image-1728\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg\" alt=\"\" width=\"1172\" height=\"426\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Карахтликнинг олдини олиш</strong></p>\n\n<h2>Манбалар</h2>\n<ol>\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\n</ol>','Алкоголь ичгандан кейинги асоратлар ва у билан бир вақтда кечадиган сувсизланишни қандай енгиш мумкин?','','inherit','closed','closed','','1505-autosave-v1','','','2021-08-31 13:28:36','2021-08-31 10:28:36','',1505,'https://reo.ua/?p=1508',0,'revision','',0);
INSERT INTO `xcgdsgjasetyca_posts` VALUES (1509,1,'2021-08-27 17:43:19','2021-08-27 14:43:19','Алкоголли ичимликлар сийдик ҳайдаш таъсирига эга, улар суиистеъмол қилинганида дегидратацияга олиб келади. Ҳаддан ортиқ алкоголь ичишдан кейинги қусиш ҳам суюқлик ва тузлар йўқотилишига олиб келиши мумкин. Айнан сувсизланиш ичкиликдан кейинги карахтлик симптомлари – бош оғриғи, бош айланиши ва чанқоқлик пайдо бўлишининг асосий сабабларидан бири ҳисобланади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Ичкиликдан кейинги карахтликда нима қилиш керак?</h2>\r\nАфсуски, алкоголдан кейинги карахтликни тез ва таъсирчан усул билан бартараф этишнинг имкони йўқ, чунки этил спиртининг заҳарли маҳсулотлари парчаланиши ва организмдан чиқарилиши вақт талаб қилади. Шунга қарамай, ўз организмингизга карахтлик синдромини енгишга ёрдам беришингиз мумкин. Қуйидаги чораларни қўллаб кўрса бўлади:\r\n<ul>\r\n 	<li>бутун кун мобайнида кўпроқ суюқлик ичинг, таркибида электролит (туз)лар бўлган суюқликларни ичиш мақсадга мувофиқ;</li>\r\n 	<li>тўйиб ухлаб олиш зарур;</li>\r\n 	<li>бош оғриғидан рецепсиз бериладиган препаратни қабул қилинг;</li>\r\n 	<li>таркибида кофеин бўлган ичимликларни суиистеъмол қилманг, чунки улар  сувсизланишни кучайтиради ва ошқозон шиллиқ қаватига таъсир қилади</li>\r\n 	<li>ҳаддан ортиқ қуёш нуридан қочинг;</li>\r\n 	<li>ошқозон шиллиқ қаватига таъсир қилмасдан қондаги қанд даражасини кўтариш учун оддий овқат (тост, крекерлар) ни истеъмол қилинг.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nИчкиликдан кейинги карахтликда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Умуман олганда бу ичилган алкоголь миқдори ва унинг ўткирлигига боғлиқ. Карахтлик белгилари мавжудлигида алкоголь суиистеъмол қилингандан кейинги бутун кун давомида бир неча дақиқа оралатиб 1-2 қултумдан сув ичиб туриш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nАлкоголли ичимликлар  организмда сув-туз мувозанатини бузади, бунинг оқибатида бош оғриғи, ҳолсизлик ва серзардалик юз беради. Бу мувозанатни тиклаш учун таркибида электролитлар – натрий, калий, магний, кальций бўлган ичимликларни истеъмол қилиш мақсадга мувофиқ. Бу юқорида санаб ўтилган белгиларни бартараф этишни тезлаштиради. Оддий сув ва газланган ширин ичимликлар таркибида электролитлар жуда паст концентрацияларда бўлади, шунинг учун сув-туз мувозанатини тўлиқ тиклай олмайди.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nReO суви «Юрия-Фарм» корпорацияси томонидан тиббий мақсадлар, хусусан организмнинг сув-туз мувозанатини тиклаш ва сақлаб туриш учун махсус ишлаб чиқилган. ReO сувининг мувозанатлаштирилган таркиби организм йўқотган электролитларни тўлдириш имконини беради, сорбитол эса ҳужайраларга энергия беради. Ёқимли нимшўр мазаси туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам кичик порцияларда ҳўплаб ичса бўлади.\r\n<h2>Карахтликда қачон врачга мурожаат қилиш керак ?</h2>\r\nИчкиликдан кейинги карахтлик – бу  бор-йўғи аксарият ҳолларда бир сутка ичида ўз-ўзидан ўтиб кетадиган  ёқимсиз белгилар мажмуидир. Алкоголдан заҳарланиш – бу бошқа гап, у ҳатто одамнинг ҳаётига хавф солиши мумкин. Агар сизда ва бошқа одамларда қуйидаги белгилар пайдо бўлса врачга мурожаат қилинг:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>талвасалар;</li>\r\n 	<li>тана ҳароратининг пасайиши;</li>\r\n 	<li>секинлашган ёки доимий бўлмаган нафас олиш.</li>\r\n</ul>\r\n<h2>Қандай қилиб ичкиликдан кейинги карахтликнинг олдини олиш мумкин?</h2>\r\nКарахтликни олдини олишнинг энг яхши усули – алкоголь ичишдан тийилиш. Лекин сиз  барибир ичкилик ичишга қарор қилган бўлсангиз, карахтлик синдроми ривожланишининг олдини олиш ёки уни енгиллаштиришнинг бир неча усуллари мавжуд.\r\n<ul>\r\n 	<li>Етарлича  сув ичинг. Алкоголнинг ҳар бир порцияси (25 мл ўткир ичимликлар, 100 мл вино, 259 мл пиво) дан кейин бир стакан  ва уйқу олдидан яна бир стакан қўшимча сув ичишни одат қилинг.</li>\r\n 	<li>Углеводларга бой овқатларни истеъмол қилинг. Жигарранг гуруч ёки макаронлар алкоголнинг ўзлаштирилишини секинлаштириши мумкин.</li>\r\n 	<li>Электролитлар етишмовчилигини тўлдиришга ҳаракат қилинг. Масалан, бананлар ва авокадо таркибида кўп калий, ёнғоқда – магний, тузланган маҳсулотларда – натрий кўп бўлади.</li>\r\n 	<li>Ранги оч ичимликларни танланг, чунки уларда карахтликни кучайтирадиган ферментация маҳсулотлари камроқ бўлади.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Газланган ичимликлардан қочинг, чунки улар алкоголнинг сўрилишини кучайтиради.</li>\r\n 	<li></li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png\"><img class=\"aligncenter size-large wp-image-827\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2-1024x375.png\" alt=\"\" width=\"1024\" height=\"375\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Карахтликнинг олдини олиш</strong></p>\r\n\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Алкоголь ичгандан кейинги асоратлар ва у билан бир вақтда кечадиган сувсизланишни қандай енгиш мумкин?','','inherit','closed','closed','','1505-revision-v1','','','2021-08-27 17:43:19','2021-08-27 14:43:19','',1505,'https://reo.ua/?p=1509',0,'revision','',0),(1510,1,'2021-06-29 17:06:08','2021-06-29 14:06:08','','infograph43','','inherit','open','closed','','infograph43','','','2021-06-29 17:06:08','2021-06-29 14:06:08','',1505,'https://reo.ua/wp-content/uploads/2021/06/infograph43.jpg',0,'attachment','image/jpeg',0),(1511,1,'2021-07-06 17:07:34','2021-07-06 14:07:34','','Web_REO_T12 Как преодолеть похмелье_1','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_1','','','2021-07-06 17:07:34','2021-07-06 14:07:34','',1505,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_1.png',0,'attachment','image/png',0),(1512,1,'2021-07-06 17:08:55','2021-07-06 14:08:55','','Web_REO_T8 Блювання_1','','inherit','open','closed','','web_reo_t8-blyuvannya_1','','','2021-07-06 17:08:55','2021-07-06 14:08:55','',1505,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_1.png',0,'attachment','image/png',0),(1513,1,'2021-07-06 17:29:25','2021-07-06 14:29:25','','Web_REO_T8 Блювання_2','','inherit','open','closed','','web_reo_t8-blyuvannya_2-2','','','2021-07-06 17:29:25','2021-07-06 14:29:25','',1505,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png',0,'attachment','image/png',0),(1514,1,'2021-07-06 17:30:20','2021-07-06 14:30:20','','Web_REO_T12 Как преодолеть похмелье_2','','inherit','open','closed','','web_reo_t12-kak-preodolet-pohmele_2-2','','','2021-07-06 17:30:20','2021-07-06 14:30:20','',1505,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t12-kak-preodolet-pohmele_2.png',0,'attachment','image/png',0),(1515,1,'2021-06-29 14:07:29','2021-06-29 11:07:29','Қайт қилиш кўплаб касалликлар ва ҳолатларнинг белгиси ҳисобланади. Сабаблари ҳам ички (ҳомиладорлик, бош мия шишлари, овқат ҳазм қилиш тизими касалликлари), ҳам ташқи омиллар (заҳарланиш) бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg\"><img class=\"aligncenter wp-image-1720 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1-1024x391.jpg\" alt=\"\" width=\"1024\" height=\"391\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Қайт қилишнинг кенг тарқалган сабаблари</strong></p>\r\n&nbsp;\r\n\r\nҚайт қилиш – организмнинг ҳимоя механизми бўлиб, заҳарли ёки зарарли моддаларни тезда ошқозондан чиқариб юбориш йўли билан уларнинг сўрилишига тўсқинлик қилади. Шунга қарамай, қайт қилишда кўп миқдорда суюқлик  ва тузлар йўқотилади, бу сувсизланишга ва нохуш белгилар: бош оғриғи ва бош айланиши, чарчоқ, кучли чанқоқ пайдо бўлишига олиб келади. Сийдик рангининг тўқ бўлиши ҳам дегидратация белгиси ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\"><img class=\"aligncenter wp-image-1723\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\" alt=\"\" width=\"724\" height=\"465\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Дегидратация белгилари</strong></p>\r\n&nbsp;\r\n<h2>Врачга мурожаат қилинг, агар:</h2>\r\n<ul>\r\n 	<li>кўнгил айниши ва қайт қилиш қаттиқ бош оғриғи, кўришнинг бузилиши, онгнинг бузилиши билан кечаётган бўлса;</li>\r\n 	<li>қайт қилиш катталар ва 2 ёшдан  катта болалар учун 2 кундан ортиқ, 2 ёшгача бўлган болалар учун  24 соат ва ундан ортиқ ва 1 ёшгача бўлган болалар учун 12 соат ва ундан ортиқ давом этаётган бўлса;</li>\r\n 	<li>вақти-вақти  билан бўлиб турадиган кўнгил айниши ва қайт қилиш ҳуружлари 1 ой мобайнида ёки ундан ортиқ безовта қилаётган бўлса;</li>\r\n 	<li>кўнгил айниши ва қайт қилиш тушунтириб бўлмайдиган озиш билан кечаётган бўлса;</li>\r\n 	<li>қусуқ массалари “кофе қуйқаси” каби бўлса, ичида қон бўлса ёки яшил рангли бўлса.</li>\r\n</ul>\r\n<h2>Қайт қилишда нима қилиш керак?</h2>\r\nКўпроқ, лекин оз-оздан суюқлик ичишга ҳаракат қилинг – бу қайт қилиш оқибатидаги сувсизланишнинг олдини олиш имконини беради.\r\n\r\nОрганизмга дам беринг. Ҳаддан ортиқ фаоллик кўнгил айнишини кучайтириши мумкин.\r\n\r\nКучли ҳидлар ва бошқа эҳтимолий қўзғатувчилар: тутун, ҳаддан ортиқ қизиб кетиш ва намлик, автотранспортда юриш, дим хоналарда бўлишдан сақланинг.\r\n\r\nОхирги қайт қилишдан кейин 6 соат мобайнида қаттиқ овқат истеъмол қилманг. Овқатланишни бошлаганингизда осон ҳазм бўладиган оддий овқатлар: тостлар, крекерлар, донли экинлар ёрмалари, гуруч, меваларни истеъмол қилинг.\r\n\r\nОвқатни кам-камдан истеъмол қилинг. Овқатдан сўнг ётиб олманг, бош оёқлардан юқори бўлган (ўтирган, ёнбошлаган) ҳолатда дам олинг.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОхирги қайт қилишдан кейинги 6-8 соат ичида ҳар 15 дақиқада бир неча қултумдан суюқлик ичинг ёки муз бўлагини шиминг. Ичилган суюқлик ҳажми нафақат  меъёрдаги кунлик эҳтиёжни (жадвалда келтирилган) таъминлаши, балки қусуқ массалари билан йўқотилган сув ўрнини ҳам қоплаши зарур.\r\n\r\n<strong>Жадвал. Болалар ва турли ёшдаги катталарнинг сувга бўлган эҳтиёжи</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Ёш</strong></th>\r\n<th><strong>Жинси</strong></th>\r\n<th><strong>Бир кунда ичиладиган сув миқдори, стакан </strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 ёш</td>\r\n<td>Қизлар ва ўғил болалар</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 ёшҚизлар</td>\r\n<td>Қизлар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 ёш</td>\r\n<td>Қизлар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 ёш</td>\r\n<td>Аёллар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Эркаклар</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Изоҳ. Маълумотлар АҚШ Тиббиёт институти тавсияларига мувофиқ тақдим этилган.</em>\r\n<h2>Нима ичиш зарур?</h2>\r\nҚайт қилишда кўп миқдорда сув ва тузлар (электролитлар) йўқотилади, шунинг учун сув-туз мувозанатини тиклаш устувор вазифа ҳисобланади. Регидратация учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади.\r\n\r\nУ натрий, хлорид, калий, магний, кальций ва гидрокарбонат ионлари билан бойитилган. Нимшўр таъми  ReO сувини ҳатто кўнгил айниганида ҳам ичиш имконини беради.\r\n<h2>Қандай қилиб қайт қилишнинг олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Ўтириб ёки ётиб олинг. Чуқур нафас олинг.</li>\r\n 	<li>Жисмоний юкланишлардан, алкоголь, таркибида кофеин бўлган ичимликлар, ёғли ва аччиқ овқатлар истеъмол қилишдан чекланинг.</li>\r\n 	<li>Муз бўлагини шиминг ёки совуқ сув ичинг.</li>\r\n</ul>\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Қайт қилиш сувсизланиш сабаби сифатида','','publish','open','open','','%d2%9bajt-%d2%9bilish-suvsizlanish-sababi-sifatida','','','2021-08-31 13:24:45','2021-08-31 10:24:45','',0,'https://reo.ua/uncategorized-uz/rvota-kak-prichina-obezvozhivaniya/',15,'post','',0),(1516,1,'2021-06-29 14:04:52','2021-06-29 11:04:52','','infograph40','','inherit','open','closed','','infograph40-2-2','','','2021-06-29 14:04:52','2021-06-29 11:04:52','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph40.jpg',0,'attachment','image/jpeg',0),(1517,1,'2021-07-07 12:01:58','2021-07-07 09:01:58','','Рвота как причина обезвоживания','','inherit','open','closed','','rvota-kak-prichina-obezvozhivaniya-2','','','2021-07-07 12:01:58','2021-07-07 09:01:58','',1515,'https://reo.ua/wp-content/uploads/2021/06/rvota-kak-prichina-obezvozhivaniya.jpg',0,'attachment','image/jpeg',0),(1518,1,'2021-08-31 13:23:38','2021-08-31 10:23:38','Қайт қилиш кўплаб касалликлар ва ҳолатларнинг белгиси ҳисобланади. Сабаблари ҳам ички (ҳомиладорлик, бош мия шишлари, овқат ҳазм қилиш тизими касалликлари), ҳам ташқи омиллар (заҳарланиш) бўлиши мумкин.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg\"><img class=\"aligncenter wp-image-1720 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1-1024x391.jpg\" alt=\"\" width=\"1024\" height=\"391\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>1-расм. Қайт қилишнинг кенг тарқалган сабаблари</strong></p>\n&nbsp;\n\nҚайт қилиш – организмнинг ҳимоя механизми бўлиб, заҳарли ёки зарарли моддаларни тезда ошқозондан чиқариб юбориш йўли билан уларнинг сўрилишига тўсқинлик қилади. Шунга қарамай, қайт қилишда кўп миқдорда суюқлик  ва тузлар йўқотилади, бу сувсизланишга ва нохуш белгилар: бош оғриғи ва бош айланиши, чарчоқ, кучли чанқоқ пайдо бўлишига олиб келади. Сийдик рангининг тўқ бўлиши ҳам дегидратация белгиси ҳисобланади.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Дегидратация белгилари</strong></p>\n&nbsp;\n<h2>Врачга мурожаат қилинг, агар:</h2>\n<ul>\n 	<li>кўнгил айниши ва қайт қилиш қаттиқ бош оғриғи, кўришнинг бузилиши, онгнинг бузилиши билан кечаётган бўлса;</li>\n 	<li>қайт қилиш катталар ва 2 ёшдан  катта болалар учун 2 кундан ортиқ, 2 ёшгача бўлган болалар учун  24 соат ва ундан ортиқ ва 1 ёшгача бўлган болалар учун 12 соат ва ундан ортиқ давом этаётган бўлса;</li>\n 	<li>вақти-вақти  билан бўлиб турадиган кўнгил айниши ва қайт қилиш ҳуружлари 1 ой мобайнида ёки ундан ортиқ безовта қилаётган бўлса;</li>\n 	<li>кўнгил айниши ва қайт қилиш тушунтириб бўлмайдиган озиш билан кечаётган бўлса;</li>\n 	<li>қусуқ массалари “кофе қуйқаси” каби бўлса, ичида қон бўлса ёки яшил рангли бўлса.</li>\n</ul>\n<h2>Қайт қилишда нима қилиш керак?</h2>\nКўпроқ, лекин оз-оздан суюқлик ичишга ҳаракат қилинг – бу қайт қилиш оқибатидаги сувсизланишнинг олдини олиш имконини беради.\n\nОрганизмга дам беринг. Ҳаддан ортиқ фаоллик кўнгил айнишини кучайтириши мумкин.\n\nКучли ҳидлар ва бошқа эҳтимолий қўзғатувчилар: тутун, ҳаддан ортиқ қизиб кетиш ва намлик, автотранспортда юриш, дим хоналарда бўлишдан сақланинг.\n\nОхирги қайт қилишдан кейин 6 соат мобайнида қаттиқ овқат истеъмол қилманг. Овқатланишни бошлаганингизда осон ҳазм бўладиган оддий овқатлар: тостлар, крекерлар, донли экинлар ёрмалари, гуруч, меваларни истеъмол қилинг.\n\nОвқатни кам-камдан истеъмол қилинг. Овқатдан сўнг ётиб олманг, бош оёқлардан юқори бўлган (ўтирган, ёнбошлаган) ҳолатда дам олинг.\n<h2>Қанча суюқлик ичиш керак?</h2>\nОхирги қайт қилишдан кейинги 6-8 соат ичида ҳар 15 дақиқада бир неча қултумдан суюқлик ичинг ёки муз бўлагини шиминг. Ичилган суюқлик ҳажми нафақат  меъёрдаги кунлик эҳтиёжни (жадвалда келтирилган) таъминлаши, балки қусуқ массалари билан йўқотилган сув ўрнини ҳам қоплаши зарур.\n\n<strong>Жадвал. Болалар ва турли ёшдаги катталарнинг сувга бўлган эҳтиёжи</strong>\n<table width=\"569\">\n<tbody>\n<tr>\n<th><strong>Ёш</strong></th>\n<th><strong>Жинси</strong></th>\n<th><strong>Бир кунда ичиладиган сув миқдори, стакан </strong></th>\n</tr>\n<tr>\n<td>4-8 ёш</td>\n<td>Қизлар ва ўғил болалар</td>\n<td>7</td>\n</tr>\n<tr>\n<td rowspan=\"2\">9-13 ёшҚизлар</td>\n<td>Қизлар</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Ўғил болалар</td>\n<td>10</td>\n</tr>\n<tr>\n<td rowspan=\"2\">14-18 ёш</td>\n<td>Қизлар</td>\n<td>10</td>\n</tr>\n<tr>\n<td>Ўғил болалар</td>\n<td>14</td>\n</tr>\n<tr>\n<td rowspan=\"2\">&gt;19 ёш</td>\n<td>Аёллар</td>\n<td>9</td>\n</tr>\n<tr>\n<td>Эркаклар</td>\n<td>13</td>\n</tr>\n</tbody>\n</table>\n<em>Изоҳ. Маълумотлар АҚШ Тиббиёт институти тавсияларига мувофиқ тақдим этилган.</em>\n<h2>Нима ичиш зарур?</h2>\nҚайт қилишда кўп миқдорда сув ва тузлар (электролитлар) йўқотилади, шунинг учун сув-туз мувозанатини тиклаш устувор вазифа ҳисобланади. Регидратация учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ.\n<h2>Тиббий мақсадлар учун ReO суви</h2>\nТиббий мақсадлар учун ReO суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади.\n\nУ натрий, хлорид, калий, магний, кальций ва гидрокарбонат ионлари билан бойитилган. Нимшўр таъми  ReO сувини ҳатто кўнгил айниганида ҳам ичиш имконини беради.\n<h2>Қандай қилиб қайт қилишнинг олдини олиш мумкин?</h2>\n<ul>\n 	<li>Ўтириб ёки ётиб олинг. Чуқур нафас олинг.</li>\n 	<li>Жисмоний юкланишлардан, алкоголь, таркибида кофеин бўлган ичимликлар, ёғли ва аччиқ овқатлар истеъмол қилишдан чекланинг.</li>\n 	<li>Муз бўлагини шиминг ёки совуқ сув ичинг.</li>\n</ul>\n<h2>Манбалар</h2>\n<ol>\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\n</ol>','Қайт қилиш сувсизланиш сабаби сифатида','','inherit','closed','closed','','1515-autosave-v1','','','2021-08-31 13:23:38','2021-08-31 10:23:38','',1515,'https://reo.ua/?p=1518',0,'revision','',0),(1726,1,'2021-08-31 13:24:11','2021-08-31 10:24:11','Қайт қилиш кўплаб касалликлар ва ҳолатларнинг белгиси ҳисобланади. Сабаблари ҳам ички (ҳомиладорлик, бош мия шишлари, овқат ҳазм қилиш тизими касалликлари), ҳам ташқи омиллар (заҳарланиш) бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg\"><img class=\"aligncenter wp-image-1720 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1-1024x391.jpg\" alt=\"\" width=\"1024\" height=\"391\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Қайт қилишнинг кенг тарқалган сабаблари</strong></p>\r\n&nbsp;\r\n\r\nҚайт қилиш – организмнинг ҳимоя механизми бўлиб, заҳарли ёки зарарли моддаларни тезда ошқозондан чиқариб юбориш йўли билан уларнинг сўрилишига тўсқинлик қилади. Шунга қарамай, қайт қилишда кўп миқдорда суюқлик  ва тузлар йўқотилади, бу сувсизланишга ва нохуш белгилар: бош оғриғи ва бош айланиши, чарчоқ, кучли чанқоқ пайдо бўлишига олиб келади. Сийдик рангининг тўқ бўлиши ҳам дегидратация белгиси ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\"><img class=\"aligncenter wp-image-1723\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\" alt=\"\" width=\"724\" height=\"465\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>2-расм. Дегидратация белгилари</strong></p>\r\n&nbsp;\r\n<h2>Врачга мурожаат қилинг, агар:</h2>\r\n<ul>\r\n 	<li>кўнгил айниши ва қайт қилиш қаттиқ бош оғриғи, кўришнинг бузилиши, онгнинг бузилиши билан кечаётган бўлса;</li>\r\n 	<li>қайт қилиш катталар ва 2 ёшдан  катта болалар учун 2 кундан ортиқ, 2 ёшгача бўлган болалар учун  24 соат ва ундан ортиқ ва 1 ёшгача бўлган болалар учун 12 соат ва ундан ортиқ давом этаётган бўлса;</li>\r\n 	<li>вақти-вақти  билан бўлиб турадиган кўнгил айниши ва қайт қилиш ҳуружлари 1 ой мобайнида ёки ундан ортиқ безовта қилаётган бўлса;</li>\r\n 	<li>кўнгил айниши ва қайт қилиш тушунтириб бўлмайдиган озиш билан кечаётган бўлса;</li>\r\n 	<li>қусуқ массалари “кофе қуйқаси” каби бўлса, ичида қон бўлса ёки яшил рангли бўлса.</li>\r\n</ul>\r\n<h2>Қайт қилишда нима қилиш керак?</h2>\r\nКўпроқ, лекин оз-оздан суюқлик ичишга ҳаракат қилинг – бу қайт қилиш оқибатидаги сувсизланишнинг олдини олиш имконини беради.\r\n\r\nОрганизмга дам беринг. Ҳаддан ортиқ фаоллик кўнгил айнишини кучайтириши мумкин.\r\n\r\nКучли ҳидлар ва бошқа эҳтимолий қўзғатувчилар: тутун, ҳаддан ортиқ қизиб кетиш ва намлик, автотранспортда юриш, дим хоналарда бўлишдан сақланинг.\r\n\r\nОхирги қайт қилишдан кейин 6 соат мобайнида қаттиқ овқат истеъмол қилманг. Овқатланишни бошлаганингизда осон ҳазм бўладиган оддий овқатлар: тостлар, крекерлар, донли экинлар ёрмалари, гуруч, меваларни истеъмол қилинг.\r\n\r\nОвқатни кам-камдан истеъмол қилинг. Овқатдан сўнг ётиб олманг, бош оёқлардан юқори бўлган (ўтирган, ёнбошлаган) ҳолатда дам олинг.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОхирги қайт қилишдан кейинги 6-8 соат ичида ҳар 15 дақиқада бир неча қултумдан суюқлик ичинг ёки муз бўлагини шиминг. Ичилган суюқлик ҳажми нафақат  меъёрдаги кунлик эҳтиёжни (жадвалда келтирилган) таъминлаши, балки қусуқ массалари билан йўқотилган сув ўрнини ҳам қоплаши зарур.\r\n\r\n<strong>Жадвал. Болалар ва турли ёшдаги катталарнинг сувга бўлган эҳтиёжи</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Ёш</strong></th>\r\n<th><strong>Жинси</strong></th>\r\n<th><strong>Бир кунда ичиладиган сув миқдори, стакан </strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 ёш</td>\r\n<td>Қизлар ва ўғил болалар</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 ёшҚизлар</td>\r\n<td>Қизлар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 ёш</td>\r\n<td>Қизлар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 ёш</td>\r\n<td>Аёллар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Эркаклар</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Изоҳ. Маълумотлар АҚШ Тиббиёт институти тавсияларига мувофиқ тақдим этилган.</em>\r\n<h2>Нима ичиш зарур?</h2>\r\nҚайт қилишда кўп миқдорда сув ва тузлар (электролитлар) йўқотилади, шунинг учун сув-туз мувозанатини тиклаш устувор вазифа ҳисобланади. Регидратация учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади.\r\n\r\nУ натрий, хлорид, калий, магний, кальций ва гидрокарбонат ионлари билан бойитилган. Нимшўр таъми  ReO сувини ҳатто кўнгил айниганида ҳам ичиш имконини беради.\r\n<h2>Қандай қилиб қайт қилишнинг олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Ўтириб ёки ётиб олинг. Чуқур нафас олинг.</li>\r\n 	<li>Жисмоний юкланишлардан, алкоголь, таркибида кофеин бўлган ичимликлар, ёғли ва аччиқ овқатлар истеъмол қилишдан чекланинг.</li>\r\n 	<li>Муз бўлагини шиминг ёки совуқ сув ичинг.</li>\r\n</ul>\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Қайт қилиш сувсизланиш сабаби сифатида','','inherit','closed','closed','','1515-revision-v1','','','2021-08-31 13:24:11','2021-08-31 10:24:11','',1515,'https://reo.ua/?p=1726',0,'revision','',0),(1519,1,'2021-08-27 17:48:40','2021-08-27 14:48:40','Қайт қилиш кўплаб касалликлар ва ҳолатларнинг белгиси ҳисобланади. Сабаблари ҳам ички (ҳомиладорлик, бош мия шишлари, овқат ҳазм қилиш тизими касалликлари), ҳам ташқи омиллар (заҳарланиш) бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg\"><img class=\"aligncenter size-large wp-image-716\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru-1024x394.jpg\" alt=\"\" width=\"1024\" height=\"394\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Қайт қилишнинг кенг тарқалган сабаблари</strong></p>\r\n&nbsp;\r\n\r\nҚайт қилиш – организмнинг ҳимоя механизми бўлиб, заҳарли ёки зарарли моддаларни тезда ошқозондан чиқариб юбориш йўли билан уларнинг сўрилишига тўсқинлик қилади. Шунга қарамай, қайт қилишда кўп миқдорда суюқлик  ва тузлар йўқотилади, бу сувсизланишга ва нохуш белгилар: бош оғриғи ва бош айланиши, чарчоқ, кучли чанқоқ пайдо бўлишига олиб келади. Сийдик рангининг тўқ бўлиши ҳам дегидратация белгиси ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg\"><img class=\"aligncenter wp-image-720\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru-1024x659.jpg\" alt=\"\" width=\"724\" height=\"466\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Дегидратация белгилари</strong></p>\r\n&nbsp;\r\n<h2>Врачга мурожаат қилинг, агар:</h2>\r\n<ul>\r\n 	<li>кўнгил айниши ва қайт қилиш қаттиқ бош оғриғи, кўришнинг бузилиши, онгнинг бузилиши билан кечаётган бўлса;</li>\r\n 	<li>қайт қилиш катталар ва 2 ёшдан  катта болалар учун 2 кундан ортиқ, 2 ёшгача бўлган болалар учун  24 соат ва ундан ортиқ ва 1 ёшгача бўлган болалар учун 12 соат ва ундан ортиқ давом этаётган бўлса;</li>\r\n 	<li>вақти-вақти  билан бўлиб турадиган кўнгил айниши ва қайт қилиш ҳуружлари 1 ой мобайнида ёки ундан ортиқ безовта қилаётган бўлса;</li>\r\n 	<li>кўнгил айниши ва қайт қилиш тушунтириб бўлмайдиган озиш билан кечаётган бўлса;</li>\r\n 	<li>қусуқ массалари “кофе қуйқаси” каби бўлса, ичида қон бўлса ёки яшил рангли бўлса.</li>\r\n</ul>\r\n<h2>Қайт қилишда нима қилиш керак?</h2>\r\nКўпроқ, лекин оз-оздан суюқлик ичишга ҳаракат қилинг – бу қайт қилиш оқибатидаги сувсизланишнинг олдини олиш имконини беради.\r\n\r\nОрганизмга дам беринг. Ҳаддан ортиқ фаоллик кўнгил айнишини кучайтириши мумкин.\r\n\r\nКучли ҳидлар ва бошқа эҳтимолий қўзғатувчилар: тутун, ҳаддан ортиқ қизиб кетиш ва намлик, автотранспортда юриш, дим хоналарда бўлишдан сақланинг.\r\n\r\nОхирги қайт қилишдан кейин 6 соат мобайнида қаттиқ овқат истеъмол қилманг. Овқатланишни бошлаганингизда осон ҳазм бўладиган оддий овқатлар: тостлар, крекерлар, донли экинлар ёрмалари, гуруч, меваларни истеъмол қилинг.\r\n\r\nОвқатни кам-камдан истеъмол қилинг. Овқатдан сўнг ётиб олманг, бош оёқлардан юқори бўлган (ўтирган, ёнбошлаган) ҳолатда дам олинг.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОхирги қайт қилишдан кейинги 6-8 соат ичида ҳар 15 дақиқада бир неча қултумдан суюқлик ичинг ёки муз бўлагини шиминг. Ичилган суюқлик ҳажми нафақат  меъёрдаги кунлик эҳтиёжни (жадвалда келтирилган) таъминлаши, балки қусуқ массалари билан йўқотилган сув ўрнини ҳам қоплаши зарур.\r\n\r\n<strong>Жадвал. Болалар ва турли ёшдаги катталарнинг сувга бўлган эҳтиёжи</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Ёш</strong></th>\r\n<th><strong>Жинси</strong></th>\r\n<th><strong>Бир кунда ичиладиган сув миқдори, стакан </strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 ёш</td>\r\n<td>Қизлар ва ўғил болалар</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 ёшҚизлар</td>\r\n<td>Қизлар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 ёш</td>\r\n<td>Қизлар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 ёш</td>\r\n<td>Аёллар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Эркаклар</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Изоҳ. Маълумотлар АҚШ Тиббиёт институти тавсияларига мувофиқ тақдим этилган.</em>\r\n<h2>Нима ичиш зарур?</h2>\r\nҚайт қилишда кўп миқдорда сув ва тузлар (электролитлар) йўқотилади, шунинг учун сув-туз мувозанатини тиклаш устувор вазифа ҳисобланади. Регидратация учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади.\r\n\r\nУ натрий, хлорид, калий, магний, кальций ва гидрокарбонат ионлари билан бойитилган. Нимшўр таъми  ReO сувини ҳатто кўнгил айниганида ҳам ичиш имконини беради.\r\n<h2>Қандай қилиб қайт қилишнинг олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Ўтириб ёки ётиб олинг. Чуқур нафас олинг.</li>\r\n 	<li>Жисмоний юкланишлардан, алкоголь, таркибида кофеин бўлган ичимликлар, ёғли ва аччиқ овқатлар истеъмол қилишдан чекланинг.</li>\r\n 	<li>Муз бўлагини шиминг ёки совуқ сув ичинг.</li>\r\n</ul>\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Қайт қилиш сувсизланиш сабаби сифатида','','inherit','closed','closed','','1515-revision-v1','','','2021-08-27 17:48:40','2021-08-27 14:48:40','',1515,'https://reo.ua/?p=1519',0,'revision','',0),(1520,1,'2021-06-29 14:06:05','2021-06-29 11:06:05','','infograph41','','inherit','open','closed','','infograph41','','','2021-06-29 14:06:05','2021-06-29 11:06:05','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph41.jpg',0,'attachment','image/jpeg',0),(1521,1,'2021-07-01 12:12:48','2021-07-01 09:12:48','','infograph-81-ua','','inherit','open','closed','','infograph-81-ua','','','2021-07-01 12:12:48','2021-07-01 09:12:48','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ua.jpg',0,'attachment','image/jpeg',0),(1522,1,'2021-07-01 12:12:49','2021-07-01 09:12:49','','infograph-82-ru','','inherit','open','closed','','infograph-82-ru','','','2021-07-01 12:12:49','2021-07-01 09:12:49','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ru.jpg',0,'attachment','image/jpeg',0),(1523,1,'2021-07-01 12:12:50','2021-07-01 09:12:50','','infograph-82-ua','','inherit','open','closed','','infograph-82-ua','','','2021-07-01 12:12:50','2021-07-01 09:12:50','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph-82-ua.jpg',0,'attachment','image/jpeg',0),(1524,1,'2021-07-01 12:12:47','2021-07-01 09:12:47','','infograph-81-ru','','inherit','open','closed','','infograph-81-ru','','','2021-07-01 12:12:47','2021-07-01 09:12:47','',1515,'https://reo.ua/wp-content/uploads/2021/06/infograph-81-ru.jpg',0,'attachment','image/jpeg',0),(1525,1,'2021-06-24 13:23:17','2021-06-24 10:23:17','Ўткир ичак инфекциялари – юқумли касалликлар гуруҳи бўлиб, улар учун тўсатдан  бошланиш, диарея, баъзида эса – кўнгил айниши ва қайт қилиш, тана ҳароратининг ошиши, қорин ва мушаклардаги оғриқ, иштаҳанинг йўқолиши каби белгилар хосдир.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\"><img class=\"aligncenter size-full wp-image-1675\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\" alt=\"\" width=\"975\" height=\"226\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Гастроэнтерит белгилари</strong></p>\r\n&nbsp;\r\n\r\nЎткир ичак инфекциялари одатда бир неча кундан кейин ўзи ўтиб кетади, лекин 2 ҳафтагача ҳам давом этиши мумкин. Ичак инфекцияларига бактериялар, вируслар ёки паразитлар сабаб бўлиши мумкин. Аксарият ҳолларда антибиотиклар керак бўлмайди ва улар фақат беморнинг аҳволини ёмонлаштириши мумкин.\r\n<h2>Ичак инфекцияларида нима қилиш керак?</h2>\r\nЎткир ичак инфекцияларининг асосий асорати ва  хавфи – бу сувсизланиш. Сувсизланиш даражасини баҳолашда  суюқлик истеъмол қилиш ҳажми, сийиш ҳажми, диарея ва қайт қилишлар сонига эътибор бериш керак.\r\n\r\nУнча юқори бўлмаган ёки ўртача сувсизланишда орал регидратация  худди вена ичига юбориладиган регидратация каби самарали бўлади ва шифохонага ётқизишнинг (Listernick R. ва ҳаммуаллифлар, 1986; Cohen M. ва ҳаммуаллифлар, 1995) олдини олади. Орал регидратация олган 25 нафар болалардан фақат 1 бола  эритмаларни вена ичига юборишни талаб қилади (Hartling L. ва ҳаммуаллифлар, 2006).\r\n\r\nИштаҳа очилганида овқатланишни қайнатилган гуруч ва картошка, тост, банан каби маҳсулотлардан бошлаш зарур. Таркибида кофеин бўлган ичимликлар, алкоголь, ёғли ва ширин овқатлар, сут маҳсулотларини (кефир ва ширин бўлмаган йогуртдан ташқари) истеъмол қилмаслик керак.\r\n<h2>Врачга қачон мурожаат қилиш керак?</h2>\r\nБолаларда ўткир ичак инфекцияси юз берган ҳолларда қуйидаги белгилар пайдо бўлганда врачга мурожаат қилиш зарур:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>қусуқ массаларида қон ёки сафро пайдо бўлиши;</li>\r\n 	<li>юзнинг кўкариб кетиши;</li>\r\n 	<li>тинмай йиғлаш, кучли таъсирчанлик;</li>\r\n 	<li>нуқтасимон қизилча пайдо бўлиши;</li>\r\n 	<li>оёқ-қўлларнинг совиб кетиши;</li>\r\n 	<li>тез-тез нафас олиш;</li>\r\n 	<li>ҳарорат 40 °С дан кўтарилиши.</li>\r\n</ul>\r\nКатталарда қуйидаги белгилар хавфли ҳисобланади:\r\n<ul>\r\n 	<li>40 °С дан ошган ҳарорат;</li>\r\n 	<li>24 соат ва ундан ортиқ тўхтамай давом этадиган ич кетиши;</li>\r\n 	<li>48 соат ва ундан ортиқ давом этаётган қайт қилиш;</li>\r\n 	<li>қусуқ массаси ва нажасда қон пайдо бўлиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (кучли чанқоқ, сийишнинг кескин камайиши ёки умуман сиймай қўйиш, бирдан юз берадиган ҳолсизлик, бош айланиши)нинг пайдо бўлиши;</li>\r\n</ul>\r\nВрачга шунингдек ўткир ичак инфекцияси симптомлари болаларда 2 кундан кўп ёки катталарда 5 кундан кўп давом этаётган бўлса мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nБолалар учун суюқлик ҳажмини вазнига қараб жадвал ёки оддий формула ёрдамида ҳисоблаб чиқиш зарур: вазнни (кг) 75 га кўпайтириш орқали. Агар боланинг вазни аниқ бўлмаса,  ёш бўйича баҳолашдан фойдаланиш мумкин.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>В</strong><strong>азн</strong></th>\r\n<th width=\"33%\"><strong>Ёш</strong></th>\r\n<th width=\"33%\"><strong>Орал регидратация учун дастлабки                4 соатда берилиши зарур б</strong><strong>ўлган </strong><strong> эритманинг тахминий миқдори</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 ой</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 ой</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 ой</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 ёш</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 ёш</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 ёш</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nАгар одам кўпроқ суюқлик ичишни истаса, кўпроқ бериш мумкин.\r\n\r\nЧақалоқларга суюқлик шприц (игнасиз), кичкинтойлар ва катта болаларга – қошиқ ёки чашкада берилади. 2 ёшгача бўлган болаларга ҳар 1-2 дақиқада  чой қошиқда сув бериш, катта болаларни эса ўзлари мустақил чашкадан тез-тез ҳўплаб сув ичиб туришларини рағбатлантириш зарур. Қайт қилишда 5-10 дақиқа кутиб туриш ва регидратацияни давом эттириш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун минерал таркиби бўйича мувозанатлаштирилган, таркибида натрий, калий ва магний бўлган ичимликлар энг мақбул ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\"><img class=\"aligncenter wp-image-1678\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\" alt=\"\" width=\"748\" height=\"464\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Сув-туз мувозанатини тиклаш</strong></p>\r\n&nbsp;\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви мувозанатлаштирилган таркибга эга ва сув-туз мувозанатини тиклаш учун энг муҳим электролитлар билан бойитилган. Ёқимли нимшўр таъми сабабли ReO сувини ҳатто ичак инфекцияларида кўп учраб турадиган кўнгил айнишларида ҳам оз-оздан ичиш имконини беради.\r\n<h2>Қандай қилиб ичак инфекцияларининг олдини олиш мумкин?</h2>\r\nИчак инфекцияларининг олдини олишнинг асосий чоралари  қўлларни тез-тез ювиб туриш ва умуман гигиенага яхши риоя қилиш ҳисобланади. Кичик ёшдаги болаларда эмизиш ичак инфекциялари учрашини ва шифохонага ётиш сонини пасайтиради. Сабзавот ва меваларни истеъмол қилишдан олдин яхшилаб ювиш; хом гўшт, балиқ ва денгиз маҳсулотларини истеъмол қилмаслик зарур. Бундан ташқари, сифатли ичимлик сувини ичиш ҳам муҳим аҳамиятга эга.\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Ичак инфекцияларида сувсизланиш','','publish','open','open','','ichak-infekcziyalarida-suvsizlanish','','','2021-08-31 12:57:35','2021-08-31 09:57:35','',0,'https://reo.ua/uncategorized-uz/obezvozhivanie-pri-kishechnyh-infekcziyah/',46,'post','',0),(1526,1,'2021-06-24 13:21:34','2021-06-24 10:21:34','','infograph-1','','inherit','open','closed','','infograph-1-2-2','','','2021-06-24 13:21:34','2021-06-24 10:21:34','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-1.jpg',0,'attachment','image/jpeg',0),(1527,1,'2021-07-06 17:39:22','2021-07-06 14:39:22','','Web_REO_T1_2','','inherit','open','closed','','web_reo_t1_2-2','','','2021-07-06 17:39:22','2021-07-06 14:39:22','',1525,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png',0,'attachment','image/png',0),(1528,1,'2021-08-31 12:55:07','2021-08-31 09:55:07','Ўткир ичак инфекциялари – юқумли касалликлар гуруҳи бўлиб, улар учун тўсатдан  бошланиш, диарея, баъзида эса – кўнгил айниши ва қайт қилиш, тана ҳароратининг ошиши, қорин ва мушаклардаги оғриқ, иштаҳанинг йўқолиши каби белгилар хосдир.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\"><img class=\"aligncenter size-full wp-image-1675\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\" alt=\"\" width=\"975\" height=\"226\" /></a>\n\n&nbsp;\n<p style=\"text-align: center;\"><strong>1-расм. Гастроэнтерит белгилари</strong></p>\n&nbsp;\n\nЎткир ичак инфекциялари одатда бир неча кундан кейин ўзи ўтиб кетади, лекин 2 ҳафтагача ҳам давом этиши мумкин. Ичак инфекцияларига бактериялар, вируслар ёки паразитлар сабаб бўлиши мумкин. Аксарият ҳолларда антибиотиклар керак бўлмайди ва улар фақат беморнинг аҳволини ёмонлаштириши мумкин.\n<h2>Ичак инфекцияларида нима қилиш керак?</h2>\nЎткир ичак инфекцияларининг асосий асорати ва  хавфи – бу сувсизланиш. Сувсизланиш даражасини баҳолашда  суюқлик истеъмол қилиш ҳажми, сийиш ҳажми, диарея ва қайт қилишлар сонига эътибор бериш керак.\n\nУнча юқори бўлмаган ёки ўртача сувсизланишда орал регидратация  худди вена ичига юбориладиган регидратация каби самарали бўлади ва шифохонага ётқизишнинг (Listernick R. ва ҳаммуаллифлар, 1986; Cohen M. ва ҳаммуаллифлар, 1995) олдини олади. Орал регидратация олган 25 нафар болалардан фақат 1 бола  эритмаларни вена ичига юборишни талаб қилади (Hartling L. ва ҳаммуаллифлар, 2006).\n\nИштаҳа очилганида овқатланишни қайнатилган гуруч ва картошка, тост, банан каби маҳсулотлардан бошлаш зарур. Таркибида кофеин бўлган ичимликлар, алкоголь, ёғли ва ширин овқатлар, сут маҳсулотларини (кефир ва ширин бўлмаган йогуртдан ташқари) истеъмол қилмаслик керак.\n<h2>Врачга қачон мурожаат қилиш керак?</h2>\nБолаларда ўткир ичак инфекцияси юз берган ҳолларда қуйидаги белгилар пайдо бўлганда врачга мурожаат қилиш зарур:\n<ul>\n 	<li>онгнинг бузилиши;</li>\n 	<li>қусуқ массаларида қон ёки сафро пайдо бўлиши;</li>\n 	<li>юзнинг кўкариб кетиши;</li>\n 	<li>тинмай йиғлаш, кучли таъсирчанлик;</li>\n 	<li>нуқтасимон қизилча пайдо бўлиши;</li>\n 	<li>оёқ-қўлларнинг совиб кетиши;</li>\n 	<li>тез-тез нафас олиш;</li>\n 	<li>ҳарорат 40 °С дан кўтарилиши.</li>\n</ul>\nКатталарда қуйидаги белгилар хавфли ҳисобланади:\n<ul>\n 	<li>40 °С дан ошган ҳарорат;</li>\n 	<li>24 соат ва ундан ортиқ тўхтамай давом этадиган ич кетиши;</li>\n 	<li>48 соат ва ундан ортиқ давом этаётган қайт қилиш;</li>\n 	<li>қусуқ массаси ва нажасда қон пайдо бўлиши;</li>\n 	<li>кучли сувсизланиш белгилари (кучли чанқоқ, сийишнинг кескин камайиши ёки умуман сиймай қўйиш, бирдан юз берадиган ҳолсизлик, бош айланиши)нинг пайдо бўлиши;</li>\n</ul>\nВрачга шунингдек ўткир ичак инфекцияси симптомлари болаларда 2 кундан кўп ёки катталарда 5 кундан кўп давом этаётган бўлса мурожаат қилиш зарур.\n<h2>Қанча суюқлик ичиш керак?</h2>\nБолалар учун суюқлик ҳажмини вазнига қараб жадвал ёки оддий формула ёрдамида ҳисоблаб чиқиш зарур: вазнни (кг) 75 га кўпайтириш орқали. Агар боланинг вазни аниқ бўлмаса,  ёш бўйича баҳолашдан фойдаланиш мумкин.\n<table>\n<thead>\n<tr>\n<th width=\"33%\"><strong>В</strong><strong>азн</strong></th>\n<th width=\"33%\"><strong>Ёш</strong></th>\n<th width=\"33%\"><strong>Орал регидратация учун дастлабки                4 соатда берилиши зарур б</strong><strong>ўлган </strong><strong> эритманинг тахминий миқдори</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>&lt;5 кг</td>\n<td>&lt;4 ой</td>\n<td>200-400 мл</td>\n</tr>\n<tr>\n<td>5-7,9 кг</td>\n<td>4-11 ой</td>\n<td>400-600 мл</td>\n</tr>\n<tr>\n<td>8-10,9 кг</td>\n<td>12-23 ой</td>\n<td>600-800 мл</td>\n</tr>\n<tr>\n<td>11-15,9 кг</td>\n<td>2-4 ёш</td>\n<td>800-1200 мл</td>\n</tr>\n<tr>\n<td>16-29,9 кг</td>\n<td>5-14 ёш</td>\n<td>1200-2200 мл</td>\n</tr>\n<tr>\n<td>≥30 кг</td>\n<td>≥15 ёш</td>\n<td>2200-4000 мл</td>\n</tr>\n</tbody>\n</table>\nАгар одам кўпроқ суюқлик ичишни истаса, кўпроқ бериш мумкин.\n\nЧақалоқларга суюқлик шприц (игнасиз), кичкинтойлар ва катта болаларга – қошиқ ёки чашкада берилади. 2 ёшгача бўлган болаларга ҳар 1-2 дақиқада  чой қошиқда сув бериш, катта болаларни эса ўзлари мустақил чашкадан тез-тез ҳўплаб сув ичиб туришларини рағбатлантириш зарур. Қайт қилишда 5-10 дақиқа кутиб туриш ва регидратацияни давом эттириш керак.\n<h2>Нима ичиш зарур?</h2>\nДиарея ва қайт қилишда нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун минерал таркиби бўйича мувозанатлаштирилган, таркибида натрий, калий ва магний бўлган ичимликлар энг мақбул ҳисобланади.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\"><img class=\"aligncenter size-full wp-image-1678\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\" alt=\"\" width=\"1140\" height=\"707\" data-wp-editing=\"1\" /></a>\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\n<strong>2-расм. Сув-туз мувозанатини тиклаш</strong></p>\n&nbsp;\n<h2>Тиббий мақсадлар учун ReO суви\n(«Юрия-Фарм»)</h2>\nТиббий мақсадлар учун ReO суви мувозанатлаштирилган таркибга эга ва сув-туз мувозанатини тиклаш учун энг муҳим электролитлар билан бойитилган. Ёқимли нимшўр таъми сабабли ReO сувини ҳатто ичак инфекцияларида кўп учраб турадиган кўнгил айнишларида ҳам оз-оздан ичиш имконини беради.\n<h2>Қандай қилиб ичак инфекцияларининг олдини олиш мумкин?</h2>\nИчак инфекцияларининг олдини олишнинг асосий чоралари  қўлларни тез-тез ювиб туриш ва умуман гигиенага яхши риоя қилиш ҳисобланади. Кичик ёшдаги болаларда эмизиш ичак инфекциялари учрашини ва шифохонага ётиш сонини пасайтиради. Сабзавот ва меваларни истеъмол қилишдан олдин яхшилаб ювиш; хом гўшт, балиқ ва денгиз маҳсулотларини истеъмол қилмаслик зарур. Бундан ташқари, сифатли ичимлик сувини ичиш ҳам муҳим аҳамиятга эга.\n<h2>Адабиётлар рўйхати</h2>\n<ol>\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\n</ol>','Ичак инфекцияларида сувсизланиш','','inherit','closed','closed','','1525-autosave-v1','','','2021-08-31 12:55:07','2021-08-31 09:55:07','',1525,'https://reo.ua/?p=1528',0,'revision','',0),(1529,1,'2021-08-27 17:53:28','2021-08-27 14:53:28','Ўткир ичак инфекциялари – юқумли касалликлар гуруҳи бўлиб, улар учун тўсатдан  бошланиш, диарея, баъзида эса – кўнгил айниши ва қайт қилиш, тана ҳароратининг ошиши, қорин ва мушаклардаги оғриқ, иштаҳанинг йўқолиши каби белгилар хосдир.\r\n\r\n<img class=\"aligncenter size-full wp-image-546\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg\" alt=\"\" width=\"968\" height=\"262\" />\r\n<p style=\"text-align: center;\"><strong>1-расм. Гастроэнтерит белгилари</strong></p>\r\n&nbsp;\r\n\r\nЎткир ичак инфекциялари одатда бир неча кундан кейин ўзи ўтиб кетади, лекин 2 ҳафтагача ҳам давом этиши мумкин. Ичак инфекцияларига бактериялар, вируслар ёки паразитлар сабаб бўлиши мумкин. Аксарият ҳолларда антибиотиклар керак бўлмайди ва улар фақат беморнинг аҳволини ёмонлаштириши мумкин.\r\n<h2>Ичак инфекцияларида нима қилиш керак?</h2>\r\nЎткир ичак инфекцияларининг асосий асорати ва  хавфи – бу сувсизланиш. Сувсизланиш даражасини баҳолашда  суюқлик истеъмол қилиш ҳажми, сийиш ҳажми, диарея ва қайт қилишлар сонига эътибор бериш керак.\r\n\r\nУнча юқори бўлмаган ёки ўртача сувсизланишда орал регидратация  худди вена ичига юбориладиган регидратация каби самарали бўлади ва шифохонага ётқизишнинг (Listernick R. ва ҳаммуаллифлар, 1986; Cohen M. ва ҳаммуаллифлар, 1995) олдини олади. Орал регидратация олган 25 нафар болалардан фақат 1 бола  эритмаларни вена ичига юборишни талаб қилади (Hartling L. ва ҳаммуаллифлар, 2006).\r\n\r\nИштаҳа очилганида овқатланишни қайнатилган гуруч ва картошка, тост, банан каби маҳсулотлардан бошлаш зарур. Таркибида кофеин бўлган ичимликлар, алкоголь, ёғли ва ширин овқатлар, сут маҳсулотларини (кефир ва ширин бўлмаган йогуртдан ташқари) истеъмол қилмаслик керак.\r\n<h2>Врачга қачон мурожаат қилиш керак?</h2>\r\nБолаларда ўткир ичак инфекцияси юз берган ҳолларда қуйидаги белгилар пайдо бўлганда врачга мурожаат қилиш зарур:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>қусуқ массаларида қон ёки сафро пайдо бўлиши;</li>\r\n 	<li>юзнинг кўкариб кетиши;</li>\r\n 	<li>тинмай йиғлаш, кучли таъсирчанлик;</li>\r\n 	<li>нуқтасимон қизилча пайдо бўлиши;</li>\r\n 	<li>оёқ-қўлларнинг совиб кетиши;</li>\r\n 	<li>тез-тез нафас олиш;</li>\r\n 	<li>ҳарорат 40 °С дан кўтарилиши.</li>\r\n</ul>\r\nКатталарда қуйидаги белгилар хавфли ҳисобланади:\r\n<ul>\r\n 	<li>40 °С дан ошган ҳарорат;</li>\r\n 	<li>24 соат ва ундан ортиқ тўхтамай давом этадиган ич кетиши;</li>\r\n 	<li>48 соат ва ундан ортиқ давом этаётган қайт қилиш;</li>\r\n 	<li>қусуқ массаси ва нажасда қон пайдо бўлиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (кучли чанқоқ, сийишнинг кескин камайиши ёки умуман сиймай қўйиш, бирдан юз берадиган ҳолсизлик, бош айланиши)нинг пайдо бўлиши;</li>\r\n</ul>\r\nВрачга шунингдек ўткир ичак инфекцияси симптомлари болаларда 2 кундан кўп ёки катталарда 5 кундан кўп давом этаётган бўлса мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nБолалар учун суюқлик ҳажмини вазнига қараб жадвал ёки оддий формула ёрдамида ҳисоблаб чиқиш зарур: вазнни (кг) 75 га кўпайтириш орқали. Агар боланинг вазни аниқ бўлмаса,  ёш бўйича баҳолашдан фойдаланиш мумкин.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>В</strong><strong>азн</strong></th>\r\n<th width=\"33%\"><strong>Ёш</strong></th>\r\n<th width=\"33%\"><strong>Орал регидратация учун дастлабки                4 соатда берилиши зарур б</strong><strong>ўлган </strong><strong> эритманинг тахминий миқдори</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 ой</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 ой</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 ой</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 ёш</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 ёш</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 ёш</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nАгар одам кўпроқ суюқлик ичишни истаса, кўпроқ бериш мумкин.\r\n\r\nЧақалоқларга суюқлик шприц (игнасиз), кичкинтойлар ва катта болаларга – қошиқ ёки чашкада берилади. 2 ёшгача бўлган болаларга ҳар 1-2 дақиқада  чой қошиқда сув бериш, катта болаларни эса ўзлари мустақил чашкадан тез-тез ҳўплаб сув ичиб туришларини рағбатлантириш зарур. Қайт қилишда 5-10 дақиқа кутиб туриш ва регидратацияни давом эттириш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун минерал таркиби бўйича мувозанатлаштирилган, таркибида натрий, калий ва магний бўлган ичимликлар энг мақбул ҳисобланади.\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2.png\"><img class=\"aligncenter wp-image-834\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_2-1024x627.png\" alt=\"\" width=\"748\" height=\"458\" /></a>\r\n<strong>2-расм. Сув-туз мувозанатини тиклаш</strong></p>\r\n&nbsp;\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви мувозанатлаштирилган таркибга эга ва сув-туз мувозанатини тиклаш учун энг муҳим электролитлар билан бойитилган. Ёқимли нимшўр таъми сабабли ReO сувини ҳатто ичак инфекцияларида кўп учраб турадиган кўнгил айнишларида ҳам оз-оздан ичиш имконини беради.\r\n<h2>Қандай қилиб ичак инфекцияларининг олдини олиш мумкин?</h2>\r\nИчак инфекцияларининг олдини олишнинг асосий чоралари  қўлларни тез-тез ювиб туриш ва умуман гигиенага яхши риоя қилиш ҳисобланади. Кичик ёшдаги болаларда эмизиш ичак инфекциялари учрашини ва шифохонага ётиш сонини пасайтиради. Сабзавот ва меваларни истеъмол қилишдан олдин яхшилаб ювиш; хом гўшт, балиқ ва денгиз маҳсулотларини истеъмол қилмаслик зарур. Бундан ташқари, сифатли ичимлик сувини ичиш ҳам муҳим аҳамиятга эга.\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Ичак инфекцияларида сувсизланиш','','inherit','closed','closed','','1525-revision-v1','','','2021-08-27 17:53:28','2021-08-27 14:53:28','',1525,'https://reo.ua/?p=1529',0,'revision','',0),(1530,1,'2021-06-24 13:21:35','2021-06-24 10:21:35','','infograph-2','','inherit','open','closed','','infograph-2','','','2021-06-24 13:21:35','2021-06-24 10:21:35','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-2.jpg',0,'attachment','image/jpeg',0),(1531,1,'2021-07-06 17:37:50','2021-07-06 14:37:50','','Web_REO_T1_1','','inherit','open','closed','','web_reo_t1_1','','','2021-07-06 17:37:50','2021-07-06 14:37:50','',1525,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t1_1.png',0,'attachment','image/png',0),(1532,1,'2021-06-25 17:35:03','2021-06-25 14:35:03','','infograph-1-ru','','inherit','open','closed','','infograph-1-ru','','','2021-06-25 17:35:03','2021-06-25 14:35:03','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ru.jpg',0,'attachment','image/jpeg',0),(1533,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-1-ua','','inherit','open','closed','','infograph-1-ua','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-1-ua.jpg',0,'attachment','image/jpeg',0),(1534,1,'2021-06-25 17:35:04','2021-06-25 14:35:04','','infograph-2-ru','','inherit','open','closed','','infograph-2-ru','','','2021-06-25 17:35:04','2021-06-25 14:35:04','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ru.jpg',0,'attachment','image/jpeg',0),(1535,1,'2021-06-25 17:35:06','2021-06-25 14:35:06','','infograph-2-ua','','inherit','open','closed','','infograph-2-ua','','','2021-06-25 17:35:06','2021-06-25 14:35:06','',1525,'https://reo.ua/wp-content/uploads/2021/06/infograph-2-ua.jpg',0,'attachment','image/jpeg',0),(1536,1,'2021-06-29 11:59:21','2021-06-29 08:59:21','Инсон танасининг ички ҳарорати ҳар доим барқарор бўлади, шунинг учун атроф-муҳит ҳарорати ошиб кетганида организм салқинликни талаб қилади. Биринчи навбатда бу қон томирларининг кенгайиши ва тери юзасига қон оқиб келишининг ошиши ҳисобига амалга ошади.  Тернинг буғланиши ҳам терини совитади, лекин ҳаддан ортиқ тер ажралиб чиқиши дегидратацияга олиб келиши мумкин.\r\n\r\nАгар сиз очиқ ҳавода ишласангиз ёки спорт билан шуғуллансангиз сувсизланиш хавфи кўпроқ бўлади. Агар ўз вақтида суюқлик захирасини тўлдирмасангиз, дегидратация ва атроф-муҳитнинг юқори ҳарорати ҳатто инсон ҳаётига хавф солиши мумкин бўладиган иссиқлик уришига олиб келиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg\"><img class=\"aligncenter wp-image-1709 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1-1024x730.jpg\" alt=\"\" width=\"1024\" height=\"730\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Иссиқ ва иссиқлик уришининг белгилари ва симптомлари</strong></p>\r\n&nbsp;\r\n<h2>Иссиқдан зарарланишда нима қилиш керак?</h2>\r\nАгар иссиқ жойда қолишда давом этсангиз иссиқдан зарарланиш ҳаёт ва саломатлик учун хавфли бўлган иссиқ уришига ўтиб кетиши мумкин, шунинг учун қуйидаги тарзда ҳаракат қилиш зарур:\r\n<ul>\r\n 	<li>салқин, соя жойга ўтинг;</li>\r\n 	<li>танангизни совуқ сув билан артинг ва елпиғич билан елпининг;</li>\r\n 	<li>қўлтиқ ости ва чов соҳаларига музли компресс қўйинг;</li>\r\n 	<li>салқин жойга ётинг ва оёқларингизни бир оз кўтаринг;</li>\r\n 	<li>сувсизланишни олдини олиш учун сув ичинг.</li>\r\n</ul>\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nАгар сиз иссиқлик уришининг ҳеч бўлмаганда битта белгисини (тананинг 40 °С дан юқори ҳарорати, терсиз қизил иссиқ қуруқ тери, томирнинг тез кучли уриши, бошнинг тўхтаб-тўхтаб оғриши, қусиш, онгнинг чалкашиши) сезсангиз, дарҳол врачга мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nСуюқлик ва тузлар-электролитларнинг меъёридаги мувозанати бузилганида уни тиклашдан кўра бу мувозанатни сақлаб туриш осонроқ. Шунинг учун чанқоқ ҳис қилишни кутиб ўтирмай, сув ичиб туриш керак. АҚШ Тиббиёт институтининг маълумотларига кўра аёллар бир кунда камида 9 стакан, эркаклар эса 13 стакан сув ичиб туришлари зарур.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\"><img class=\"aligncenter size-full wp-image-1712\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\" alt=\"\" width=\"945\" height=\"459\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Нима ичиш зарур?</h2>\r\nЖисмоний юкланишларда иссиқда соатига 1-2,5 литр тер йўқотилади, бир литр тер таркибидаги натрий эса 100-700 мг ни ташкил этади. Натрийнинг сезиларли танқислиги аҳволни анча ёмонлаштиради ва ҳатто талваса ва онгнинг бузилишига олиб келади. Оддий сув тер ва сийдик билан йўқотилган электролитларнинг ўрнини боса олмайди, шунинг учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган ичимликларни ичиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви сувсизланишнинг олдини олиш ва бартараф этишда ичиш учун тайёр эритма ҳисобланади. ReO суви – бу кам минераллашган сув бўлиб, таркибида барча зарур электролитлар (натрий, калий, магний, кальций) ва сорбитол – ҳужайралар осон ўзлаштирадиган энергиянинг қўшимча манбаи мавжуд. Ёқимли таъми туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам ичиш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"161\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Карбонат кислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минераллашиши (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Иссиқдан зарарланишда нима учун ReO сувини танлаш зарур?</h2>\r\n<ul>\r\n 	<li>ReO мувозанатлаштирилган сув-электролит таркибига эга;</li>\r\n 	<li>ReO сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>ReO таркибида консервантлар, углеводлар ва бўёвчи моддалар йўқ;</li>\r\n 	<li>ReO ёқимли таъмга эга, уни ҳатто кўнгил айниб турганда ҳам ичиш осон.</li>\r\n</ul>\r\n<h2>Иссиқда сувсизланишнинг олдини қандай олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Сувсизланиш ва чанқоқ ҳиссини кутманг. Олдиндан ҳаракат қилинг: ҳар қандай иш ёки бошқа бир жисмоний фаоллик олдидан, шунингдек очиқ жойда бўлишдан олдин сув ичинг.</li>\r\n 	<li>Энг иссиқ соатларда қуёшда бўлишдан сақланинг. Агар бу жуда зарур бўлса, енгил ёпиқ кийим кийинг, қуёшдан ҳимоя кўзойнакларини тақинг, бош кийим кийинг ва қуёшдан ҳимоялаш воситаларидан фойдаланинг.</li>\r\n 	<li>Сув ичиш учун доимий танаффусларни режалаштиринг ва ҳар доим ёнингизда бир бутилка сув олиб юринг.</li>\r\n 	<li>Нафақат сув захирасини, балки тузлар захирасини ҳам тўлдирадиган мувозанатлаштирилган ичимликларни афзал кўринг.</li>\r\n 	<li>Тамадди қилиб олиш учун сувга бой янги мевалар ва сабзавотларни (резавор мевалар, тарвуз, шафтоли, нектаринлар, грейпфрутлар, бодринглар, помидорлар ва ширин қалампир) танланг.</li>\r\n 	<li>Сийдикнинг рангига эътибор беринг. Сийдик ранги тўқ бўлганида ичиладиган суюқлик ҳажмини оширинг.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\"><img class=\"aligncenter size-full wp-image-1715\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\" alt=\"\" width=\"950\" height=\"240\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Қандай қилиб иссиқлик уришининг олдини олиш мумкин?</strong></p>\r\n&nbsp;\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Ёзги иссиқда қандай қилиб иссиқлик уриши ва сувсизланишнинг олдини олиш мумкин?','','publish','open','open','','yozgi-issi%d2%9bda-%d2%9bandaj-%d2%9bilib-issi%d2%9blik-urishi-va-suvsizlanishning-oldini-olish-mumkin','','','2021-08-31 13:19:49','2021-08-31 10:19:49','',0,'https://reo.ua/uncategorized-uz/kak-predupredit-teplovoj-udar-i-obezvozhivanie-v-letnyuyu-zharu/',18,'post','',0),(1537,1,'2021-06-29 11:56:02','2021-06-29 08:56:02','','infograph30','','inherit','open','closed','','infograph30-2-2','','','2021-06-29 11:56:02','2021-06-29 08:56:02','',1536,'https://reo.ua/wp-content/uploads/2021/06/infograph30.jpg',0,'attachment','image/jpeg',0),(1538,1,'2021-07-07 12:03:21','2021-07-07 09:03:21','','Как предупредить тепловой удар','','inherit','open','closed','','kak-predupredit-teplovoj-udar-2-2','','','2021-07-07 12:03:21','2021-07-07 09:03:21','',1536,'https://reo.ua/wp-content/uploads/2021/06/kak-predupredit-teplovoj-udar.jpg',0,'attachment','image/jpeg',0),(1540,1,'2021-08-28 13:44:29','2021-08-28 10:44:29','Инсон танасининг ички ҳарорати ҳар доим барқарор бўлади, шунинг учун атроф-муҳит ҳарорати ошиб кетганида организм салқинликни талаб қилади. Биринчи навбатда бу қон томирларининг кенгайиши ва тери юзасига қон оқиб келишининг ошиши ҳисобига амалга ошади.  Тернинг буғланиши ҳам терини совитади, лекин ҳаддан ортиқ тер ажралиб чиқиши дегидратацияга олиб келиши мумкин.\r\n\r\nАгар сиз очиқ ҳавода ишласангиз ёки спорт билан шуғуллансангиз сувсизланиш хавфи кўпроқ бўлади. Агар ўз вақтида суюқлик захирасини тўлдирмасангиз, дегидратация ва атроф-муҳитнинг юқори ҳарорати ҳатто инсон ҳаётига хавф солиши мумкин бўладиган иссиқлик уришига олиб келиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4.png\"><img class=\"aligncenter size-large wp-image-890\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t7-speka_4-1024x720.png\" alt=\"\" width=\"1024\" height=\"720\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Иссиқ ва иссиқлик уришининг белгилари ва симптомлари</strong></p>\r\n&nbsp;\r\n<h2>Иссиқдан зарарланишда нима қилиш керак?</h2>\r\nАгар иссиқ жойда қолишда давом этсангиз иссиқдан зарарланиш ҳаёт ва саломатлик учун хавфли бўлган иссиқ уришига ўтиб кетиши мумкин, шунинг учун қуйидаги тарзда ҳаракат қилиш зарур:\r\n<ul>\r\n 	<li>салқин, соя жойга ўтинг;</li>\r\n 	<li>танангизни совуқ сув билан артинг ва елпиғич билан елпининг;</li>\r\n 	<li>қўлтиқ ости ва чов соҳаларига музли компресс қўйинг;</li>\r\n 	<li>салқин жойга ётинг ва оёқларингизни бир оз кўтаринг;</li>\r\n 	<li>сувсизланишни олдини олиш учун сув ичинг.</li>\r\n</ul>\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nАгар сиз иссиқлик уришининг ҳеч бўлмаганда битта белгисини (тананинг 40 °С дан юқори ҳарорати, терсиз қизил иссиқ қуруқ тери, томирнинг тез кучли уриши, бошнинг тўхтаб-тўхтаб оғриши, қусиш, онгнинг чалкашиши) сезсангиз, дарҳол врачга мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nСуюқлик ва тузлар-электролитларнинг меъёридаги мувозанати бузилганида уни тиклашдан кўра бу мувозанатни сақлаб туриш осонроқ. Шунинг учун чанқоқ ҳис қилишни кутиб ўтирмай, сув ичиб туриш керак. АҚШ Тиббиёт институтининг маълумотларига кўра аёллар бир кунда камида 9 стакан, эркаклар эса 13 стакан сув ичиб туришлари зарур.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\"><img class=\"aligncenter size-full wp-image-703\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-62-ru.jpg\" alt=\"\" width=\"967\" height=\"456\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Нима ичиш зарур?</h2>\r\nЖисмоний юкланишларда иссиқда соатига 1-2,5 литр тер йўқотилади, бир литр тер таркибидаги натрий эса 100-700 мг ни ташкил этади. Натрийнинг сезиларли танқислиги аҳволни анча ёмонлаштиради ва ҳатто талваса ва онгнинг бузилишига олиб келади. Оддий сув тер ва сийдик билан йўқотилган электролитларнинг ўрнини боса олмайди, шунинг учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган ичимликларни ичиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви сувсизланишнинг олдини олиш ва бартараф этишда ичиш учун тайёр эритма ҳисобланади. ReO суви – бу кам минераллашган сув бўлиб, таркибида барча зарур электролитлар (натрий, калий, магний, кальций) ва сорбитол – ҳужайралар осон ўзлаштирадиган энергиянинг қўшимча манбаи мавжуд. Ёқимли таъми туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам ичиш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"161\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Карбонат кислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минераллашиши (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Иссиқдан зарарланишда нима учун ReO сувини танлаш зарур?</h2>\r\n<ul>\r\n 	<li>ReO мувозанатлаштирилган сув-электролит таркибига эга;</li>\r\n 	<li>ReO сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>ReO таркибида консервантлар, углеводлар ва бўёвчи моддалар йўқ;</li>\r\n 	<li>ReO ёқимли таъмга эга, уни ҳатто кўнгил айниб турганда ҳам ичиш осон.</li>\r\n</ul>\r\n<h2>Иссиқда сувсизланишнинг олдини қандай олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Сувсизланиш ва чанқоқ ҳиссини кутманг. Олдиндан ҳаракат қилинг: ҳар қандай иш ёки бошқа бир жисмоний фаоллик олдидан, шунингдек очиқ жойда бўлишдан олдин сув ичинг.</li>\r\n 	<li>Энг иссиқ соатларда қуёшда бўлишдан сақланинг. Агар бу жуда зарур бўлса, енгил ёпиқ кийим кийинг, қуёшдан ҳимоя кўзойнакларини тақинг, бош кийим кийинг ва қуёшдан ҳимоялаш воситаларидан фойдаланинг.</li>\r\n 	<li>Сув ичиш учун доимий танаффусларни режалаштиринг ва ҳар доим ёнингизда бир бутилка сув олиб юринг.</li>\r\n 	<li>Нафақат сув захирасини, балки тузлар захирасини ҳам тўлдирадиган мувозанатлаштирилган ичимликларни афзал кўринг.</li>\r\n 	<li>Тамадди қилиб олиш учун сувга бой янги мевалар ва сабзавотларни (резавор мевалар, тарвуз, шафтоли, нектаринлар, грейпфрутлар, бодринглар, помидорлар ва ширин қалампир) танланг.</li>\r\n 	<li>Сийдикнинг рангига эътибор беринг. Сийдик ранги тўқ бўлганида ичиладиган суюқлик ҳажмини оширинг.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\"><img class=\"aligncenter size-full wp-image-707\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-63-ru.jpg\" alt=\"\" width=\"970\" height=\"237\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Қандай қилиб иссиқлик уришининг олдини олиш мумкин?</strong></p>\r\n&nbsp;\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Ёзги иссиқда қандай қилиб иссиқлик уриши ва сувсизланишнинг олдини олиш мумкин?','','inherit','closed','closed','','1536-revision-v1','','','2021-08-28 13:44:29','2021-08-28 10:44:29','',1536,'https://reo.ua/?p=1540',0,'revision','',0),(1541,1,'2021-06-29 11:56:47','2021-06-29 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11:47:39','',1403,'https://reo.ua/?p=1563',0,'revision','',0),(1564,1,'2021-08-28 14:49:01','2021-08-28 11:49:01','','Ишлаб чиқарувчи','','inherit','closed','closed','','1403-revision-v1','','','2021-08-28 14:49:01','2021-08-28 11:49:01','',1403,'https://reo.ua/?p=1564',0,'revision','',0),(1565,1,'2021-08-28 14:51:02','2021-08-28 11:51:02','','Ишлаб чиқарувчи','','inherit','closed','closed','','1403-revision-v1','','','2021-08-28 14:51:02','2021-08-28 11:51:02','',1403,'https://reo.ua/?p=1565',0,'revision','',0),(1566,1,'2021-07-16 17:11:50','2021-07-16 14:11:50','Кўнгил айниши ва қайт қилиш – кенг тарқалган муаммо бўлиб, унга 50-80% аёл ҳомиладорликнинг биринчи триместрида у ёки бу даражада дуч келади.\r\n\r\nТоксикоз белгилари ҳомиладорликнинг 8-12 ҳафтасида пайдо бўлади, 16-18 ҳафтасида эса, одатда, камаяди ёки умуман йўқолади.\r\n\r\nАксарият ҳолларда бу белгилар ҳомиладорликнинг кечишига таъсир қилмайди ва физиологик ҳолат сифатида қаралади.\r\n\r\nЛекин бундай ҳолатларнинг мавжудлиги, ҳатто улар унчалик кучли намоён бўлмаса ҳам, ҳомиладорнинг ҳаёт сифатини анча ёмонлаштиради: чарчоқлик, ҳолсизлик ошади, уйқунинг бузилиши юз беради, иштаҳа пасаяди ва ҳ. (Ушкалова Е. ва ҳаммуллифлар, 2011; Ребров Б. А. ва ҳаммуаллифлар, 2010).\r\n\r\nБундан ташқари, токсикозда қайт қилиш сув ва микроэлементлар танқислигига олиб келиши мумкин, ҳомиладорликда эса уларга эҳтиёж янада ошган бўлади  (Давыдова Ю. В. ва ҳаммуллифлар, 2014).\r\n\r\nБундай ҳолларда “ёрдамчи” –организмни регидратация ва дезинтоксикациялаш учун «Юрия-Фарм» фармацетика корпорациясининг ReO махсус суви  қутқаради.\r\n<h2>Ҳаёт фаолиятини сақлашда сувнинг ўрни жуда катта</h2>\r\nСув билан боғлиқ ҳаётий муҳим жараёнлар – кимёвий, физик, ферментатив жараёнлар бунинг тасдиғи бўлиб хизмат қилади.\r\n\r\nҚизиқ, одам қанчалик ёш бўлса, унинг сувга бўлган эҳтиёжи шунчалик кўп ва организмдаги сув миқдори ҳам шунчалик юқори бўлади. Масалан, чақалоқларда тана вазнининг 80% дан ортиғини суюқлик ташкил этади. Катталарда бу кўрсаткич пасайишни бошлайди, лекин барибир сув миқдори тахминан 60% ни (кекса ёшдагиларда 45% дан ёш эркакларда 70% гача) ташкил қилади.\r\n\r\nШуни қайд қилиш муҳимки, қайт қилиш, сувни кам ичиш ва ҳоказо сабабли юзага келган сувсизланишда одам минерал тузларни ҳам йўқотади, бу эса организмнинг барча суюқлик тизимларида электролит дисбалансининг сабабчиси бўлади.\r\n\r\nОрганизм сув билан бирга кўп миқдорда <strong>Na, Cl, K, Mg, Са</strong> ионларини йўқотади.\r\n\r\nОдам организми ўзи мустақил минерал ва бошқа ионларни синтез қила олмаслиги сабабли, улар организмга овқат ва сув билан тушиши зарур (Ершова И. Б. ва ҳаммуаллифлар, 2012; Корягина Ю. В. ва ҳаммуаллифлар, 2018).\r\n\r\nГап ҳомиладорлар тўғрисида кетганида, шуни ҳисобга олиш керакки, гестозда кўпинча кетон таначалари шаклланиши кузатилади, афсуски бу лаборатор равишда кеч аниқланади. Шунинг учун регидратация, кўнгил айниши ва қайт қилишни камайтириш ва аёлни нормал овқатланишга қайтариш орқали кетон таначалари шаклланишининг олдини олишга алоҳида эътибор қаратиш зарур (Кучук Д. О. ва ҳамммуаллифлар, 2018).\r\n\r\nБу ҳолатда организмнинг регидратацияси ва дезинтоксикацияси учун «Юрия-Фарм»  фармацевтика корпорациясининг ReO махсус суви фойда беради. У қуйидагилар учун махсус ишлаб чиқилган:\r\n<ul>\r\n 	<li>сув ва электролитларнинг максимал равишда тез сўрилиши учун;</li>\r\n 	<li>дегидратация белгиларини (чарчоқ, бош оғриғи, тери ва шиллиқ қаватларнинг қуруқлиги) бартараф этиш учун;</li>\r\n 	<li>сувсизланишни олдини олиш, диурезни нормаллаштириш ва интоксикацияни камайтириш учун.</li>\r\n</ul>\r\n<h2>ReO – оддий сув етарли бўлмаганда.</h2>\r\nСув – организмдаги биологик суюқликларнинг асоси, шунинг учун ҳам истеъмол қилинаётган сув таркибининг ўзгариши организм биологик суюқликлари таркиби ва хусусиятларининг ўзгаришига олиб келади.\r\n\r\nТиббий мақсадлар учун мўлжалланган ReO суви мувозанатлаштирилган сув-туз таркибига эга бўлиб, таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Жадвал. Организмни регидратация ва дезинтоксикацияси учун ReO махсус сувининг таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO нинг кимёвий таркиби ўз ичига қуйидагиларни олади:</h2>\r\n<ul>\r\n 	<li>Натрий – организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. У организмнинг ҳужайрадан ташқаридаги осмотик босимини сақлаб, сувни тутиб туради</li>\r\n 	<li>Калий, натрийдан фарқли ўлароқ, ҳужайра ичи катиони ҳисобланади, ҳужайра ичида организм суюқликларининг осмотик босимини сақлаб туради. Эритроцитларда калий натрийга нисбатан 10,5 маротаба кўп, қон плазмасида эса, аксинча, натрий  калийга нисбатан 30 маротаба кўп. Юракнинг иши, унинг ритми, шунингдек асаб-мушак фаолияти ҳам калийга боғлиқ. У шишларни камайтиради ва чарчоқни пасайтиради.</li>\r\n 	<li>Хлор – макроэлемент, у натрий ва калий билан биргаликда сув-туз мувозанатини бошқаради, организмдаги биологик фаол бирикмалар таркибига киради, қон, лимфа,  орқа мия ва бошқа суюқликларда осмотик босимни меъёрига келтиради. Ва яна хлор иштаҳани рағбатлантиради,  жигар функциясини яхшилайди ва организмдан шлаклар ва токсинларнинг чиқарилишига ёрдам беради.</li>\r\n 	<li>Кальций – нафақат суяк тўқимасининг асоси. У ҳаракат функцияларини (мушакларнинг қисқариши, нерв импульсларининг узатилиши, асаб қўзғалишларига мушаклар реакцияси) таъминлашда, шунингдек гормонлар фаоллигининг ўзгаришида, юрак қисқаришларининг ритмини бошқаришда фаол иштирок этади. Кальций юрак уриш сонини камайтиради, артериал босимни меъёрлаштиради ва стрессга қаршилик кўрсатади.</li>\r\n 	<li>Магний ҳам одам организмида муҳим роль ўйнайди: у кальций, С витамини, фосфор, натрий ва калий алмашинуви учун зарур. Магний углеводларнинг парчаланиш жараёни (гликолиз) да, натрий, калий, кальций ионларини ҳужайра мембраналари орқали ташишда, импульсларни нерв-мушакларга узатишда иштирок этади, глюкозанинг энергияга айланиши учун муҳим.  Ўзининг жуда кичик ўлчамлари туфайли магний ионлари таркибида кислород бўлган барча органик молекулалар билан, уларни ўзаро бириктириб, ион-ковалент алоқага киришади. Магнийнинг йўқотилиши молекуляр гуруҳлар, масалан оқсил молекулалари синтез қилинадиган рибосомаларнинг парчаланишига  олиб келиши мумкин.</li>\r\n 	<li>Гидрокарбонат организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.</li>\r\n 	<li>Сорбитол – олти атомли спирт бўлиб, ўзига хос ширин таъмга эга.</li>\r\n</ul>\r\nҲомиладорларда кўпинча қабзият каби муаммонинг  қайд этилишини ҳисобга олган ҳолда сорбитолнинг ичак микрофлорасига тикловчи таъсири мақсадга мувофиқдир. Бунинг устига сорбитол аёлга унга жуда зарур бўлган  энергияни беради (Белоконова Н. А. ва ҳаммуаллифлар, 2016; Лысиков Ю. А., 2009; Ершова И. Б. ва ҳаммуаллифлар, 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nШундай таркибга эгалиги туфайли ReO токсикоз симптомларини камайтиришга ёрдам беради, сувсизланишнинг олдини олади, организмдан токсинларни (заҳарли моддалар) чиқаради, бу эса ҳомиладорнинг соғайишини тезлаштиради, кайфиятини яхшилайди, қайт қилишни ва сийдикдаги ацетон даражасини камайтиради.\r\n\r\n<strong>Регидратация ва дезинтоксикация учун ReO махсус сувининг муҳим афзаллиги – унинг жуда яхши таъм сифатлари:</strong>\r\n<ul>\r\n 	<li>нимшўр ёқимли таъмга эга;</li>\r\n 	<li>осон ичилади;</li>\r\n 	<li>ҳатто кўнгил айнишида ҳам ичиш мумкин.</li>\r\n 	<li></li>\r\n</ul>\r\nReO сингари “ёрдамчи”нинг  ҳақиқатан ҳам ҳомиладорларга фойдаси тегади ва у токсикознинг “нохуш” симптомларини енгишга  ёрдам беради.','Токсикознинг “нохуш” белгиларини қандай енгиш мумкин?','','publish','open','open','','toksikozning-nohush-belgilarini-%d2%9bandaj-engish-mumkin','','','2021-08-28 15:26:25','2021-08-28 12:26:25','',0,'https://reo.ua/uncategorized-uz/kak-spravitsya-s-nepriyatnymi-simptomami-toksikoza/',6,'post','',0),(1567,1,'2021-07-16 17:11:43','2021-07-16 14:11:43','','Як впоратися з неприємними симптомами токсикозу','','inherit','open','closed','','yak-vporatisya-z-nepri%d1%94mnimi-simptomami-toksikozu-2-2','','','2021-07-16 17:11:43','2021-07-16 14:11:43','',1566,'https://reo.ua/wp-content/uploads/2021/07/yak-vporatisya-z-nepriєmnimi-simptomami-toksikozu.pdf',0,'attachment','application/pdf',0),(1568,1,'2021-07-16 17:14:38','2021-07-16 14:14:38','','prew','','inherit','open','closed','','prew-3-2-2','','','2021-07-16 17:14:38','2021-07-16 14:14:38','',1566,'https://reo.ua/wp-content/uploads/2021/07/prew-1.png',0,'attachment','image/png',0),(1569,1,'2021-08-30 11:35:28','2021-08-30 08:35:28','Кўнгил айниши ва қайт қилиш – кенг тарқалган муаммо бўлиб, унга 50-80% аёл ҳомиладорликнинг биринчи триместрида у ёки бу даражада дуч келади.\n\nТоксикоз белгилари ҳомиладорликнинг 8-12 ҳафтасида пайдо бўлади, 16-18 ҳафтасида эса, одатда, камаяди ёки умуман йўқолади.\n\nАксарият ҳолларда бу белгилар ҳомиладорликнинг кечишига таъсир қилмайди ва физиологик ҳолат сифатида қаралади.\n\nЛекин бундай ҳолатларнинг мавжудлиги, ҳатто улар унчалик кучли намоён бўлмаса ҳам, ҳомиладорнинг ҳаёт сифатини анча ёмонлаштиради: чарчоқлик, ҳолсизлик ошади, уйқунинг бузилиши юз беради, иштаҳа пасаяди ва ҳ. (Ушкалова Е. ва ҳаммуллифлар, 2011; Ребров Б. А. ва ҳаммуаллифлар, 2010).\n\nБундан ташқари, токсикозда қайт қилиш сув ва микроэлементлар танқислигига олиб келиши мумкин, ҳомиладорликда эса уларга эҳтиёж янада ошган бўлади  (Давыдова Ю. В. ва ҳаммуллифлар, 2014).\n\nБундай ҳолларда “ёрдамчи” –организмни регидратация ва дезинтоксикациялаш учун «Юрия-Фарм» фармацетика корпорациясининг ReO махсус суви  қутқаради.\n<h2>Ҳаёт фаолиятини сақлашда сувнинг ўрни жуда катта</h2>\nСув билан боғлиқ ҳаётий муҳим жараёнлар – кимёвий, физик, ферментатив жараёнлар бунинг тасдиғи бўлиб хизмат қилади.\n\nҚизиқ, одам қанчалик ёш бўлса, унинг сувга бўлган эҳтиёжи шунчалик кўп ва организмдаги сув миқдори ҳам шунчалик юқори бўлади. Масалан, чақалоқларда тана вазнининг 80% дан ортиғини суюқлик ташкил этади. Катталарда бу кўрсаткич пасайишни бошлайди, лекин барибир сув миқдори тахминан 60% ни (кекса ёшдагиларда 45% дан ёш эркакларда 70% гача) ташкил қилади.\n\nШуни қайд қилиш муҳимки, қайт қилиш, сувни кам ичиш ва ҳоказо сабабли юзага келган сувсизланишда одам минерал тузларни ҳам йўқотади, бу эса организмнинг барча суюқлик тизимларида электролит дисбалансининг сабабчиси бўлади.\n\nОрганизм сув билан бирга кўп миқдорда <strong>Na, Cl, K, Mg, Са</strong> ионларини йўқотади.\n\nОдам организми ўзи мустақил минерал ва бошқа ионларни синтез қила олмаслиги сабабли, улар организмга овқат ва сув билан тушиши зарур (Ершова И. Б. ва ҳаммуаллифлар, 2012; Корягина Ю. В. ва ҳаммуаллифлар, 2018).\n\nГап ҳомиладорлар тўғрисида кетганида, шуни ҳисобга олиш керакки, гестозда кўпинча кетон таначалари шаклланиши кузатилади, афсуски бу лаборатор равишда кеч аниқланади. Шунинг учун регидратация, кўнгил айниши ва қайт қилишни камайтириш ва аёлни нормал овқатланишга қайтариш орқали кетон таначалари шаклланишининг олдини олишга алоҳида эътибор қаратиш зарур (Кучук Д. О. ва ҳамммуаллифлар, 2018).\n\nБу ҳолатда организмнинг регидратацияси ва дезинтоксикацияси учун «Юрия-Фарм»  фармацевтика корпорациясининг ReO махсус суви фойда беради. У қуйидагилар учун махсус ишлаб чиқилган:\n<ul>\n 	<li>сув ва электролитларнинг максимал равишда тез сўрилиши учун;</li>\n 	<li>дегидратация белгиларини (чарчоқ, бош оғриғи, тери ва шиллиқ қаватларнинг қуруқлиги) бартараф этиш учун;</li>\n 	<li>сувсизланишни олдини олиш, диурезни нормаллаштириш ва интоксикацияни камайтириш учун.</li>\n</ul>\n<h2>ReO – оддий сув етарли бўлмаганда.</h2>\nСув – организмдаги биологик суюқликларнинг асоси, шунинг учун ҳам истеъмол қилинаётган сув таркибининг ўзгариши организм биологик суюқликлари таркиби ва хусусиятларининг ўзгаришига олиб келади.\n\nТиббий мақсадлар учун мўлжалланган ReO суви мувозанатлаштирилган сув-туз таркибига эга бўлиб, таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Жадвал. Организмни регидратация ва дезинтоксикацияси учун ReO махсус сувининг таркиби</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Таркиби</strong></th>\n<th width=\"151\"><strong>Миқдори</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>ReO нинг кимёвий таркиби ўз ичига қуйидагиларни олади:</h2>\n<ul>\n 	<li>Натрий – организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. У организмнинг ҳужайрадан ташқаридаги осмотик босимини сақлаб, сувни тутиб туради</li>\n 	<li>Калий, натрийдан фарқли ўлароқ, ҳужайра ичи катиони ҳисобланади, ҳужайра ичида организм суюқликларининг осмотик босимини сақлаб туради. Эритроцитларда калий натрийга нисбатан 10,5 маротаба кўп, қон плазмасида эса, аксинча, натрий  калийга нисбатан 30 маротаба кўп. Юракнинг иши, унинг ритми, шунингдек асаб-мушак фаолияти ҳам калийга боғлиқ. У шишларни камайтиради ва чарчоқни пасайтиради.</li>\n 	<li>Хлор – макроэлемент, у натрий ва калий билан биргаликда сув-туз мувозанатини бошқаради, организмдаги биологик фаол бирикмалар таркибига киради, қон, лимфа,  орқа мия ва бошқа суюқликларда осмотик босимни меъёрига келтиради. Ва яна хлор иштаҳани рағбатлантиради,  жигар функциясини яхшилайди ва организмдан шлаклар ва токсинларнинг чиқарилишига ёрдам беради.</li>\n 	<li>Кальций – нафақат суяк тўқимасининг асоси. У ҳаракат функцияларини (мушакларнинг қисқариши, нерв импульсларининг узатилиши, асаб қўзғалишларига мушаклар реакцияси) таъминлашда, шунингдек гормонлар фаоллигининг ўзгаришида, юрак қисқаришларининг ритмини бошқаришда фаол иштирок этади. Кальций юрак уриш сонини камайтиради, артериал босимни меъёрлаштиради ва стрессга қаршилик кўрсатади.</li>\n 	<li>Магний ҳам одам организмида муҳим роль ўйнайди: у кальций, С витамини, фосфор, натрий ва калий алмашинуви учун зарур. Магний углеводларнинг парчаланиш жараёни (гликолиз) да, натрий, калий, кальций ионларини ҳужайра мембраналари орқали ташишда, импульсларни нерв-мушакларга узатишда иштирок этади, глюкозанинг энергияга айланиши учун муҳим.  Ўзининг жуда кичик ўлчамлари туфайли магний ионлари таркибида кислород бўлган барча органик молекулалар билан, уларни ўзаро бириктириб, ион-ковалент алоқага киришади. Магнийнинг йўқотилиши молекуляр гуруҳлар, масалан оқсил молекулалари синтез қилинадиган рибосомаларнинг парчаланишига  олиб келиши мумкин.</li>\n 	<li>Гидрокарбонат организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.</li>\n 	<li>Сорбитол – олти атомли спирт бўлиб, ўзига хос ширин таъмга эга.</li>\n</ul>\nҲомиладорларда кўпинча қабзият каби муаммонинг  қайд этилишини ҳисобга олган ҳолда сорбитолнинг ичак микрофлорасига тикловчи таъсири мақсадга мувофиқдир. Бунинг устига сорбитол аёлга унга жуда зарур бўлган  энергияни беради (Белоконова Н. А. ва ҳаммуаллифлар, 2016; Лысиков Ю. А., 2009; Ершова И. Б. ва ҳаммуаллифлар, 2012; Егорова И. А., Комарова С. Г., 2015).\n\nШундай таркибга эгалиги туфайли ReO токсикоз симптомларини камайтиришга ёрдам беради, сувсизланишнинг олдини олади, организмдан токсинларни (заҳарли моддалар) чиқаради, бу эса ҳомиладорнинг соғайишини тезлаштиради, кайфиятини яхшилайди, қайт қилишни ва сийдикдаги ацетон даражасини камайтиради.\n\n<strong>Регидратация ва дезинтоксикация учун ReO махсус сувининг муҳим афзаллиги – унинг жуда яхши таъм сифатлари:</strong>\n<ul>\n 	<li>нимшўр ёқимли таъмга эга;</li>\n 	<li>осон ичилади;</li>\n 	<li>ҳатто кўнгил айнишида ҳам ичиш мумкин.</li>\n 	<li></li>\n</ul>\nReO сингари “ёрдамчи”нинг  ҳақиқатан ҳам ҳомиладорларга фойдаси тегади ва у токсикознинг “нохуш” симптомларини енгишга  ёрдам беради.','Токсикознинг “нохуш” белгиларини қандай енгиш мумкин?','','inherit','closed','closed','','1566-autosave-v1','','','2021-08-30 11:35:28','2021-08-30 08:35:28','',1566,'https://reo.ua/?p=1569',0,'revision','',0),(1570,1,'2021-08-28 15:26:25','2021-08-28 12:26:25','Кўнгил айниши ва қайт қилиш – кенг тарқалган муаммо бўлиб, унга 50-80% аёл ҳомиладорликнинг биринчи триместрида у ёки бу даражада дуч келади.\r\n\r\nТоксикоз белгилари ҳомиладорликнинг 8-12 ҳафтасида пайдо бўлади, 16-18 ҳафтасида эса, одатда, камаяди ёки умуман йўқолади.\r\n\r\nАксарият ҳолларда бу белгилар ҳомиладорликнинг кечишига таъсир қилмайди ва физиологик ҳолат сифатида қаралади.\r\n\r\nЛекин бундай ҳолатларнинг мавжудлиги, ҳатто улар унчалик кучли намоён бўлмаса ҳам, ҳомиладорнинг ҳаёт сифатини анча ёмонлаштиради: чарчоқлик, ҳолсизлик ошади, уйқунинг бузилиши юз беради, иштаҳа пасаяди ва ҳ. (Ушкалова Е. ва ҳаммуллифлар, 2011; Ребров Б. А. ва ҳаммуаллифлар, 2010).\r\n\r\nБундан ташқари, токсикозда қайт қилиш сув ва микроэлементлар танқислигига олиб келиши мумкин, ҳомиладорликда эса уларга эҳтиёж янада ошган бўлади  (Давыдова Ю. В. ва ҳаммуллифлар, 2014).\r\n\r\nБундай ҳолларда “ёрдамчи” –организмни регидратация ва дезинтоксикациялаш учун «Юрия-Фарм» фармацетика корпорациясининг ReO махсус суви  қутқаради.\r\n<h2>Ҳаёт фаолиятини сақлашда сувнинг ўрни жуда катта</h2>\r\nСув билан боғлиқ ҳаётий муҳим жараёнлар – кимёвий, физик, ферментатив жараёнлар бунинг тасдиғи бўлиб хизмат қилади.\r\n\r\nҚизиқ, одам қанчалик ёш бўлса, унинг сувга бўлган эҳтиёжи шунчалик кўп ва организмдаги сув миқдори ҳам шунчалик юқори бўлади. Масалан, чақалоқларда тана вазнининг 80% дан ортиғини суюқлик ташкил этади. Катталарда бу кўрсаткич пасайишни бошлайди, лекин барибир сув миқдори тахминан 60% ни (кекса ёшдагиларда 45% дан ёш эркакларда 70% гача) ташкил қилади.\r\n\r\nШуни қайд қилиш муҳимки, қайт қилиш, сувни кам ичиш ва ҳоказо сабабли юзага келган сувсизланишда одам минерал тузларни ҳам йўқотади, бу эса организмнинг барча суюқлик тизимларида электролит дисбалансининг сабабчиси бўлади.\r\n\r\nОрганизм сув билан бирга кўп миқдорда <strong>Na, Cl, K, Mg, Са</strong> ионларини йўқотади.\r\n\r\nОдам организми ўзи мустақил минерал ва бошқа ионларни синтез қила олмаслиги сабабли, улар организмга овқат ва сув билан тушиши зарур (Ершова И. Б. ва ҳаммуаллифлар, 2012; Корягина Ю. В. ва ҳаммуаллифлар, 2018).\r\n\r\nГап ҳомиладорлар тўғрисида кетганида, шуни ҳисобга олиш керакки, гестозда кўпинча кетон таначалари шаклланиши кузатилади, афсуски бу лаборатор равишда кеч аниқланади. Шунинг учун регидратация, кўнгил айниши ва қайт қилишни камайтириш ва аёлни нормал овқатланишга қайтариш орқали кетон таначалари шаклланишининг олдини олишга алоҳида эътибор қаратиш зарур (Кучук Д. О. ва ҳамммуаллифлар, 2018).\r\n\r\nБу ҳолатда организмнинг регидратацияси ва дезинтоксикацияси учун «Юрия-Фарм»  фармацевтика корпорациясининг ReO махсус суви фойда беради. У қуйидагилар учун махсус ишлаб чиқилган:\r\n<ul>\r\n 	<li>сув ва электролитларнинг максимал равишда тез сўрилиши учун;</li>\r\n 	<li>дегидратация белгиларини (чарчоқ, бош оғриғи, тери ва шиллиқ қаватларнинг қуруқлиги) бартараф этиш учун;</li>\r\n 	<li>сувсизланишни олдини олиш, диурезни нормаллаштириш ва интоксикацияни камайтириш учун.</li>\r\n</ul>\r\n<h2>ReO – оддий сув етарли бўлмаганда.</h2>\r\nСув – организмдаги биологик суюқликларнинг асоси, шунинг учун ҳам истеъмол қилинаётган сув таркибининг ўзгариши организм биологик суюқликлари таркиби ва хусусиятларининг ўзгаришига олиб келади.\r\n\r\nТиббий мақсадлар учун мўлжалланган ReO суви мувозанатлаштирилган сув-туз таркибига эга бўлиб, таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Жадвал. Организмни регидратация ва дезинтоксикацияси учун ReO махсус сувининг таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO нинг кимёвий таркиби ўз ичига қуйидагиларни олади:</h2>\r\n<ul>\r\n 	<li>Натрий – организмда суюқлик мувозанатини таъминлайдиган энг муҳим микроэлементлардан бири. У организмнинг ҳужайрадан ташқаридаги осмотик босимини сақлаб, сувни тутиб туради</li>\r\n 	<li>Калий, натрийдан фарқли ўлароқ, ҳужайра ичи катиони ҳисобланади, ҳужайра ичида организм суюқликларининг осмотик босимини сақлаб туради. Эритроцитларда калий натрийга нисбатан 10,5 маротаба кўп, қон плазмасида эса, аксинча, натрий  калийга нисбатан 30 маротаба кўп. Юракнинг иши, унинг ритми, шунингдек асаб-мушак фаолияти ҳам калийга боғлиқ. У шишларни камайтиради ва чарчоқни пасайтиради.</li>\r\n 	<li>Хлор – макроэлемент, у натрий ва калий билан биргаликда сув-туз мувозанатини бошқаради, организмдаги биологик фаол бирикмалар таркибига киради, қон, лимфа,  орқа мия ва бошқа суюқликларда осмотик босимни меъёрига келтиради. Ва яна хлор иштаҳани рағбатлантиради,  жигар функциясини яхшилайди ва организмдан шлаклар ва токсинларнинг чиқарилишига ёрдам беради.</li>\r\n 	<li>Кальций – нафақат суяк тўқимасининг асоси. У ҳаракат функцияларини (мушакларнинг қисқариши, нерв импульсларининг узатилиши, асаб қўзғалишларига мушаклар реакцияси) таъминлашда, шунингдек гормонлар фаоллигининг ўзгаришида, юрак қисқаришларининг ритмини бошқаришда фаол иштирок этади. Кальций юрак уриш сонини камайтиради, артериал босимни меъёрлаштиради ва стрессга қаршилик кўрсатади.</li>\r\n 	<li>Магний ҳам одам организмида муҳим роль ўйнайди: у кальций, С витамини, фосфор, натрий ва калий алмашинуви учун зарур. Магний углеводларнинг парчаланиш жараёни (гликолиз) да, натрий, калий, кальций ионларини ҳужайра мембраналари орқали ташишда, импульсларни нерв-мушакларга узатишда иштирок этади, глюкозанинг энергияга айланиши учун муҳим.  Ўзининг жуда кичик ўлчамлари туфайли магний ионлари таркибида кислород бўлган барча органик молекулалар билан, уларни ўзаро бириктириб, ион-ковалент алоқага киришади. Магнийнинг йўқотилиши молекуляр гуруҳлар, масалан оқсил молекулалари синтез қилинадиган рибосомаларнинг парчаланишига  олиб келиши мумкин.</li>\r\n 	<li>Гидрокарбонат организмни токсинлардан тозалайди, сув мувозанатини, углевод ва оқсил алмашинувини тартибга солади, овқат ҳазм бўлишига ёрдам беради. Гидрокарбонатлар ошқозонда кислород ҳосил бўлишини тўхтатади, ҳамда микро- ва макроэлементларнинг ўзлаштирилишини яхшилайди.</li>\r\n 	<li>Сорбитол – олти атомли спирт бўлиб, ўзига хос ширин таъмга эга.</li>\r\n</ul>\r\nҲомиладорларда кўпинча қабзият каби муаммонинг  қайд этилишини ҳисобга олган ҳолда сорбитолнинг ичак микрофлорасига тикловчи таъсири мақсадга мувофиқдир. Бунинг устига сорбитол аёлга унга жуда зарур бўлган  энергияни беради (Белоконова Н. А. ва ҳаммуаллифлар, 2016; Лысиков Ю. А., 2009; Ершова И. Б. ва ҳаммуаллифлар, 2012; Егорова И. А., Комарова С. Г., 2015).\r\n\r\nШундай таркибга эгалиги туфайли ReO токсикоз симптомларини камайтиришга ёрдам беради, сувсизланишнинг олдини олади, организмдан токсинларни (заҳарли моддалар) чиқаради, бу эса ҳомиладорнинг соғайишини тезлаштиради, кайфиятини яхшилайди, қайт қилишни ва сийдикдаги ацетон даражасини камайтиради.\r\n\r\n<strong>Регидратация ва дезинтоксикация учун ReO махсус сувининг муҳим афзаллиги – унинг жуда яхши таъм сифатлари:</strong>\r\n<ul>\r\n 	<li>нимшўр ёқимли таъмга эга;</li>\r\n 	<li>осон ичилади;</li>\r\n 	<li>ҳатто кўнгил айнишида ҳам ичиш мумкин.</li>\r\n 	<li></li>\r\n</ul>\r\nReO сингари “ёрдамчи”нинг  ҳақиқатан ҳам ҳомиладорларга фойдаси тегади ва у токсикознинг “нохуш” симптомларини енгишга  ёрдам беради.','Токсикознинг “нохуш” белгиларини қандай енгиш мумкин?','','inherit','closed','closed','','1566-revision-v1','','','2021-08-28 15:26:25','2021-08-28 12:26:25','',1566,'https://reo.ua/?p=1570',0,'revision','',0),(1572,1,'2021-06-25 11:47:32','2021-06-25 08:47:32','Ҳомиладорлар токсикози – бу ҳомиладор аёл организмидаги патологик ўзгаришлар мажмуи бўлиб, одатда ҳомиладорликнинг 13-16 ҳафтасида юзага келади. Ҳомиладорликнинг биринчи триместрида кузатиладиган эрта токсикозлар анча одатий ҳисобланади, лекин  ҳомиладорликнинг 34-40 ҳафтасида кечки токсикозлар ҳам ривожланиши мумкин. Токсикознинг энг кенг тарқалган кўриниши – кўнгил айниши ва/ёки қайт қилиш бўлиб, 10 нафар ҳомиладор аёлдан 8 нафари ундан азият чекади. Аксарият ҳолларда эрта токсикозлар ҳомиладорликнинг 16-20-ҳафтасигача тўхтайди, аммо баъзи аёлларда кўпроқ ҳам давом этиши мумкин.\r\n\r\nТиббиётда ҳомиладорларнинг ҳаддан ортиқ қайт қилиш каби алоҳида оғриқли ҳолат ажратиб кўрсатилади, у ўз ичига нафақат кучли кўнгил айниши ва қайт қилишни (кунига 4 мартадан ортиқ), балки тик ҳолатга ўтишда артерал босимнинг пасайиб кетиши, шунингдек қусуқ массалари билан суюқлик йўқотилиши оқибатида сувсизланишни ҳам олади. Чанқоқлик ва оғиз қуриши, чарчоқ ёки уйқучанликни ҳис қилиш, бош айланиши, мушакларнинг тортилиши, сийдик миқдорининг камайиши ва унинг хусусиятлари ўзгариши (тўқ ранги, кучли ҳиди) сувсизланиш белгилари ҳисобланади.\r\n\r\nҲомиладорларда ҳаддан ортиқ қайт қилишнинг сабаблари  аниқ  ўрганилмаган, лекин  бундай ҳолат олдинги ҳомиладорликда ёки яқин қариндошлар (она, сингил) да кузатилган бўлса, унинг юз бериш эҳтимоли ортади. Шунингдек, кўнгил айниши ва қайт қилиш хавфи ёш аёллар, семиз аёлларда, биринчи ёки кўп ҳомилали ҳомиладорликда анча юқори деб ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>1-расм. Ҳомиладорларда гидратация</strong></p>\r\n&nbsp;\r\n<h2>Ҳомиладорларда сувсизланиш нимаси билан хавфли?</h2>\r\nҲомила йўлдоши, ҳомила йўлдошининг қобиқлари ва ҳомила йўлдоши сувларининг тўғри шаклланиши учун етарлича миқдордаги сув зарур. Ҳомиладорликнинг иккинчи ва учинчи триместрларида дегидратация бачадон қисқаришини чақирувчи окситоцин даражасининг ошиб кетиши оқибатида вақтидан олдинги туғруққа олиб келиши мумкин.\r\n\r\nБундан ташқари, ҳаддан ортиқ қайт қилиш натижасида артериал босим пасайиши ва аёл тўсатдан йиқилиши мумкин, бунда аёл ва ҳомиланинг жароҳат олиш эҳтимоли юқори бўлади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Ҳомиладор бўлмаган ва ҳомиладор, шунингдек эмизикли аёлларда сув мувозанати</strong></p>\r\n&nbsp;\r\n<h2>Ҳомиладорлар сувсизланишнинг қандай ҳолларида врачга мурожаат қилиши зарур?</h2>\r\n<ul>\r\n 	<li>Ҳомиланинг одатий ҳаракатлари ўзгарганида.</li>\r\n 	<li>Қон кетиши ёки йўлдош сувининг оқиб чиқиши бошланганида.</li>\r\n 	<li>Давомийлиги 12 соатдан ортиқ бўлган қайт қилиш ёки диареяда.</li>\r\n 	<li>Диурез жуда кам ёки умуман бўлмаганда.</li>\r\n 	<li>Ҳушдан кетиш, талваса ҳуружлари, онгнинг бузилишларида.</li>\r\n 	<li>Вақтидан олдин туғруқ бошланишидан дарак бериши мумкин бўлган бачадон қисқаришлари юзага келганда.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nАмерика акушер ва гинекологлар коллегиясининг тавсияларига мувофиқ сувсизланишнинг олдини олиш учун  кунига 8-12 стакан (1,9-3,0) литр сув ичиш зарур. Таркибида кофеин бўлган ичимликлар (кофе, энерготониклар) ва ширин газланган ичимликларни ичмаслик керак.\r\n\r\nТурли профессионал ташкилотлар томонидан катта ёшдаги аёллар, ҳомиладор ва эмизикли аёллар учун тавсия этилган суюқлик миқдори жадвалда келтирилган.\r\n\r\n<strong>1-жадвал. Аёлларнинг турли гуруҳи учун суюқликка бўлган кунлик эҳтиёж</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Аёллар гуруҳи</strong></th>\r\n<th width=\"50%\"><strong>ЖССТ, 2003</strong></th>\r\n<th width=\"50%\"><strong>АҚШ ва </strong><strong>Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Катта ёшдаги аёллар</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Ҳомиладорлар</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Эмизикли аёллар</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Нима ичиш зарур?</h2>\r\nДегидратацияда нафақат сув, балки организм учун зарур бўлган тузлар ҳам йўқотилади, шунинг учун сувсизланишни бартараф этиб, тузлар захирасини ҳам тўлдириш зарур. Бундан ташқари, оддий сув организмда узоқ сақланмайди, чунки суюқликнинг организмга тушиши бир вақтнинг ўзида  уни сийдик билан чиқариш жараёнларини фаоллаштиради. Бунда тузлар суюқликни организмда тутиб қолиб, барча ҳужайра ва тўқималарни сув билан тўлиқ тўйинтиради. Шунинг учун ҳомиладорларнинг қайт қилишида таркибида  тузлар (электролитлар), яъни натрий, калий, магний ва бошқалар бўлган  мувозанатлаштирилган эритмалардан фойдаланиш афзал ҳисобланади.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма ҳисобланади. Шуниси муҳимки, ReO суви таркибида барча зарур электролитлар (натрий, калий, магний, кальций), шунингдек  организм ҳужайралари инсулинсиз ўзлаштирадиган қўшимча энергия манбаи – сорбитол мавжуд. ReO сувида консервантлар ва бўёвчи моддалар мавжуд эмас, ёқимли таъми эса унинг қўшимча афзаллиги ҳисобланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>2-жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳомиладорлар учун ReO суви афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва уни сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n</ul>\r\n<h2>Ҳомиладорларда сувсизланишга қандай тўсқинлиқ қилиш мумкин?</h2>\r\n<ul>\r\n 	<li>кўпроқ суюқлик ичиш – кунига 8-12 стакан (1,9-3,0 л);</li>\r\n 	<li>суюқ овқатлар (шўрвалар, мевалар, сабзавотлар) ни ейиш;</li>\r\n 	<li>чанқоқ ҳиссига эътиборлироқ бўлиш;</li>\r\n 	<li>куннинг иссиқ вақтида спорт машғулотлари билан шуғулланмаслик ва кўчада сайр қилмаслик;</li>\r\n 	<li>ҳар доим ўзи билан бир бутилка сув олиб юриш.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз:қандай қилиб ҳомиладорликнинг одатий кечишига қайтиш мумкин?','','publish','open','open','','toksikoz%d2%9bandaj-%d2%9bilib-%d2%b3omiladorlikning-odatij-kechishiga-%d2%9bajtish-mumkin','','','2021-08-28 15:46:55','2021-08-28 12:46:55','',0,'https://reo.ua/uncategorized-uz/toksikoz-kak-vernutsya-k-obychnomu-techeniyu-beremennosti/',30,'post','',0),(1573,1,'2021-06-25 11:44:26','2021-06-25 08:44:26','','infograph-15','','inherit','open','closed','','infograph-15-2-3','','','2021-06-25 11:44:26','2021-06-25 08:44:26','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-15.jpg',0,'attachment','image/jpeg',0),(1574,1,'2021-07-07 12:07:24','2021-07-07 09:07:24','','Токсикоз','','inherit','open','closed','','toksikoz-2-2','','','2021-07-07 12:07:24','2021-07-07 09:07:24','',1572,'https://reo.ua/wp-content/uploads/2021/06/toksikoz.jpg',0,'attachment','image/jpeg',0),(1575,1,'2021-08-28 15:45:46','2021-08-28 12:45:46','Ҳомиладорлар токсикози – бу ҳомиладор аёл организмидаги патологик ўзгаришлар мажмуи бўлиб, одатда ҳомиладорликнинг 13-16 ҳафтасида юзага келади. Ҳомиладорликнинг биринчи триместрида кузатиладиган эрта токсикозлар анча одатий ҳисобланади, лекин  ҳомиладорликнинг 34-40 ҳафтасида кечки токсикозлар ҳам ривожланиши мумкин. Токсикознинг энг кенг тарқалган кўриниши – кўнгил айниши ва/ёки қайт қилиш бўлиб, 10 нафар ҳомиладор аёлдан 8 нафари ундан азият чекади. Аксарият ҳолларда эрта токсикозлар ҳомиладорликнинг 16-20-ҳафтасигача тўхтайди, аммо баъзи аёлларда кўпроқ ҳам давом этиши мумкин.\n\nТиббиётда ҳомиладорларнинг ҳаддан ортиқ қайт қилиш каби алоҳида оғриқли ҳолат ажратиб кўрсатилади, у ўз ичига нафақат кучли кўнгил айниши ва қайт қилишни (кунига 4 мартадан ортиқ), балки тик ҳолатга ўтишда артерал босимнинг пасайиб кетиши, шунингдек қусуқ массалари билан суюқлик йўқотилиши оқибатида сувсизланишни ҳам олади. Чанқоқлик ва оғиз қуриши, чарчоқ ёки уйқучанликни ҳис қилиш, бош айланиши, мушакларнинг тортилиши, сийдик миқдорининг камайиши ва унинг хусусиятлари ўзгариши (тўқ ранги, кучли ҳиди) сувсизланиш белгилари ҳисобланади.\n\nҲомиладорларда ҳаддан ортиқ қайт қилишнинг сабаблари  аниқ  ўрганилмаган, лекин  бундай ҳолат олдинги ҳомиладорликда ёки яқин қариндошлар (она, сингил) да кузатилган бўлса, унинг юз бериш эҳтимоли ортади. Шунингдек, кўнгил айниши ва қайт қилиш хавфи ёш аёллар, семиз аёлларда, биринчи ёки кўп ҳомилали ҳомиладорликда анча юқори деб ҳисобланади.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\n<p style=\"text-align: center;\"><strong>1-расм. Ҳомиладорларда гидратация</strong></p>\n&nbsp;\n<h2>Ҳомиладорларда сувсизланиш нимаси билан хавфли?</h2>\nҲомила йўлдоши, ҳомила йўлдошининг қобиқлари ва ҳомила йўлдоши сувларининг тўғри шаклланиши учун етарлича миқдордаги сув зарур. Ҳомиладорликнинг иккинчи ва учинчи триместрларида дегидратация бачадон қисқаришини чақирувчи окситоцин даражасининг ошиб кетиши оқибатида вақтидан олдинги туғруққа олиб келиши мумкин.\n\nБундан ташқари, ҳаддан ортиқ қайт қилиш натижасида артериал босим пасайиши ва аёл тўсатдан йиқилиши мумкин, бунда аёл ва ҳомиланинг жароҳат олиш эҳтимоли юқори бўлади.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Ҳомиладор бўлмаган ва ҳомиладор, шунингдек эмизикли аёлларда сув мувозанати</strong></p>\n&nbsp;\n<h2>Ҳомиладорлар сувсизланишнинг қандай ҳолларида врачга мурожаат қилиши зарур?</h2>\n<ul>\n 	<li>Ҳомиланинг одатий ҳаракатлари ўзгарганида.</li>\n 	<li>Қон кетиши ёки йўлдош сувининг оқиб чиқиши бошланганида.</li>\n 	<li>Давомийлиги 12 соатдан ортиқ бўлган қайт қилиш ёки диареяда.</li>\n 	<li>Диурез жуда кам ёки умуман бўлмаганда.</li>\n 	<li>Ҳушдан кетиш, талваса ҳуружлари, онгнинг бузилишларида.</li>\n 	<li>Вақтидан олдин туғруқ бошланишидан дарак бериши мумкин бўлган бачадон қисқаришлари юзага келганда.</li>\n</ul>\n<h2>Қанча суюқлик ичиш керак?</h2>\nАмерика акушер ва гинекологлар коллегиясининг тавсияларига мувофиқ сувсизланишнинг олдини олиш учун  кунига 8-12 стакан (1,9-3,0) литр сув ичиш зарур. Таркибида кофеин бўлган ичимликлар (кофе, энерготониклар) ва ширин газланган ичимликларни ичмаслик керак.\n\nТурли профессионал ташкилотлар томонидан катта ёшдаги аёллар, ҳомиладор ва эмизикли аёллар учун тавсия этилган суюқлик миқдори жадвалда келтирилган.\n\n<strong>1-жадвал. Аёлларнинг турли гуруҳи учун суюқликка бўлган кунлик эҳтиёж</strong>\n<table>\n<tbody>\n<tr>\n<th width=\"50%\"><strong>Аёллар гуруҳи</strong></th>\n<th width=\"50%\"><strong>ЖССТ, 2003</strong></th>\n<th width=\"50%\"><strong>АҚШ ва </strong><strong>Канада, 2004</strong></th>\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\n</tr>\n<tr>\n<td>Катта ёшдаги аёллар</td>\n<td>2200 мл</td>\n<td>2700 мл</td>\n<td>2000 мл</td>\n</tr>\n<tr>\n<td>Ҳомиладорлар</td>\n<td>4800 мл</td>\n<td>3000 мл</td>\n<td>2300 мл</td>\n</tr>\n<tr>\n<td>Эмизикли аёллар</td>\n<td>5500 мл</td>\n<td>3800 мл</td>\n<td>2700 мл</td>\n</tr>\n</tbody>\n</table>\n<h2>Нима ичиш зарур?</h2>\nДегидратацияда нафақат сув, балки организм учун зарур бўлган тузлар ҳам йўқотилади, шунинг учун сувсизланишни бартараф этиб, тузлар захирасини ҳам тўлдириш зарур. Бундан ташқари, оддий сув организмда узоқ сақланмайди, чунки суюқликнинг организмга тушиши бир вақтнинг ўзида  уни сийдик билан чиқариш жараёнларини фаоллаштиради. Бунда тузлар суюқликни организмда тутиб қолиб, барча ҳужайра ва тўқималарни сув билан тўлиқ тўйинтиради. Шунинг учун ҳомиладорларнинг қайт қилишида таркибида  тузлар (электролитлар), яъни натрий, калий, магний ва бошқалар бўлган  мувозанатлаштирилган эритмалардан фойдаланиш афзал ҳисобланади.\n<h2>Тиббий мақсадлар учун ReO суви</h2>\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма ҳисобланади. Шуниси муҳимки, ReO суви таркибида барча зарур электролитлар (натрий, калий, магний, кальций), шунингдек  организм ҳужайралари инсулинсиз ўзлаштирадиган қўшимча энергия манбаи – сорбитол мавжуд. ReO сувида консервантлар ва бўёвчи моддалар мавжуд эмас, ёқимли таъми эса унинг қўшимча афзаллиги ҳисобланади.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>2-жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Таркиби</strong></th>\n<th width=\"50%\"><strong>Миқдори</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО для беременных:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания.</li>\n</ul>\n<h2>Как препятствовать обезвоживанию у беременных?</h2>\n<ul>\n 	<li>пить больше жидкости – 8-12 стаканов (1,9-3,0 л) в день;</li>\n 	<li>есть жидкую еду (супы, фрукты, овощи);</li>\n 	<li>обращать внимание на ощущение жажды;</li>\n 	<li>избегать спортивных занятий на улице и прогулок в жаркое время;</li>\n 	<li>всегда носить с собой бутылку воды.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\n</ol>','Токсикоз:қандай қилиб ҳомиладорликнинг одатий кечишига қайтиш мумкин?','','inherit','closed','closed','','1572-autosave-v1','','','2021-08-28 15:45:46','2021-08-28 12:45:46','',1572,'https://reo.ua/?p=1575',0,'revision','',0),(1576,1,'2021-08-28 15:46:55','2021-08-28 12:46:55','Ҳомиладорлар токсикози – бу ҳомиладор аёл организмидаги патологик ўзгаришлар мажмуи бўлиб, одатда ҳомиладорликнинг 13-16 ҳафтасида юзага келади. Ҳомиладорликнинг биринчи триместрида кузатиладиган эрта токсикозлар анча одатий ҳисобланади, лекин  ҳомиладорликнинг 34-40 ҳафтасида кечки токсикозлар ҳам ривожланиши мумкин. Токсикознинг энг кенг тарқалган кўриниши – кўнгил айниши ва/ёки қайт қилиш бўлиб, 10 нафар ҳомиладор аёлдан 8 нафари ундан азият чекади. Аксарият ҳолларда эрта токсикозлар ҳомиладорликнинг 16-20-ҳафтасигача тўхтайди, аммо баъзи аёлларда кўпроқ ҳам давом этиши мумкин.\r\n\r\nТиббиётда ҳомиладорларнинг ҳаддан ортиқ қайт қилиш каби алоҳида оғриқли ҳолат ажратиб кўрсатилади, у ўз ичига нафақат кучли кўнгил айниши ва қайт қилишни (кунига 4 мартадан ортиқ), балки тик ҳолатга ўтишда артерал босимнинг пасайиб кетиши, шунингдек қусуқ массалари билан суюқлик йўқотилиши оқибатида сувсизланишни ҳам олади. Чанқоқлик ва оғиз қуриши, чарчоқ ёки уйқучанликни ҳис қилиш, бош айланиши, мушакларнинг тортилиши, сийдик миқдорининг камайиши ва унинг хусусиятлари ўзгариши (тўқ ранги, кучли ҳиди) сувсизланиш белгилари ҳисобланади.\r\n\r\nҲомиладорларда ҳаддан ортиқ қайт қилишнинг сабаблари  аниқ  ўрганилмаган, лекин  бундай ҳолат олдинги ҳомиладорликда ёки яқин қариндошлар (она, сингил) да кузатилган бўлса, унинг юз бериш эҳтимоли ортади. Шунингдек, кўнгил айниши ва қайт қилиш хавфи ёш аёллар, семиз аёлларда, биринчи ёки кўп ҳомилали ҳомиладорликда анча юқори деб ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-662\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg\" alt=\"\" width=\"1122\" height=\"628\" />\r\n<p style=\"text-align: center;\"><strong>1-расм. Ҳомиладорларда гидратация</strong></p>\r\n&nbsp;\r\n<h2>Ҳомиладорларда сувсизланиш нимаси билан хавфли?</h2>\r\nҲомила йўлдоши, ҳомила йўлдошининг қобиқлари ва ҳомила йўлдоши сувларининг тўғри шаклланиши учун етарлича миқдордаги сув зарур. Ҳомиладорликнинг иккинчи ва учинчи триместрларида дегидратация бачадон қисқаришини чақирувчи окситоцин даражасининг ошиб кетиши оқибатида вақтидан олдинги туғруққа олиб келиши мумкин.\r\n\r\nБундан ташқари, ҳаддан ортиқ қайт қилиш натижасида артериал босим пасайиши ва аёл тўсатдан йиқилиши мумкин, бунда аёл ва ҳомиланинг жароҳат олиш эҳтимоли юқори бўлади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\"><img class=\"aligncenter wp-image-666\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg\" alt=\"\" width=\"720\" height=\"354\" /></a>\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png\"><img class=\"aligncenter size-large wp-image-1059\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2-1024x458.png\" alt=\"\" width=\"1024\" height=\"458\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Ҳомиладор бўлмаган ва ҳомиладор, шунингдек эмизикли аёлларда сув мувозанати</strong></p>\r\n&nbsp;\r\n<h2>Ҳомиладорлар сувсизланишнинг қандай ҳолларида врачга мурожаат қилиши зарур?</h2>\r\n<ul>\r\n 	<li>Ҳомиланинг одатий ҳаракатлари ўзгарганида.</li>\r\n 	<li>Қон кетиши ёки йўлдош сувининг оқиб чиқиши бошланганида.</li>\r\n 	<li>Давомийлиги 12 соатдан ортиқ бўлган қайт қилиш ёки диареяда.</li>\r\n 	<li>Диурез жуда кам ёки умуман бўлмаганда.</li>\r\n 	<li>Ҳушдан кетиш, талваса ҳуружлари, онгнинг бузилишларида.</li>\r\n 	<li>Вақтидан олдин туғруқ бошланишидан дарак бериши мумкин бўлган бачадон қисқаришлари юзага келганда.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nАмерика акушер ва гинекологлар коллегиясининг тавсияларига мувофиқ сувсизланишнинг олдини олиш учун  кунига 8-12 стакан (1,9-3,0) литр сув ичиш зарур. Таркибида кофеин бўлган ичимликлар (кофе, энерготониклар) ва ширин газланган ичимликларни ичмаслик керак.\r\n\r\nТурли профессионал ташкилотлар томонидан катта ёшдаги аёллар, ҳомиладор ва эмизикли аёллар учун тавсия этилган суюқлик миқдори жадвалда келтирилган.\r\n\r\n<strong>1-жадвал. Аёлларнинг турли гуруҳи учун суюқликка бўлган кунлик эҳтиёж</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th width=\"50%\"><strong>Аёллар гуруҳи</strong></th>\r\n<th width=\"50%\"><strong>ЖССТ, 2003</strong></th>\r\n<th width=\"50%\"><strong>АҚШ ва </strong><strong>Канада, 2004</strong></th>\r\n<th width=\"50%\"><strong>Европа, 2010</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Катта ёшдаги аёллар</td>\r\n<td>2200 мл</td>\r\n<td>2700 мл</td>\r\n<td>2000 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Ҳомиладорлар</td>\r\n<td>4800 мл</td>\r\n<td>3000 мл</td>\r\n<td>2300 мл</td>\r\n</tr>\r\n<tr>\r\n<td>Эмизикли аёллар</td>\r\n<td>5500 мл</td>\r\n<td>3800 мл</td>\r\n<td>2700 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Нима ичиш зарур?</h2>\r\nДегидратацияда нафақат сув, балки организм учун зарур бўлган тузлар ҳам йўқотилади, шунинг учун сувсизланишни бартараф этиб, тузлар захирасини ҳам тўлдириш зарур. Бундан ташқари, оддий сув организмда узоқ сақланмайди, чунки суюқликнинг организмга тушиши бир вақтнинг ўзида  уни сийдик билан чиқариш жараёнларини фаоллаштиради. Бунда тузлар суюқликни организмда тутиб қолиб, барча ҳужайра ва тўқималарни сув билан тўлиқ тўйинтиради. Шунинг учун ҳомиладорларнинг қайт қилишида таркибида  тузлар (электролитлар), яъни натрий, калий, магний ва бошқалар бўлган  мувозанатлаштирилган эритмалардан фойдаланиш афзал ҳисобланади.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма ҳисобланади. Шуниси муҳимки, ReO суви таркибида барча зарур электролитлар (натрий, калий, магний, кальций), шунингдек  организм ҳужайралари инсулинсиз ўзлаштирадиган қўшимча энергия манбаи – сорбитол мавжуд. ReO сувида консервантлар ва бўёвчи моддалар мавжуд эмас, ёқимли таъми эса унинг қўшимча афзаллиги ҳисобланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>2-жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳомиладорлар учун ReO суви афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва уни сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n</ul>\r\n<h2>Ҳомиладорларда сувсизланишга қандай тўсқинлиқ қилиш мумкин?</h2>\r\n<ul>\r\n 	<li>кўпроқ суюқлик ичиш – кунига 8-12 стакан (1,9-3,0 л);</li>\r\n 	<li>суюқ овқатлар (шўрвалар, мевалар, сабзавотлар) ни ейиш;</li>\r\n 	<li>чанқоқ ҳиссига эътиборлироқ бўлиш;</li>\r\n 	<li>куннинг иссиқ вақтида спорт машғулотлари билан шуғулланмаслик ва кўчада сайр қилмаслик;</li>\r\n 	<li>ҳар доим ўзи билан бир бутилка сув олиб юриш.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Американской коллегии акушеров и гинекологов. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.</li>\r\n 	<li>Available at: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting.</li>\r\n 	<li>Lee N., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40 (2): 309-vii.</li>\r\n 	<li>Available at: https://www.healthline.com/health/pregnancy/dehydration#Next-steps.</li>\r\n 	<li>Available at: https://www.hydrationforhealth.com/en/hydration-science/hydration-lab/hydration-pregnancy-and-breastfeeding/#i22-adaptations-to-ensure-body-water-balance.</li>\r\n</ol>','Токсикоз:қандай қилиб ҳомиладорликнинг одатий кечишига қайтиш мумкин?','','inherit','closed','closed','','1572-revision-v1','','','2021-08-28 15:46:55','2021-08-28 12:46:55','',1572,'https://reo.ua/?p=1576',0,'revision','',0),(1577,1,'2021-06-25 11:45:12','2021-06-25 08:45:12','','infograph-16','','inherit','open','closed','','infograph-16','','','2021-06-25 11:45:12','2021-06-25 08:45:12','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-16.jpg',0,'attachment','image/jpeg',0),(1578,1,'2021-06-25 11:47:29','2021-06-25 08:47:29','','infograph-15','','inherit','open','closed','','infograph-15-2','','','2021-06-25 11:47:29','2021-06-25 08:47:29','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-15-1.jpg',0,'attachment','image/jpeg',0),(1579,1,'2021-06-29 18:26:48','2021-06-29 15:26:48','','infograph-40-ru','','inherit','open','closed','','infograph-40-ru-2','','','2021-06-29 18:26:48','2021-06-29 15:26:48','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ru.jpg',0,'attachment','image/jpeg',0),(1580,1,'2021-06-29 18:26:50','2021-06-29 15:26:50','','infograph-40-ua','','inherit','open','closed','','infograph-40-ua-2','','','2021-06-29 18:26:50','2021-06-29 15:26:50','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-40-ua.jpg',0,'attachment','image/jpeg',0),(1581,1,'2021-06-29 18:26:51','2021-06-29 15:26:51','','infograph-41-ru','','inherit','open','closed','','infograph-41-ru-2','','','2021-06-29 18:26:51','2021-06-29 15:26:51','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ru.jpg',0,'attachment','image/jpeg',0),(1582,1,'2021-06-29 18:26:52','2021-06-29 15:26:52','','infograph-41-ua','','inherit','open','closed','','infograph-41-ua-2','','','2021-06-29 18:26:52','2021-06-29 15:26:52','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-41-ua.jpg',0,'attachment','image/jpeg',0),(1583,1,'2021-06-29 18:26:53','2021-06-29 15:26:53','','infograph-42-ru','','inherit','open','closed','','infograph-42-ru-2','','','2021-06-29 18:26:53','2021-06-29 15:26:53','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ru.jpg',0,'attachment','image/jpeg',0),(1584,1,'2021-06-29 18:28:54','2021-06-29 15:28:54','','infograph-42-ua','','inherit','open','closed','','infograph-42-ua','','','2021-06-29 18:28:54','2021-06-29 15:28:54','',1572,'https://reo.ua/wp-content/uploads/2021/06/infograph-42-ua.jpg',0,'attachment','image/jpeg',0),(1585,1,'2021-07-09 14:58:06','2021-07-09 11:58:06','','Web_REO_T6 при беременности_2','','inherit','open','closed','','web_reo_t6-pri-beremennosti_2-2','','','2021-07-09 14:58:06','2021-07-09 11:58:06','',1572,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png',0,'attachment','image/png',0),(1586,1,'2021-08-30 11:21:07','2021-08-30 08:21:07','<h5><span lang=\"UZ-CYR\">Агар Сиз бизнинг ҳамкоримиз бўлишни ва </span>ReO <span lang=\"UZ-CYR\">тиббий мақсадлар учун сувини дўконингизда, дорихонангизда ёки бошқа савдо муассасасида сотишни истасангиз бизга қуйидаги контактлар бўйича мурожаат қилинг:</span></h5>','Ҳамкорлар учун','','inherit','closed','closed','','1424-revision-v1','','','2021-08-30 11:21:07','2021-08-30 08:21:07','',1424,'https://reo.ua/?p=1586',0,'revision','',0),(1587,1,'2021-08-30 11:22:24','2021-08-30 08:22:24','<h2>“GD-Pharm” МЧЖ нинг Хорижий корхонаси</h2>','Контактлар','','inherit','closed','closed','','1401-revision-v1','','','2021-08-30 11:22:24','2021-08-30 08:22:24','',1401,'https://reo.ua/?p=1587',0,'revision','',0),(1589,1,'2021-06-24 14:27:25','2021-06-24 11:27:25','Овқатдан заҳарланиш бузилган ёки бактериялар билан зарарланган овқатни истеъмол қилиш оқибати ҳисобланади. Бу кўпинча қуйидаги ҳолларда юз беради:\r\n<ul>\r\n 	<li>овқат етарлича тайёрланмаган ёки етарлича иситилмаган бўлса;</li>\r\n 	<li>овқат нотўғри сақланган (музлатилмаган ва совитилмаган) бўлса;</li>\r\n 	<li>овқат хона ҳароратида узоқ вақт қолиб кетган бўлса;</li>\r\n 	<li>овқатни касал одам ёки қўлларини тегишли даражада ювмаган одам тайёрлаган бўлса;</li>\r\n 	<li>маҳсулотнинг яроқлилик муддати тугаган бўлса.</li>\r\n</ul>\r\nОвқатдан заҳарланишда, одатда, қорин оғриғи, ич кетиши, қайт қилиш, иштаҳа йўқолиши, ҳарорат ўртача ошиши, ҳолсизлик, кўнгил айниши, бош оғриғи каби камида учта симптом бўлади.\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nҚуйидагилар хавфли овқатдан заҳарланиш белгилари ҳисобланади:\r\n<ul>\r\n 	<li>3 кундан кўп давом этадиган ич кетиши;</li>\r\n 	<li>тез-тез қайт қилиш;</li>\r\n 	<li>38, юқори ҳарорат;5 °С дан</li>\r\n 	<li>кўришнинг кескин ёмонлашиши ёки нутқнинг кескин бузилиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (оғиз қуриши, сийишнинг  камайиши ёки умуман сиймаслик);</li>\r\n 	<li>сийдик ёки нажасда қон пайдо бўлиши.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>1-расм. Хавфли овқатдан заҳарланиш белгилари</strong></p>\r\n&nbsp;\r\n<h2>Овқатдан заҳарланишда нима қилиш керак ?</h2>\r\nАксарият ҳолларда овқатдан заҳарланишни уй шароитида ҳам даволаш мумкин. Одатда, 3-5 кундан кейин соғайиш бошланади.\r\n\r\nАсосий даволаш усулларидан бири регидратация ҳисобланади, чунки ич кетиши ва қайт қилиш билан кўп миқдорда суюқлик йўқотилади, суюқлик йўқотилиши токсинларнинг тегишлича чиқарилишига тўсқинлик қилади.\r\n\r\nДиарея ва қайт қилишга қарши дорилардан фойдаланиш мумкин, лекин уларни қўллашдан олдин врач билан маслаҳатлашиш зарур, чунки ич кетиши ва қайт қилиш организмнинг токсинлардан қутилишининг табиий усули ҳисобланади.\r\n\r\nОвқатланишни тиклашни осон ҳазм бўладиган маҳсулотлар: тузли крекерлар, бананлар, гуруч, сули бўтқаси, товуқ бульони, қайнатилган картошка ва бошқа сабзавотлар, тостлардан бошлаш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОвқатдан заҳарланишда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Фақат шу нарса маълумки, имкон қадар кўпроқ суюқлик ичиш зарур, лекин оз-оздан, тез-тез ва қултумлаб: қанча ича олсангиз шунча ичишингиз керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда танадан ҳам сув, ҳам тузлар (электролитлар) йўқотилади. Шу сабабли сув-туз мувозанатини тиклашда таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ. Таркибида қанд моддаси бўлган ичимликлар ичишдан тийилинг, чунки улар диареяни кучайтиради. Шунингдек таркибида кофеин бўлган ва сувсизланишни кучайтирадиган ичимликлардан ҳам сақланинг.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма бўлиб, таркибида барча зарур электролитларни, шунингдек қўшимча энергия манбаи бўлмиш сорбитолни сақлайди. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Жадвал. ReO сувининг баланслашган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Овқатдан заҳарланишда регидратация учун ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва уни сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n</ul>\r\n<h2>Овқатдан заҳарланишлардан қандай сақланиш мумкин?</h2>\r\nОвқатдан заҳарланишни олдини олишнинг асосий усули – хавфли бўлиши мумкин бўлган овқатни емаслик. Гўшт, парранда, тухум ва денгиз маҳсулотлари хавфли бактериялар билан зарарланган бўлиши мумкин (улар иссиқлик билан ишлов берилганида ҳалок бўлади). Шунинг учун бундай маҳсулотларни хомлигича ёки етарли даражада тайёрланмаган ҳолда истеъмол қилишда заҳарланиш хавфи ортади. Пастеризацияланмаган сут ва творог, шунингдек ювилмаган хом мевалар ва сабзавотлар ҳам хавфли маҳсулотлар ҳисобланади.\r\n\r\nОвқат тайёрлашдан ёки овқат ейишдан олдин ҳар доим қўлларингизни ювинг. Сизнинг овқатингиз тўғри сақланаётганига ишонч ҳосил қилинг. Хом маҳсулотларга тегадиган барча ошхона анжомларини ювиш воситаси билан иссиқ сувда яхшилаб ювинг. Хом гўшт ва балиқни кесиш учун алоҳида тахтакачлардан фойдаланинг. Хом гўштни тайёр овқатдан алоҳида, имкон борича совиткичнинг  қуйи полкасида сақланг, бу ерда унинг сели сизиб, бошқа маҳсулотларга оқиб чиқа олмайди. Хом гўштни овқат тайёрлаш олдидан ювманг, чунки бу бактерияларнинг ошхона бўйлаб тарқалишига олиб келади.\r\n\r\nСовиткичда 5 °C дан қуйи ҳароратни сақланг. Совиткични тўлдириб юборманг – бу  ҳаво айланишига ва тегишлича совитишга тўсқинлик қилади.  Қолган тайёр овқатни тайёрланганидан кейин 90 дақиқа мобайнида совитинг.Тайёр овқатни совуткичда 2 кундан ортиқ сақламанг ва уни 1 мартадан кўп иситманг. Яроқлилик муддати ўтган маҳсулотларни, агар уларнинг кўриниши яхши ва ҳиди меъёрида бўлса ҳам, ишлатманг.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Овқатдан заҳарланишни олдини олиш чоралари</strong></p>\r\n&nbsp;\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Овқатдан заҳарланишларда сувсизланиш','','publish','open','open','','ov%d2%9batdan-za%d2%b3arlanishlarda-suvsizlanish','','','2021-08-30 11:48:02','2021-08-30 08:48:02','',0,'https://reo.ua/uncategorized-uz/obezvozhivanie-pri-pishhevyh-otravleniyah/',42,'post','',0),(1590,1,'2021-06-24 14:26:36','2021-06-24 11:26:36','','infograph-3','','inherit','open','closed','','infograph-3-2-2','','','2021-06-24 14:26:36','2021-06-24 11:26:36','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-3.jpg',0,'attachment','image/jpeg',0),(1591,1,'2021-07-07 12:09:57','2021-07-07 09:09:57','','Обезвоживание при пищевых отравлениях','','inherit','open','closed','','obezvozhivanie-pri-pishhevyh-otravleniyah-2-2','','','2021-07-07 12:09:57','2021-07-07 09:09:57','',1589,'https://reo.ua/wp-content/uploads/2021/06/obezvozhivanie-pri-pishhevyh-otravleniyah.jpg',0,'attachment','image/jpeg',0),(1592,1,'2021-08-30 11:46:50','2021-08-30 08:46:50','Овқатдан заҳарланиш бузилган ёки бактериялар билан зарарланган овқатни истеъмол қилиш оқибати ҳисобланади. Бу кўпинча қуйидаги ҳолларда юз беради:\n<ul>\n 	<li>овқат етарлича тайёрланмаган ёки етарлича иситилмаган бўлса;</li>\n 	<li>овқат нотўғри сақланган (музлатилмаган ва совитилмаган) бўлса;</li>\n 	<li>овқат хона ҳароратида узоқ вақт қолиб кетган бўлса;</li>\n 	<li>овқатни касал одам ёки қўлларини тегишли даражада ювмаган одам тайёрлаган бўлса;</li>\n 	<li>маҳсулотнинг яроқлилик муддати тугаган бўлса.</li>\n</ul>\nОвқатдан заҳарланишда, одатда, қорин оғриғи, ич кетиши, қайт қилиш, иштаҳа йўқолиши, ҳарорат ўртача ошиши, ҳолсизлик, кўнгил айниши, бош оғриғи каби камида учта симптом бўлади.\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\nҚуйидагилар хавфли овқатдан заҳарланиш белгилари ҳисобланади:\n<ul>\n 	<li>3 кундан кўп давом этадиган ич кетиши;</li>\n 	<li>тез-тез қайт қилиш;</li>\n 	<li>38, юқори ҳарорат;5 °С дан</li>\n 	<li>кўришнинг кескин ёмонлашиши ёки нутқнинг кескин бузилиши;</li>\n 	<li>кучли сувсизланиш белгилари (оғиз қуриши, сийишнинг  камайиши ёки умуман сиймаслик);</li>\n 	<li>сийдик ёки нажасда қон пайдо бўлиши.</li>\n</ul>\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\n<p style=\"text-align: center;\"><strong>1-расм. Хавфли овқатдан заҳарланиш белгилари</strong></p>\n&nbsp;\n<h2>Овқатдан заҳарланишда нима қилиш керак ?</h2>\nАксарият ҳолларда овқатдан заҳарланишни уй шароитида ҳам даволаш мумкин. Одатда, 3-5 кундан кейин соғайиш бошланади.\n\nАсосий даволаш усулларидан бири регидратация ҳисобланади, чунки ич кетиши ва қайт қилиш билан кўп миқдорда суюқлик йўқотилади, суюқлик йўқотилиши токсинларнинг тегишлича чиқарилишига тўсқинлик қилади.\n\nДиарея ва қайт қилишга қарши дорилардан фойдаланиш мумкин, лекин уларни қўллашдан олдин врач билан маслаҳатлашиш зарур, чунки ич кетиши ва қайт қилиш организмнинг токсинлардан қутилишининг табиий усули ҳисобланади.\n\nОвқатланишни тиклашни осон ҳазм бўладиган маҳсулотлар: тузли крекерлар, бананлар, гуруч, сули бўтқаси, товуқ бульони, қайнатилган картошка ва бошқа сабзавотлар, тостлардан бошлаш зарур.\n<h2>Қанча суюқлик ичиш керак?</h2>\nОвқатдан заҳарланишда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Фақат шу нарса маълумки, имкон қадар кўпроқ суюқлик ичиш зарур, лекин оз-оздан, тез-тез ва қултумлаб: қанча ича олсангиз шунча ичишингиз керак.\n<h2>Нима ичиш зарур?</h2>\nДиарея ва қайт қилишда танадан ҳам сув, ҳам тузлар (электролитлар) йўқотилади. Шу сабабли сув-туз мувозанатини тиклашда таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ. Таркибида қанд моддаси бўлган ичимликлар ичишдан тийилинг, чунки улар диареяни кучайтиради. Шунингдек таркибида кофеин бўлган ва сувсизланишни кучайтирадиган ичимликлардан ҳам сақланинг.\n<h2>Тиббий мақсадлар учун ReO суви</h2>\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма бўлиб, таркибида барча зарур электролитларни, шунингдек қўшимча энергия манбаи бўлмиш сорбитолни сақлайди. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\">Жадвал. ReO сувининг баланслашган таркиби</th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Таркиби</strong></th>\n<th width=\"50%\"><strong>Миқдори</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Овқатдан заҳарланишда регидратация учун ReO сувининг афзалликлари:</h2>\n<ul>\n 	<li>мувозанатлаштирилган таркибга эга;</li>\n 	<li>помогает восстановить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус и ее легко пить даже при тошноте;</li>\n 	<li>устраняет симптомы обезвоживания.</li>\n</ul>\n<h2>Как избежать пищевых отравлений?</h2>\nОсновной способ профилактики пищевого отравления – избегать еды, которая может быть опасной. Мясо, птица, яйца и морепродукты могут быть загрязнены опасными бактериями, которые гибнут при тепловой обработке. Поэтому при употреблении этих продуктов в сыром или недостаточно приготовленном виде риск отравления возрастает. Другими потенциально опасными продуктами являются непастеризованное молоко и творог, а также сырые немытые фрукты и овощи.\n\nВсегда мойте руки перед приготовлением или употреблением еды. Убедитесь, что ваша еда сохраняется правильно. Тщательно мойте горячей водой с моющим средством все кухонные приборы, которые контактируют с сырыми продуктами. Для нарезания сырого мяса и рыбы пользуйтесь отдельными досками. Храните сырое мясо отдельно от еды, готовой к употреблению, желательно – на нижней полке холодильника, где оно не сможет протечь на другие продукты. Не мойте сырое мясо перед приготовлением, поскольку это способствует распространению бактерий по кухне. Поддерживайте в холодильнике температуру ниже 5 °C. Избегайте переполнения холодильника – это препятствует циркуляции воздуха и, соответственно, должному охлаждению. Охлаждайте остатки еды на протяжении 90 минут после приготовления. Не сохраняйте готовую еду в холодильнике дольше 2 дней и не разогревайте ее более 1 раза. Не употребляйте продукты, срок годности которых прошел, даже если они выглядят и пахнут нормально.\n\n&nbsp;\n\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\n<p style=\"text-align: center;\"><strong>Рис. 2. Меры по предотвращению пищевых отравлений</strong></p>\n&nbsp;\n<h2>Список литературы</h2>\n<ol>\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\n</ol>','Овқатдан заҳарланишларда сувсизланиш','','inherit','closed','closed','','1589-autosave-v1','','','2021-08-30 11:46:50','2021-08-30 08:46:50','',1589,'https://reo.ua/?p=1592',0,'revision','',0),(1593,1,'2021-08-30 11:48:02','2021-08-30 08:48:02','Овқатдан заҳарланиш бузилган ёки бактериялар билан зарарланган овқатни истеъмол қилиш оқибати ҳисобланади. Бу кўпинча қуйидаги ҳолларда юз беради:\r\n<ul>\r\n 	<li>овқат етарлича тайёрланмаган ёки етарлича иситилмаган бўлса;</li>\r\n 	<li>овқат нотўғри сақланган (музлатилмаган ва совитилмаган) бўлса;</li>\r\n 	<li>овқат хона ҳароратида узоқ вақт қолиб кетган бўлса;</li>\r\n 	<li>овқатни касал одам ёки қўлларини тегишли даражада ювмаган одам тайёрлаган бўлса;</li>\r\n 	<li>маҳсулотнинг яроқлилик муддати тугаган бўлса.</li>\r\n</ul>\r\nОвқатдан заҳарланишда, одатда, қорин оғриғи, ич кетиши, қайт қилиш, иштаҳа йўқолиши, ҳарорат ўртача ошиши, ҳолсизлик, кўнгил айниши, бош оғриғи каби камида учта симптом бўлади.\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nҚуйидагилар хавфли овқатдан заҳарланиш белгилари ҳисобланади:\r\n<ul>\r\n 	<li>3 кундан кўп давом этадиган ич кетиши;</li>\r\n 	<li>тез-тез қайт қилиш;</li>\r\n 	<li>38, юқори ҳарорат;5 °С дан</li>\r\n 	<li>кўришнинг кескин ёмонлашиши ёки нутқнинг кескин бузилиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (оғиз қуриши, сийишнинг  камайиши ёки умуман сиймаслик);</li>\r\n 	<li>сийдик ёки нажасда қон пайдо бўлиши.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-534\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg\" alt=\"\" width=\"994\" height=\"252\" />\r\n<p style=\"text-align: center;\"><strong>1-расм. Хавфли овқатдан заҳарланиш белгилари</strong></p>\r\n&nbsp;\r\n<h2>Овқатдан заҳарланишда нима қилиш керак ?</h2>\r\nАксарият ҳолларда овқатдан заҳарланишни уй шароитида ҳам даволаш мумкин. Одатда, 3-5 кундан кейин соғайиш бошланади.\r\n\r\nАсосий даволаш усулларидан бири регидратация ҳисобланади, чунки ич кетиши ва қайт қилиш билан кўп миқдорда суюқлик йўқотилади, суюқлик йўқотилиши токсинларнинг тегишлича чиқарилишига тўсқинлик қилади.\r\n\r\nДиарея ва қайт қилишга қарши дорилардан фойдаланиш мумкин, лекин уларни қўллашдан олдин врач билан маслаҳатлашиш зарур, чунки ич кетиши ва қайт қилиш организмнинг токсинлардан қутилишининг табиий усули ҳисобланади.\r\n\r\nОвқатланишни тиклашни осон ҳазм бўладиган маҳсулотлар: тузли крекерлар, бананлар, гуруч, сули бўтқаси, товуқ бульони, қайнатилган картошка ва бошқа сабзавотлар, тостлардан бошлаш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОвқатдан заҳарланишда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Фақат шу нарса маълумки, имкон қадар кўпроқ суюқлик ичиш зарур, лекин оз-оздан, тез-тез ва қултумлаб: қанча ича олсангиз шунча ичишингиз керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда танадан ҳам сув, ҳам тузлар (электролитлар) йўқотилади. Шу сабабли сув-туз мувозанатини тиклашда таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ. Таркибида қанд моддаси бўлган ичимликлар ичишдан тийилинг, чунки улар диареяни кучайтиради. Шунингдек таркибида кофеин бўлган ва сувсизланишни кучайтирадиган ичимликлардан ҳам сақланинг.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун тайёр эритма бўлиб, таркибида барча зарур электролитларни, шунингдек қўшимча энергия манбаи бўлмиш сорбитолни сақлайди. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\">Жадвал. ReO сувининг баланслашган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Овқатдан заҳарланишда регидратация учун ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва уни сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n</ul>\r\n<h2>Овқатдан заҳарланишлардан қандай сақланиш мумкин?</h2>\r\nОвқатдан заҳарланишни олдини олишнинг асосий усули – хавфли бўлиши мумкин бўлган овқатни емаслик. Гўшт, парранда, тухум ва денгиз маҳсулотлари хавфли бактериялар билан зарарланган бўлиши мумкин (улар иссиқлик билан ишлов берилганида ҳалок бўлади). Шунинг учун бундай маҳсулотларни хомлигича ёки етарли даражада тайёрланмаган ҳолда истеъмол қилишда заҳарланиш хавфи ортади. Пастеризацияланмаган сут ва творог, шунингдек ювилмаган хом мевалар ва сабзавотлар ҳам хавфли маҳсулотлар ҳисобланади.\r\n\r\nОвқат тайёрлашдан ёки овқат ейишдан олдин ҳар доим қўлларингизни ювинг. Сизнинг овқатингиз тўғри сақланаётганига ишонч ҳосил қилинг. Хом маҳсулотларга тегадиган барча ошхона анжомларини ювиш воситаси билан иссиқ сувда яхшилаб ювинг. Хом гўшт ва балиқни кесиш учун алоҳида тахтакачлардан фойдаланинг. Хом гўштни тайёр овқатдан алоҳида, имкон борича совиткичнинг  қуйи полкасида сақланг, бу ерда унинг сели сизиб, бошқа маҳсулотларга оқиб чиқа олмайди. Хом гўштни овқат тайёрлаш олдидан ювманг, чунки бу бактерияларнинг ошхона бўйлаб тарқалишига олиб келади.\r\n\r\nСовиткичда 5 °C дан қуйи ҳароратни сақланг. Совиткични тўлдириб юборманг – бу  ҳаво айланишига ва тегишлича совитишга тўсқинлик қилади.  Қолган тайёр овқатни тайёрланганидан кейин 90 дақиқа мобайнида совитинг.Тайёр овқатни совуткичда 2 кундан ортиқ сақламанг ва уни 1 мартадан кўп иситманг. Яроқлилик муддати ўтган маҳсулотларни, агар уларнинг кўриниши яхши ва ҳиди меъёрида бўлса ҳам, ишлатманг.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter size-full wp-image-538\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg\" alt=\"\" width=\"1165\" height=\"726\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Овқатдан заҳарланишни олдини олиш чоралари</strong></p>\r\n&nbsp;\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Материалы Национальной службы здоровья Великобритании [Электронный ресурс]. – Режим доступа: https://www.nhs.uk/conditions/food-poisoning.</li>\r\n 	<li>Центр контроля и профилактики болезней США [Электронный ресурс]. – Режим доступа: https://www.cdc.gov/foodsafety/symptoms.html.</li>\r\n 	<li>Available at: https://www.healthline.com/health/food-poisoning.</li>\r\n 	<li>Available at: https://www.verywellhealth.com/food-poisoning-overview-1958818.</li>\r\n 	<li>Available at: https://www.mayoclinic.org/diseases-conditions/food-poisoning/symptoms-causes/syc-20356230.</li>\r\n</ol>','Овқатдан заҳарланишларда сувсизланиш','','inherit','closed','closed','','1589-revision-v1','','','2021-08-30 11:48:02','2021-08-30 08:48:02','',1589,'https://reo.ua/?p=1593',0,'revision','',0),(1594,1,'2021-06-24 14:27:13','2021-06-24 11:27:13','','infograph-4','','inherit','open','closed','','infograph-4','','','2021-06-24 14:27:13','2021-06-24 11:27:13','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-4.jpg',0,'attachment','image/jpeg',0),(1595,1,'2021-06-25 17:32:54','2021-06-25 14:32:54','','infograph-3-ru','','inherit','open','closed','','infograph-3-ru','','','2021-06-25 17:32:54','2021-06-25 14:32:54','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ru.jpg',0,'attachment','image/jpeg',0),(1596,1,'2021-06-25 17:32:55','2021-06-25 14:32:55','','infograph-3-ua','','inherit','open','closed','','infograph-3-ua','','','2021-06-25 17:32:55','2021-06-25 14:32:55','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-3-ua.jpg',0,'attachment','image/jpeg',0),(1597,1,'2021-06-25 17:32:56','2021-06-25 14:32:56','','infograph-4-ru','','inherit','open','closed','','infograph-4-ru','','','2021-06-25 17:32:56','2021-06-25 14:32:56','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ru.jpg',0,'attachment','image/jpeg',0),(1598,1,'2021-06-25 17:32:57','2021-06-25 14:32:57','','infograph-4-ua','','inherit','open','closed','','infograph-4-ua','','','2021-06-25 17:32:57','2021-06-25 14:32:57','',1589,'https://reo.ua/wp-content/uploads/2021/06/infograph-4-ua.jpg',0,'attachment','image/jpeg',0),(1599,1,'2021-06-25 13:53:50','2021-06-25 10:53:50','<h2>Кекса ёшдаги одамларда орал регидратация</h2>\r\n65 ёшдан ошган одамлар кекса ёшдаги одамлар ҳисобланади. Ўз навбатида, “гериатрик пациент” тушунчаси  энг аввало ёш билан эмас, балки одамнинг анча қувватсизлиги ва кўплаб касалликлари билан боғлиқ. Гериатик пациентларни парваришлашнинг асосий мақсади – уларнинг  ўз-ўзига хизмат кўрсатиш қобилиятини сақлаб қолиш ва ҳаёт сифатини яхшилаш мақсадида уларнинг функционал ҳолатини яхшилаш ва сақлаб туришдан иборат [1].\r\n\r\nКекса ва қари ёшдаги одамларда дегидратация  оғир муаммолардан бири ҳисобланади [1].  Лимфа, юрак-қон томир, овқат ҳазм қилиш ва сийдик тизимининг тўлиқ ишлаши учун етарли миқдордаги суюқлик зарур.  Лекин ёш ўтган сари организмда умумий сув миқдори камайиши юз беради, бу юқорида санаб ўтилган тизимларнинг ишини ёмонлаштиради [2]. Масалан, ёш одамда организмдаги сувнинг жами миқдори  тахминан 60% ни, 70 ёшдаги пациентда эса  - тахминан 40% ни ташкил этади [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Организмда сув миқдорининг ёшга қараб камайиши</strong></p>\r\nЖаҳон соғлиқни сақлаш ташкилоти кекса ёшдаги аёлларга ҳар куни 2,2 л, эркакларга эса – 2,9 л суюқлик ичишни тавсия этади. Лекин ҳақиқий ҳаётда 70 ёшдан ошган ўртача статистик одам 1,5 л дан кам суюқлик ичади [4]. Бу ёшда етарлича сув ичмасликнинг сабаблари  жисмоний чекланганлик, ҳожатга чиқишдаги қийинчиликлар, фикрлаш ва руҳий ҳолатнинг бузилиши, кўп миқдорда дори-дармонлар қабул қилиш ҳисобланади, улар сув мувозанатини бузилишига олиб келиши мумкин.\r\n<h2><strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари, клиник кўриниши ва хавфини баҳолаш</strong></h2>\r\n<strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари:</strong>\r\n<ul>\r\n 	<li>суюқликнинг танадаги фоиз миқдори камлиги сабабли суюқлик захирасининг камлиги;</li>\r\n 	<li>чанқоқни ҳис қилишнинг камайиши</li>\r\n 	<li>мушак/ёғ тўқималари нисбатининг камайиши (бу муҳим, чунки мушакларда ёғ тўқималарига қараганда 2-7 марта кўпроқ сув сақланади);</li>\r\n 	<li>дегидратация симптомларини аниқлашдаги қийинчиликлар (коллаген ва тери ости ёғ қаватининг камайиши муносабати билан тери таранглигининг камайиши ва кўзларнинг ботиқлиги, оғиз шиллиқ қаватининг қуруқлигига олиб келадиган ва сувсизланишни ўз вақтида ташхислашни қийинлаштирадиган ўпка ва юракнинг сурункали касалликлари натижасида тез-тез нафас олиш);</li>\r\n 	<li>деменция;</li>\r\n 	<li>диуретикларни  қабул қилиш [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Кекса ёшдаги шахсларда дегидратациянинг юқори хавфи</strong></p>\r\nДегидратация бир қатор оғир патологик ҳолатлар билан боғлиқлиги сабабли хавфли.\r\n\r\nДегидратация билан боғлиқ соғлиқ бузилишлари:\r\n<ul>\r\n 	<li>йиқилиш ва синишлар;</li>\r\n 	<li>онгнинг ва фикрлашнинг бузилиши;</li>\r\n 	<li>қабзиятлар;</li>\r\n 	<li>сийдик чиқариш тизимининг инфекциялари;</li>\r\n 	<li>буйрак етишмовчилиги;</li>\r\n 	<li>дори-дармонларнинг потенциал токсиклигининг ошиши;</li>\r\n 	<li>яралар битишининг секинлашиши;</li>\r\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан вертикал ҳолатга ўтишда  артериал босимнинг &gt;20 мм симоб устунидан пасайиши);</li>\r\n 	<li>тана ҳарорати кўтарилиши;</li>\r\n 	<li>қандли диабетда глюкоза миқдорини назорат қилишнинг ёмонлашиши [6].</li>\r\n</ul>\r\nТурли тадқиқотлар маълумотларига кўра дегидратация хавфи ҳар-хил омиллар билан боғлиқ (1-жадвал).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">1-жадвал. Кекса ёшдаги шахсларда дегидратация хавфини баҳолаш (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Анамне</strong><strong>з маълумотлари</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ёш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Қабзият/ сийдик тутолмаслик</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ич суриши/ қайт қилиш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Овқатдан чекланишлар</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>1-жадвал. Кекса ёшдаги шахслардадегидратация хавфини баҳолаш (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ютишнинг қийинлашуви</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Бош айланиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Чанқоқни ҳис қилиш</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ёмон кайфият</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Баъзи препаратларни қабул қилиш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Кўплаб йўлдош касалликлар</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Чекланган ҳаракат/йиқилиш/кескин ҳолсизлик</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Оғриқ</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Стационарда яқинда даволанганлик</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик чиқариш йўлининг такрорий инфекциялари</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Кўришнинг бузилиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Кўрик ва кузатув маълумотлари </strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Суткада ичилган ва чиқарилган суюқлик нисбати</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериал қон босими/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Онгнинг чалкашиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Уйқучанлик, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Оғиз қуриши, кўзлар қуруқлиги, тери қуруқлиги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Иситма</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нафас олиш тезлиги ошиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Етарли бўлмаган тўлалик</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Очиқ яралар мавжудлиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Терлаш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Текширишлар натижалари</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик рангининг тўқлиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик зичлигининг юқорилиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Умуман олганда, кекса одамларда дегидратация хавфининг барча омилларини 4 та катта гуруҳга бўлиш мумкин (3-расм)</strong>\r\n\r\nДегидратациянинг энг муҳим клиник белгилари: қўлтиқ ости терлашининг камайиши, тери таранглигининг пасайиши, оғиз шиллиқ қаватининг қуруқлиги, яқин орада юз берган онг бузилиши, сийдик рангининг тўқлиги [16]. Шунингдек, гиповолемик шок белгиларига ҳам эътибор қаратиш зарур: совуқ ва ёпишқоқ тери, сийдик ажралиб чиқишининг камайиши, бўйин веналарининг яссиланиши,  онгнинг бузилиши, юрак иш унумининг пасайиши.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Кекса ёшдаги шахсларда регидратация хавфи омиллари</strong></p>\r\n\r\n<h2>Кекса ёшдаги шахсларда регидратациянинг ўзига хос хусусиятлари</h2>\r\nКекса ёшдаги шахсларда регидратация пациентнинг когнитив ўзгаришлари, унинг жисмоний чекланишлари, шунингдек сийдик тутиб тура олмаслик ва бунинг оқибатида сув ичишни истамаслик  сабабли қийинлашади. Регидратация тактикасини  сувсизланиш даражасига боғлиқ ҳолда танлаш зарур. Масалан, енгил дегидратацияда орал регидратация, ўртачада – орал ва вена ичига регидратация ( баланслашган кристаллоидлар эритмаси ёрдамида) қўлланилади. Асосий белгилари гипотензия ва тахикардия бўлган оғир дегидратация ҳолларида веналар ичига регидратация, имкони бўлса орал регидратация билан бирга тайинланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">2-жадвал. Дегидратацияни коррекциялаш учун зарур суюқлик миқдорини ҳисоблаш</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Ҳисоблаш</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Дегидратациягача вазни (кг) – айни вақтдаги вазни (кг) =  </strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Та</strong><strong>нқисликни қоплаш так</strong><strong>тика</strong><strong>си</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутка</td>\r\n<td width=\"197\">Қопланган танқислик улуши (%)</td>\r\n<td width=\"180\">Базавий кунлик эҳтиёжлар</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Изоҳ. Суткалик суюқлик истеъмоли ўз ичига базавий кунлик эҳтиёж + тегишли танқислик улушини олиши керак</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nКекса ёшдаги пациентлар коморбид (йўлдош) касалликларининг кўплиги ва умумий ҳолсизланиши билан тавсифланади. Шунинг учун бу пациентларда ҳар қандай даволашнинг хавфсизлиги алоҳида аҳамият касб этади. Орал регидратация суюқлик ва электролитлар танқислигини секин-аста физиологик йўл билан тўлдириш имконини беради ва бир қатор бошқа афзалликларга эга.\r\n<h2>Профилактика</h2>\r\n<strong>Орал регидратациянинг вена ичига регидратациядан афзалликлари </strong><strong>[17]:</strong>\r\n<ul>\r\n 	<li>вена ичига регидратациядан анча физиологик;</li>\r\n 	<li>юқори самарадорлик;</li>\r\n 	<li>жуда яхши хавфсизлик профили ( инфузияларга хос бўлган асоратлар ривожланиш хавфисиз);</li>\r\n 	<li>қийматининг пастлиги.</li>\r\n</ul>\r\n<strong>Кекса ёшдаги шахсларда дегидратациянинг олдини олиш бўйича тавсиялар [16]:</strong>\r\n<ul>\r\n 	<li>ёрқин чашкалардан фойдаланинг;</li>\r\n 	<li>кулерлар ва сув баллонларини қўлланг;</li>\r\n 	<li>ҳар 1,5 соатда ва муайян ҳаракатлар  (душ қабул қилиш, ҳожатхонага кириб-чиқиш, дори қабул қилиш)дан  сўнг сув таклиф қилинг;</li>\r\n 	<li>овқат устидан сув ичиш ва суюқ овқат (шўрва, желе, йогурт, мева пюрелари, мороженое) истеъмол қилишни рағбатлантиринг;</li>\r\n 	<li>суюқлик ичиш ва сийишни ҳисобга олиш журналини юритинг;</li>\r\n 	<li>агар 7 кун мобайнида тана массасининг 4% дан кўп йўқотилиши кузатилса 3 кунга фаол орал регидратация тайинлаш мақсадга мувофиқ.</li>\r\n 	<li>оғир дегидратация ҳолатларида шифохонага ётқизиш ва вена ичига регидратация қилиш зарур.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">3-жадвал. Тана вазнига боғлиқ ҳолда суюқликка эҳтиёж (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вазн (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Суюқликка эҳтиёж (л/сутки)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>4-расм. Сув истеъмолини ошириш бўйича маслаҳатлар</strong></p>\r\n\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТаркибида барча зарур электролитлар ва сорбитол бўлган тиббий мақсадлар учун ReO суви орал регидратацияда фойдаланиш учун тайёр эритма ҳисобланади. Сорбитол – бу энергиянинг қўшимча манбаи бўлиб, уни организм ҳужайралари инсулин иштирокисиз ўзлаштиради. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">4-жадвал. ReO сувининг мувозанатлаштирилган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Таркиби</th>\r\n<th width=\"151\">Миқдори</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради [18].</li>\r\n 	<li></li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Кекса ёшдаги одамларда орал регидратация','','publish','open','open','','keksa-yoshdagi-odamlarda-oral-regidratacziya','','','2021-08-30 12:26:29','2021-08-30 09:26:29','',0,'https://reo.ua/uncategorized-uz/oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta/',21,'post','',0),(1600,1,'2021-06-25 13:42:13','2021-06-25 10:42:13','','Оральна регідратація у осіб похилого віку_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021-2-2','','','2021-06-25 13:42:13','2021-06-25 10:42:13','',1599,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-osib-pohilogo-viku_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(1601,1,'2021-06-25 13:42:40','2021-06-25 10:42:40','','prew3','','inherit','open','closed','','prew3-2-2','','','2021-06-25 13:42:40','2021-06-25 10:42:40','',1599,'https://reo.ua/wp-content/uploads/2021/06/prew3.jpg',0,'attachment','image/jpeg',0),(1602,1,'2021-08-30 12:25:59','2021-08-30 09:25:59','<h2>Кекса ёшдаги одамларда орал регидратация</h2>\n65 ёшдан ошган одамлар кекса ёшдаги одамлар ҳисобланади. Ўз навбатида, “гериатрик пациент” тушунчаси  энг аввало ёш билан эмас, балки одамнинг анча қувватсизлиги ва кўплаб касалликлари билан боғлиқ. Гериатик пациентларни парваришлашнинг асосий мақсади – уларнинг  ўз-ўзига хизмат кўрсатиш қобилиятини сақлаб қолиш ва ҳаёт сифатини яхшилаш мақсадида уларнинг функционал ҳолатини яхшилаш ва сақлаб туришдан иборат [1].\n\nКекса ва қари ёшдаги одамларда дегидратация  оғир муаммолардан бири ҳисобланади [1].  Лимфа, юрак-қон томир, овқат ҳазм қилиш ва сийдик тизимининг тўлиқ ишлаши учун етарли миқдордаги суюқлик зарур.  Лекин ёш ўтган сари организмда умумий сув миқдори камайиши юз беради, бу юқорида санаб ўтилган тизимларнинг ишини ёмонлаштиради [2]. Масалан, ёш одамда организмдаги сувнинг жами миқдори  тахминан 60% ни, 70 ёшдаги пациентда эса  - тахминан 40% ни ташкил этади [3].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\n<p style=\"text-align: center;\"><strong>1-расм. Организмда сув миқдорининг ёшга қараб камайиши</strong></p>\nЖаҳон соғлиқни сақлаш ташкилоти кекса ёшдаги аёлларга ҳар куни 2,2 л, эркакларга эса – 2,9 л суюқлик ичишни тавсия этади. Лекин ҳақиқий ҳаётда 70 ёшдан ошган ўртача статистик одам 1,5 л дан кам суюқлик ичади [4]. Бу ёшда етарлича сув ичмасликнинг сабаблари  жисмоний чекланганлик, ҳожатга чиқишдаги қийинчиликлар, фикрлаш ва руҳий ҳолатнинг бузилиши, кўп миқдорда дори-дармонлар қабул қилиш ҳисобланади, улар сув мувозанатини бузилишига олиб келиши мумкин.\n<h2><strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари, клиник кўриниши ва хавфини баҳолаш</strong></h2>\n<strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари:</strong>\n<ul>\n 	<li>суюқликнинг танадаги фоиз миқдори камлиги сабабли суюқлик захирасининг камлиги;</li>\n 	<li>чанқоқни ҳис қилишнинг камайиши</li>\n 	<li>мушак/ёғ тўқималари нисбатининг камайиши (бу муҳим, чунки мушакларда ёғ тўқималарига қараганда 2-7 марта кўпроқ сув сақланади);</li>\n 	<li>дегидратация симптомларини аниқлашдаги қийинчиликлар (коллаген ва тери ости ёғ қаватининг камайиши муносабати билан тери таранглигининг камайиши ва кўзларнинг ботиқлиги, оғиз шиллиқ қаватининг қуруқлигига олиб келадиган ва сувсизланишни ўз вақтида ташхислашни қийинлаштирадиган ўпка ва юракнинг сурункали касалликлари натижасида тез-тез нафас олиш);</li>\n 	<li>деменция;</li>\n 	<li>диуретикларни  қабул қилиш [2].</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Кекса ёшдаги шахсларда дегидратациянинг юқори хавфи</strong></p>\nДегидратация бир қатор оғир патологик ҳолатлар билан боғлиқлиги сабабли хавфли.\n\nДегидратация билан боғлиқ соғлиқ бузилишлари:\n<ul>\n 	<li>йиқилиш ва синишлар;</li>\n 	<li>онгнинг ва фикрлашнинг бузилиши;</li>\n 	<li>қабзиятлар;</li>\n 	<li>сийдик чиқариш тизимининг инфекциялари;</li>\n 	<li>буйрак етишмовчилиги;</li>\n 	<li>дори-дармонларнинг потенциал токсиклигининг ошиши;</li>\n 	<li>яралар битишининг секинлашиши;</li>\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан вертикал ҳолатга ўтишда  артериал босимнинг &gt;20 мм симоб устунидан пасайиши);</li>\n 	<li>тана ҳарорати кўтарилиши;</li>\n 	<li>қандли диабетда глюкоза миқдорини назорат қилишнинг ёмонлашиши [6].</li>\n</ul>\nТурли тадқиқотлар маълумотларига кўра дегидратация хавфи ҳар-хил омиллар билан боғлиқ (1-жадвал).\n<table>\n<tbody>\n<tr>\n<th colspan=\"9\" width=\"623\">1-жадвал. Кекса ёшдаги шахсларда дегидратация хавфини баҳолаш (7)</th>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<td colspan=\"9\" width=\"623\"><strong>Анамне</strong><strong>з маълумотлари</strong></td>\n</tr>\n<tr>\n<td width=\"169\">Ёш</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     70+</td>\n<td width=\"53\">✓     85+</td>\n<td width=\"68\">✓        85+</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓     85+</td>\n</tr>\n<tr>\n<td width=\"169\">Қабзият/ сийдик тутолмаслик</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Ич суриши/ қайт қилиш</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Овқатдан чекланишлар</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n&nbsp;\n<table>\n<tbody>\n<tr>\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>1-жадвал. Кекса ёшдаги шахслардадегидратация хавфини баҳолаш (7)</strong></td>\n</tr>\n<tr>\n<th width=\"169\"></th>\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\n<th width=\"53\"><strong>Wotton [10]</strong></th>\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\n<th width=\"53\"><strong>GULP [11]</strong></th>\n<th width=\"53\"><strong>Mentes [14]</strong></th>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Ютишнинг қийинлашуви</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Бош айланиши</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Чанқоқни ҳис қилиш</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Ёмон кайфият</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Баъзи препаратларни қабул қилиш</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Кўплаб йўлдош касалликлар</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      3+</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"68\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\nX</td>\n<td width=\"53\">&nbsp;\n\n✓      4+</td>\n</tr>\n<tr>\n<td width=\"169\">Чекланган ҳаракат/йиқилиш/кескин ҳолсизлик</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Оғриқ</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Стационарда яқинда даволанганлик</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Сийдик чиқариш йўлининг такрорий инфекциялари</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Кўришнинг бузилиши</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Кўрик ва кузатув маълумотлари </strong></th>\n</tr>\n<tr>\n<td width=\"169\">Суткада ичилган ва чиқарилган суюқлик нисбати</td>\n<td width=\"53\">X</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"68\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n<td width=\"53\">&nbsp;\n\n✓</td>\n</tr>\n<tr>\n<td width=\"169\">Артериал қон босими/пульс</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Онгнинг чалкашиши</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Уйқучанлик, летаргия</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Оғиз қуриши, кўзлар қуруқлиги, тери қуруқлиги</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Иситма</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Нафас олиш тезлиги ошиши</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Етарли бўлмаган тўлалик</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Очиқ яралар мавжудлиги</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Терлаш</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<th colspan=\"9\" width=\"623\"><strong>Текширишлар натижалари</strong></th>\n</tr>\n<tr>\n<td width=\"169\">Гипергликемия</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">X</td>\n<td width=\"68\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n</tr>\n<tr>\n<td width=\"169\">Сийдик рангининг тўқлиги</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">✓</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">✓</td>\n</tr>\n<tr>\n<td width=\"169\">Сийдик зичлигининг юқорилиги</td>\n<td width=\"53\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n<td width=\"53\">X</td>\n<td width=\"68\">✓</td>\n<td width=\"68\">X</td>\n<td width=\"53\">X</td>\n<td width=\"53\">✓</td>\n</tr>\n</tbody>\n</table>\n<strong>Умуман олганда, кекса одамларда дегидратация хавфининг барча омилларини 4 та катта гуруҳга бўлиш мумкин (3-расм)</strong>\n\nДегидратациянинг энг муҳим клиник белгилари: қўлтиқ ости терлашининг камайиши, тери таранглигининг пасайиши, оғиз шиллиқ қаватининг қуруқлиги, яқин орада юз берган онг бузилиши, сийдик рангининг тўқлиги [16]. Шунингдек, гиповолемик шок белгиларига ҳам эътибор қаратиш зарур: совуқ ва ёпишқоқ тери, сийдик ажралиб чиқишининг камайиши, бўйин веналарининг яссиланиши,  онгнинг бузилиши, юрак иш унумининг пасайиши.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\n<p style=\"text-align: center;\"><strong>3-расм. Кекса ёшдаги шахсларда регидратация хавфи омиллари</strong></p>\n\n<h2>Кекса ёшдаги шахсларда регидратациянинг ўзига хос хусусиятлари</h2>\nКекса ёшдаги шахсларда регидратация пациентнинг когнитив ўзгаришлари, унинг жисмоний чекланишлари, шунингдек сийдик тутиб тура олмаслик ва бунинг оқибатида сув ичишни истамаслик  сабабли қийинлашади. Регидратация тактикасини  сувсизланиш даражасига боғлиқ ҳолда танлаш зарур. Масалан, енгил дегидратацияда орал регидратация, ўртачада – орал ва вена ичига регидратация ( баланслашган кристаллоидлар эритмаси ёрдамида) қўлланилади. Асосий белгилари гипотензия ва тахикардия бўлган оғир дегидратация ҳолларида веналар ичига регидратация, имкони бўлса орал регидратация билан бирга тайинланади.\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"472\">2-жадвал. Дегидратацияни коррекциялаш учун зарур суюқлик миқдорини ҳисоблаш</th>\n</tr>\n<tr>\n<th width=\"94\"><strong>Ҳисоблаш</strong></th>\n<th colspan=\"2\" width=\"378\"><strong>Дегидратациягача вазни (кг) – айни вақтдаги вазни (кг) =  </strong></th>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><strong>Та</strong><strong>нқисликни қоплаш так</strong><strong>тика</strong><strong>си</strong></td>\n</tr>\n<tr>\n<td width=\"94\">Сутка</td>\n<td width=\"197\">Қопланган танқислик улуши (%)</td>\n<td width=\"180\">Базавий кунлик эҳтиёжлар</td>\n</tr>\n<tr>\n<td width=\"94\">1</td>\n<td width=\"197\">50</td>\n<td width=\"180\">Камида 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">2</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Камида 1500 мл</td>\n</tr>\n<tr>\n<td width=\"94\">3</td>\n<td width=\"197\">25</td>\n<td width=\"180\">Камида 1500 мл</td>\n</tr>\n<tr>\n<td colspan=\"3\" width=\"472\"><em>Изоҳ. Суткалик суюқлик истеъмоли ўз ичига базавий кунлик эҳтиёж + тегишли танқислик улушини олиши керак</em></td>\n</tr>\n</tbody>\n</table>\nКекса ёшдаги пациентлар коморбид (йўлдош) касалликларининг кўплиги ва умумий ҳолсизланиши билан тавсифланади. Шунинг учун бу пациентларда ҳар қандай даволашнинг хавфсизлиги алоҳида аҳамият касб этади. Орал регидратация суюқлик ва электролитлар танқислигини секин-аста физиологик йўл билан тўлдириш имконини беради ва бир қатор бошқа афзалликларга эга.\n<h2>Профилактика</h2>\n<strong>Орал регидратациянинг вена ичига регидратациядан афзалликлари </strong><strong>[17]:</strong>\n<ul>\n 	<li>вена ичига регидратациядан анча физиологик;</li>\n 	<li>юқори самарадорлик;</li>\n 	<li>жуда яхши хавфсизлик профили ( инфузияларга хос бўлган асоратлар ривожланиш хавфисиз);</li>\n 	<li>қийматининг пастлиги.</li>\n</ul>\n<strong>Кекса ёшдаги шахсларда дегидратациянинг олдини олиш бўйича тавсиялар [16]:</strong>\n<ul>\n 	<li>ёрқин чашкалардан фойдаланинг;</li>\n 	<li>кулерлар ва сув баллонларини қўлланг;</li>\n 	<li>ҳар 1,5 соатда ва муайян ҳаракатлар  (душ қабул қилиш, ҳожатхонага кириб-чиқиш, дори қабул қилиш)дан  сўнг сув таклиф қилинг;</li>\n 	<li>овқат устидан сув ичиш ва суюқ овқат (шўрва, желе, йогурт, мева пюрелари, мороженое) истеъмол қилишни рағбатлантиринг;</li>\n 	<li>суюқлик ичиш ва сийишни ҳисобга олиш журналини юритинг;</li>\n 	<li>агар 7 кун мобайнида тана массасининг 4% дан кўп йўқотилиши кузатилса 3 кунга фаол орал регидратация тайинлаш мақсадга мувофиқ.</li>\n 	<li>оғир дегидратация ҳолатларида шифохонага ётқизиш ва вена ичига регидратация қилиш зарур.</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"17\" width=\"621\">3-жадвал. Тана вазнига боғлиқ ҳолда суюқликка эҳтиёж (16)</th>\n</tr>\n<tr>\n<th width=\"137\"><strong>Вазн (кг)</strong></th>\n<td width=\"30\">≤30</td>\n<td width=\"30\">35</td>\n<td width=\"30\">40</td>\n<td width=\"30\">45</td>\n<td width=\"30\">50</td>\n<td width=\"30\">55</td>\n<td width=\"30\">60</td>\n<td width=\"30\">65</td>\n<td width=\"30\">70</td>\n<td width=\"30\">75</td>\n<td width=\"30\">80</td>\n<td width=\"30\">85</td>\n<td width=\"30\">90</td>\n<td width=\"30\">95</td>\n<td width=\"30\">100</td>\n<td width=\"30\">105</td>\n</tr>\n<tr>\n<th width=\"137\"><strong>Суюқликка эҳтиёж (л/сутки)</strong></th>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,7</td>\n<td width=\"30\">1,8</td>\n<td width=\"30\">1,9</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,0</td>\n<td width=\"30\">2,1</td>\n<td width=\"30\">2,2</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,3</td>\n<td width=\"30\">2,4</td>\n<td width=\"30\">2,5</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,6</td>\n<td width=\"30\">2,7</td>\n<td width=\"30\">2,8</td>\n</tr>\n</tbody>\n</table>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\n<p style=\"text-align: center;\"><strong>4-расм. Сув истеъмолини ошириш бўйича маслаҳатлар</strong></p>\n\n<h2>Тиббий мақсадлар учун ReO суви\n(«Юрия-Фарм»)</h2>\nТаркибида барча зарур электролитлар ва сорбитол бўлган тиббий мақсадлар учун ReO суви орал регидратацияда фойдаланиш учун тайёр эритма ҳисобланади. Сорбитол – бу энергиянинг қўшимча манбаи бўлиб, уни организм ҳужайралари инсулин иштирокисиз ўзлаштиради. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">4-жадвал. ReO сувининг мувозанатлаштирилган таркиби</th>\n</tr>\n<tr>\n<th width=\"151\">Таркиби</th>\n<th width=\"151\">Миқдори</th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\n</tr>\n</tbody>\n</table>\n<h2>ReO сувининг афзалликлари</h2>\n<ul>\n 	<li>мувозанатлаштирилган таркибга эга;</li>\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\n 	<li>имеет приятный вкус и легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>нормализует диурез, снижает интоксикацию [18].</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\n</ol>','Кекса ёшдаги одамларда орал регидратация','','inherit','closed','closed','','1599-autosave-v1','','','2021-08-30 12:25:59','2021-08-30 09:25:59','',1599,'https://reo.ua/?p=1602',0,'revision','',0),(1603,1,'2021-08-30 12:26:29','2021-08-30 09:26:29','<h2>Кекса ёшдаги одамларда орал регидратация</h2>\r\n65 ёшдан ошган одамлар кекса ёшдаги одамлар ҳисобланади. Ўз навбатида, “гериатрик пациент” тушунчаси  энг аввало ёш билан эмас, балки одамнинг анча қувватсизлиги ва кўплаб касалликлари билан боғлиқ. Гериатик пациентларни парваришлашнинг асосий мақсади – уларнинг  ўз-ўзига хизмат кўрсатиш қобилиятини сақлаб қолиш ва ҳаёт сифатини яхшилаш мақсадида уларнинг функционал ҳолатини яхшилаш ва сақлаб туришдан иборат [1].\r\n\r\nКекса ва қари ёшдаги одамларда дегидратация  оғир муаммолардан бири ҳисобланади [1].  Лимфа, юрак-қон томир, овқат ҳазм қилиш ва сийдик тизимининг тўлиқ ишлаши учун етарли миқдордаги суюқлик зарур.  Лекин ёш ўтган сари организмда умумий сув миқдори камайиши юз беради, бу юқорида санаб ўтилган тизимларнинг ишини ёмонлаштиради [2]. Масалан, ёш одамда организмдаги сувнинг жами миқдори  тахминан 60% ни, 70 ёшдаги пациентда эса  - тахминан 40% ни ташкил этади [3].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1.png\"><img class=\"aligncenter size-large wp-image-926\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_1-1024x645.png\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Организмда сув миқдорининг ёшга қараб камайиши</strong></p>\r\nЖаҳон соғлиқни сақлаш ташкилоти кекса ёшдаги аёлларга ҳар куни 2,2 л, эркакларга эса – 2,9 л суюқлик ичишни тавсия этади. Лекин ҳақиқий ҳаётда 70 ёшдан ошган ўртача статистик одам 1,5 л дан кам суюқлик ичади [4]. Бу ёшда етарлича сув ичмасликнинг сабаблари  жисмоний чекланганлик, ҳожатга чиқишдаги қийинчиликлар, фикрлаш ва руҳий ҳолатнинг бузилиши, кўп миқдорда дори-дармонлар қабул қилиш ҳисобланади, улар сув мувозанатини бузилишига олиб келиши мумкин.\r\n<h2><strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари, клиник кўриниши ва хавфини баҳолаш</strong></h2>\r\n<strong>Дегидратациянинг ёш билан боғлиқ хусусиятлари:</strong>\r\n<ul>\r\n 	<li>суюқликнинг танадаги фоиз миқдори камлиги сабабли суюқлик захирасининг камлиги;</li>\r\n 	<li>чанқоқни ҳис қилишнинг камайиши</li>\r\n 	<li>мушак/ёғ тўқималари нисбатининг камайиши (бу муҳим, чунки мушакларда ёғ тўқималарига қараганда 2-7 марта кўпроқ сув сақланади);</li>\r\n 	<li>дегидратация симптомларини аниқлашдаги қийинчиликлар (коллаген ва тери ости ёғ қаватининг камайиши муносабати билан тери таранглигининг камайиши ва кўзларнинг ботиқлиги, оғиз шиллиқ қаватининг қуруқлигига олиб келадиган ва сувсизланишни ўз вақтида ташхислашни қийинлаштирадиган ўпка ва юракнинг сурункали касалликлари натижасида тез-тез нафас олиш);</li>\r\n 	<li>деменция;</li>\r\n 	<li>диуретикларни  қабул қилиш [2].</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1.png\"><img class=\"aligncenter size-large wp-image-929\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_2_1-1024x782.png\" alt=\"\" width=\"1024\" height=\"782\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Кекса ёшдаги шахсларда дегидратациянинг юқори хавфи</strong></p>\r\nДегидратация бир қатор оғир патологик ҳолатлар билан боғлиқлиги сабабли хавфли.\r\n\r\nДегидратация билан боғлиқ соғлиқ бузилишлари:\r\n<ul>\r\n 	<li>йиқилиш ва синишлар;</li>\r\n 	<li>онгнинг ва фикрлашнинг бузилиши;</li>\r\n 	<li>қабзиятлар;</li>\r\n 	<li>сийдик чиқариш тизимининг инфекциялари;</li>\r\n 	<li>буйрак етишмовчилиги;</li>\r\n 	<li>дори-дармонларнинг потенциал токсиклигининг ошиши;</li>\r\n 	<li>яралар битишининг секинлашиши;</li>\r\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан вертикал ҳолатга ўтишда  артериал босимнинг &gt;20 мм симоб устунидан пасайиши);</li>\r\n 	<li>тана ҳарорати кўтарилиши;</li>\r\n 	<li>қандли диабетда глюкоза миқдорини назорат қилишнинг ёмонлашиши [6].</li>\r\n</ul>\r\nТурли тадқиқотлар маълумотларига кўра дегидратация хавфи ҳар-хил омиллар билан боғлиқ (1-жадвал).\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\">1-жадвал. Кекса ёшдаги шахсларда дегидратация хавфини баҳолаш (7)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"9\" width=\"623\"><strong>Анамне</strong><strong>з маълумотлари</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ёш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     70+</td>\r\n<td width=\"53\">✓     85+</td>\r\n<td width=\"68\">✓        85+</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓     85+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Қабзият/ сийдик тутолмаслик</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ич суриши/ қайт қилиш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Овқатдан чекланишлар</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n&nbsp;\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center;\" colspan=\"9\" width=\"623\"><strong>1-жадвал. Кекса ёшдаги шахслардадегидратация хавфини баҳолаш (7)</strong></td>\r\n</tr>\r\n<tr>\r\n<th width=\"169\"></th>\r\n<th width=\"53\"><strong>Vivanti, 2010 </strong><strong>[8]</strong></th>\r\n<th width=\"53\"><strong>Vivanti, 2008 </strong><strong>[9]</strong></th>\r\n<th width=\"53\"><strong>Wotton [10]</strong></th>\r\n<th width=\"53\"><strong>Mentes, Wang [15]</strong></th>\r\n<th width=\"68\"><strong>Zembrzuski [12]</strong></th>\r\n<th width=\"68\"><strong>NHS </strong><strong>East </strong><strong>of England [13]</strong></th>\r\n<th width=\"53\"><strong>GULP [11]</strong></th>\r\n<th width=\"53\"><strong>Mentes [14]</strong></th>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Данные анамнеза</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ютишнинг қийинлашуви</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Бош айланиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Чанқоқни ҳис қилиш</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Ёмон кайфият</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Баъзи препаратларни қабул қилиш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Кўплаб йўлдош касалликлар</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      3+</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"68\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\nX</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓      4+</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Чекланган ҳаракат/йиқилиш/кескин ҳолсизлик</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Оғриқ</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Стационарда яқинда даволанганлик</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик чиқариш йўлининг такрорий инфекциялари</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Кўришнинг бузилиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Кўрик ва кузатув маълумотлари </strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Суткада ичилган ва чиқарилган суюқлик нисбати</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"68\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n<td width=\"53\">&nbsp;\r\n\r\n✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Артериал қон босими/пульс</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Онгнинг чалкашиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Уйқучанлик, летаргия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Оғиз қуриши, кўзлар қуруқлиги, тери қуруқлиги</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Иситма</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Нафас олиш тезлиги ошиши</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Етарли бўлмаган тўлалик</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Очиқ яралар мавжудлиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Терлаш</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<th colspan=\"9\" width=\"623\"><strong>Текширишлар натижалари</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Гипергликемия</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик рангининг тўқлиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n<tr>\r\n<td width=\"169\">Сийдик зичлигининг юқорилиги</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"68\">✓</td>\r\n<td width=\"68\">X</td>\r\n<td width=\"53\">X</td>\r\n<td width=\"53\">✓</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<strong>Умуман олганда, кекса одамларда дегидратация хавфининг барча омилларини 4 та катта гуруҳга бўлиш мумкин (3-расм)</strong>\r\n\r\nДегидратациянинг энг муҳим клиник белгилари: қўлтиқ ости терлашининг камайиши, тери таранглигининг пасайиши, оғиз шиллиқ қаватининг қуруқлиги, яқин орада юз берган онг бузилиши, сийдик рангининг тўқлиги [16]. Шунингдек, гиповолемик шок белгиларига ҳам эътибор қаратиш зарур: совуқ ва ёпишқоқ тери, сийдик ажралиб чиқишининг камайиши, бўйин веналарининг яссиланиши,  онгнинг бузилиши, юрак иш унумининг пасайиши.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2.png\"><img class=\"aligncenter size-large wp-image-991\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_4-2-1024x313.png\" alt=\"\" width=\"1024\" height=\"313\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Кекса ёшдаги шахсларда регидратация хавфи омиллари</strong></p>\r\n\r\n<h2>Кекса ёшдаги шахсларда регидратациянинг ўзига хос хусусиятлари</h2>\r\nКекса ёшдаги шахсларда регидратация пациентнинг когнитив ўзгаришлари, унинг жисмоний чекланишлари, шунингдек сийдик тутиб тура олмаслик ва бунинг оқибатида сув ичишни истамаслик  сабабли қийинлашади. Регидратация тактикасини  сувсизланиш даражасига боғлиқ ҳолда танлаш зарур. Масалан, енгил дегидратацияда орал регидратация, ўртачада – орал ва вена ичига регидратация ( баланслашган кристаллоидлар эритмаси ёрдамида) қўлланилади. Асосий белгилари гипотензия ва тахикардия бўлган оғир дегидратация ҳолларида веналар ичига регидратация, имкони бўлса орал регидратация билан бирга тайинланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"472\">2-жадвал. Дегидратацияни коррекциялаш учун зарур суюқлик миқдорини ҳисоблаш</th>\r\n</tr>\r\n<tr>\r\n<th width=\"94\"><strong>Ҳисоблаш</strong></th>\r\n<th colspan=\"2\" width=\"378\"><strong>Дегидратациягача вазни (кг) – айни вақтдаги вазни (кг) =  </strong></th>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><strong>Та</strong><strong>нқисликни қоплаш так</strong><strong>тика</strong><strong>си</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">Сутка</td>\r\n<td width=\"197\">Қопланган танқислик улуши (%)</td>\r\n<td width=\"180\">Базавий кунлик эҳтиёжлар</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">1</td>\r\n<td width=\"197\">50</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">2</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td width=\"94\">3</td>\r\n<td width=\"197\">25</td>\r\n<td width=\"180\">Камида 1500 мл</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"3\" width=\"472\"><em>Изоҳ. Суткалик суюқлик истеъмоли ўз ичига базавий кунлик эҳтиёж + тегишли танқислик улушини олиши керак</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nКекса ёшдаги пациентлар коморбид (йўлдош) касалликларининг кўплиги ва умумий ҳолсизланиши билан тавсифланади. Шунинг учун бу пациентларда ҳар қандай даволашнинг хавфсизлиги алоҳида аҳамият касб этади. Орал регидратация суюқлик ва электролитлар танқислигини секин-аста физиологик йўл билан тўлдириш имконини беради ва бир қатор бошқа афзалликларга эга.\r\n<h2>Профилактика</h2>\r\n<strong>Орал регидратациянинг вена ичига регидратациядан афзалликлари </strong><strong>[17]:</strong>\r\n<ul>\r\n 	<li>вена ичига регидратациядан анча физиологик;</li>\r\n 	<li>юқори самарадорлик;</li>\r\n 	<li>жуда яхши хавфсизлик профили ( инфузияларга хос бўлган асоратлар ривожланиш хавфисиз);</li>\r\n 	<li>қийматининг пастлиги.</li>\r\n</ul>\r\n<strong>Кекса ёшдаги шахсларда дегидратациянинг олдини олиш бўйича тавсиялар [16]:</strong>\r\n<ul>\r\n 	<li>ёрқин чашкалардан фойдаланинг;</li>\r\n 	<li>кулерлар ва сув баллонларини қўлланг;</li>\r\n 	<li>ҳар 1,5 соатда ва муайян ҳаракатлар  (душ қабул қилиш, ҳожатхонага кириб-чиқиш, дори қабул қилиш)дан  сўнг сув таклиф қилинг;</li>\r\n 	<li>овқат устидан сув ичиш ва суюқ овқат (шўрва, желе, йогурт, мева пюрелари, мороженое) истеъмол қилишни рағбатлантиринг;</li>\r\n 	<li>суюқлик ичиш ва сийишни ҳисобга олиш журналини юритинг;</li>\r\n 	<li>агар 7 кун мобайнида тана массасининг 4% дан кўп йўқотилиши кузатилса 3 кунга фаол орал регидратация тайинлаш мақсадга мувофиқ.</li>\r\n 	<li>оғир дегидратация ҳолатларида шифохонага ётқизиш ва вена ичига регидратация қилиш зарур.</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"17\" width=\"621\">3-жадвал. Тана вазнига боғлиқ ҳолда суюқликка эҳтиёж (16)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Вазн (кг)</strong></th>\r\n<td width=\"30\">≤30</td>\r\n<td width=\"30\">35</td>\r\n<td width=\"30\">40</td>\r\n<td width=\"30\">45</td>\r\n<td width=\"30\">50</td>\r\n<td width=\"30\">55</td>\r\n<td width=\"30\">60</td>\r\n<td width=\"30\">65</td>\r\n<td width=\"30\">70</td>\r\n<td width=\"30\">75</td>\r\n<td width=\"30\">80</td>\r\n<td width=\"30\">85</td>\r\n<td width=\"30\">90</td>\r\n<td width=\"30\">95</td>\r\n<td width=\"30\">100</td>\r\n<td width=\"30\">105</td>\r\n</tr>\r\n<tr>\r\n<th width=\"137\"><strong>Суюқликка эҳтиёж (л/сутки)</strong></th>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,7</td>\r\n<td width=\"30\">1,8</td>\r\n<td width=\"30\">1,9</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,0</td>\r\n<td width=\"30\">2,1</td>\r\n<td width=\"30\">2,2</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,3</td>\r\n<td width=\"30\">2,4</td>\r\n<td width=\"30\">2,5</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,6</td>\r\n<td width=\"30\">2,7</td>\r\n<td width=\"30\">2,8</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6.png\"><img class=\"aligncenter size-large wp-image-948\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_6-1024x345.png\" alt=\"\" width=\"1024\" height=\"345\" /></a>\r\n<p style=\"text-align: center;\"><strong>4-расм. Сув истеъмолини ошириш бўйича маслаҳатлар</strong></p>\r\n\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТаркибида барча зарур электролитлар ва сорбитол бўлган тиббий мақсадлар учун ReO суви орал регидратацияда фойдаланиш учун тайёр эритма ҳисобланади. Сорбитол – бу энергиянинг қўшимча манбаи бўлиб, уни организм ҳужайралари инсулин иштирокисиз ўзлаштиради. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">4-жадвал. ReO сувининг мувозанатлаштирилган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\">Таркиби</th>\r\n<th width=\"151\">Миқдори</th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация <span style=\"font-family: inherit; font-size: inherit;\">(мг/дм3): 2500-3000</span></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради [18].</li>\r\n 	<li></li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li><em>Volkert , et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2019; 38: 10-47.</em></li>\r\n 	<li><em>Miller</em> <em>J.</em> <em>Dehydration</em> <em>in</em> <em>the</em> <em>older</em> <em>adult.</em> <em>Journal</em> <em>of Gerontological Nursing. 2015; 41 (9): 8-13.</em></li>\r\n 	<li><em>O’Donnell E. Assessing fluid and electrolyte balance in elders. American Journal of Nursing. 2013; 95: 40-46.</em></li>\r\n 	<li><em>Thomas R., et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors </em><em>Association. 2008; 9: 292-301.</em></li>\r\n 	<li><em>Hydration in the Available at: https://</em><em>www.hydrationforhealth.com/en/hydration-science/hydration-lab/</em> <em>hydration-aging.</em></li>\r\n 	<li><em>Thomas Why is dehydration a problem in older patients and care home residents? Nursing Times [online]. 2020; 116 (8): 45-48.</em></li>\r\n 	<li><em>Oates L., Price C.I. Clinical assessments and care interventions to promote oral hydration amongst older patients: </em><em>a narrative systematic review. BMC Nurs. 2017; 16 (4).</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch. Gerontol. Geriatr. 2010; 50 (2): 156-164.</em></li>\r\n 	<li><em>Vivanti , Harvey K., Ash S., Battistutta D. Clinical assessment of dehydration in older people admitted to hospital. What are the strongest indicators? Arch. Gerontol. Geriatr. 2008; 47: 340-355.</em></li>\r\n 	<li><em>Wotton , Crannitch K., Munt R. Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemp. </em><em>Nurse. 2008; 31: 44-56.</em></li>\r\n 	<li><em>Food First team, part of SEPT Community Health Services GULP tool. 2012. Available at: http:// </em><em>www.sept.nhs.uk/wp-content/uploads/2014/07/GULP-Dehydration-risk-screening-tool.pdf.</em></li>\r\n 	<li><em>Zembrzuski D. A three-dimensional approach to hydration of elders: administration, clinical staff, and in-service </em><em>education. Geriatr. Nurs. 1997; 18 (1): 20-26.</em></li>\r\n 	<li><em>NHS East of Adult intelligent fluid management bundle. 2011. Available at: </em><em>http://www.harmfreecare.org/</em> <em>wp-content/uploads/2012/04/In-Action-Direct-Upload-EOE-3.pdf.</em></li>\r\n 	<li><em>Mentes C., Iowa-Veterans Affairs Nursing Research Consortium. Hydration management protocol. J. Gerontol. Nurs. </em><em>2000; 26 (10): 6-15.</em></li>\r\n 	<li><em>Mentes , Wang J. Measuring risk for dehydration in nursing home residents. Evaluation of the dehydration risk </em><em>appraisal checklist. Res. Gerontol. Nurs. 2011; 4 (2): 148-56.</em></li>\r\n 	<li><em>Woodward</em> <em> Guidelines to ef fective hydration in aged care facilities.</em> <em>Heidelberg</em> <em>Repatriation</em> <em>Hospital, </em><em>2013.</em></li>\r\n 	<li><em>Greenough W.B. Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people. Annals </em><em>of Long-Term Care: Clinical Care and 2016; 24 (2): 34-38.</em></li>\r\n 	<li><em>Кирпач</em> <em>Г.</em> <em>RеО</em> <em>вода</em> <em>для</em> <em>медичних</em> <em>цілей</em> <em>–</em> <em>гармонія</em> <em>води</em> <em>та</em> <em>електролітів</em> <em>у</em> <em>пляшці.</em> <em>Современная</em> <em>фармация.</em> <em>2021;</em></li>\r\n</ol>','Кекса ёшдаги одамларда орал регидратация','','inherit','closed','closed','','1599-revision-v1','','','2021-08-30 12:26:29','2021-08-30 09:26:29','',1599,'https://reo.ua/?p=1603',0,'revision','',0),(1604,1,'2021-06-25 13:43:31','2021-06-25 10:43:31','','infograph-23','','inherit','open','closed','','infograph-23','','','2021-06-25 13:43:31','2021-06-25 10:43:31','',1599,'https://reo.ua/wp-content/uploads/2021/06/infograph-23.jpg',0,'attachment','image/jpeg',0),(1605,1,'2021-06-25 13:45:08','2021-06-25 10:45:08','','infograph-24','','inherit','open','closed','','infograph-24','','','2021-06-25 13:45:08','2021-06-25 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10:38:31','',1599,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t10-regidradacziya-pozhilogo-vozrasta_5-1.png',0,'attachment','image/png',0),(1619,1,'2021-06-25 13:36:57','2021-06-25 10:36:57','<h2>Дегидратация: тушунчалар ва турлари</h2>\r\nДегидратация – бу патологик ҳолат бўлиб, бунда организм сувни истеъмол қилганига қараганда уни кўпроқ йўқотади.\r\n\r\nИчимлик суви бемалол бўлганида соғлом катта ёшдагиларда дегидратация кам учрайди, лекин у ҳар қандай одамда турли касалликлар ва ҳолатларнинг асорати сифатида, масалан, гипергликемияда  юзага келиши мумкин (1). Сув тери, ўпка, буйрак ва овқат ҳазм қилиш тизими орқали йўқотилиши мумкин (2).\r\n<h2> Дегидратацияда организм нафақат сув, балки электролитлар, энг аввало натрийни йўқотади.</h2>\r\n<strong>Суюқлик ва натрий йўқотилишининг нисбатига боғлиқ ҳолда дегидратациянинг учта шакли ажратиб кўрсатилади:</strong>\r\n<ul>\r\n 	<li>изотоник (суюқлик йўқотилиши=натрий йўқотилиши);</li>\r\n 	<li>гипертоник (суюқлик йўқотилиши &gt; натрий йўқотилиши);</li>\r\n 	<li>гипотоник (суюқлик йўқотилиши &lt; натрий йўқотилиши) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">1-жадвал. Дегидратация асосий турларининг сабаблари (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипертони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Қайт қилиш\r\n\r\n• Ич кетиши\r\n\r\n• Кўп терлаш\r\n\r\n• Куйишлар\r\n\r\n• Буйрак касалликлари\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Иситма\r\n\r\n• Тез-тез нафас олиш\r\n\r\n• Қандсиз диабет</td>\r\n<td width=\"113\">• Диуретиклар қабул қилиш</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Дегидратацияни шунингдек унга сабаб бўлган омил хусусиятларига боғлиқ ҳолда таснифлаш мумкин:</h2>\r\n<ul>\r\n 	<li>суюқликнинг овқат ҳазм қилиш тракти орқали ҳаддан ортиқ йўқотилиши: қайт қилиш, ич кетиши, ич сурадиган воситаларни қабул қилиш, ошқозонни ювиш, оқма яраларнинг мавжудлиги;</li>\r\n 	<li>суюқликнинг тери орқали ҳаддан ортиқ йўқотилиши: кучли тер ажралиб чиқиши, жисмоний юкланишлар, куйишлар, оғир дерматологик касалликлар;</li>\r\n 	<li>суюқликнинг сийдик билан ҳаддан ортиқ йўқотилиши: сийдик ҳайдовчи препаратларни қабул қилиш, ўткир ва сурункали буйрак касалликлари, сийдик чиқариш йўллари обструкцияси бартараф этилганидан сўнг сийдикнинг кучли ажралаб чиқиши, Аддисон касаллиги, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>суюқликнинг қорин ичида йўқотилиши:  панкреатит, асцит, перитонит;</li>\r\n 	<li>суюқлик йўқотилишининг ўрнини тўлдира олмаслик: фикрлаш ва руҳий ҳолатнинг бузилиши, иммобилизация, чанқоқни ҳис қилишнинг бузилиши, дори препаратлари дозасининг ошириб юборилиши ва оқибатда кома ривожланиши;</li>\r\n 	<li>Бошқа сабаблар: сепсис, гипертиReOз, бронхиал астма, ўпканинг сурункали обструктив касалликлари, наркотикларни истеъмол қилиш [1].</li>\r\n</ul>\r\n<h2 style=\"background: white; margin: 0cm 0cm 11.25pt 0cm;\"><span style=\"font-size: 19.0pt; line-height: 115%; font-family: \'Arial\',sans-serif; color: #4b9b47;\">Клиник картинаси</span></h2>\r\n<strong>Унча оғир бўлмаган ва ўртача дегидратацияга қ</strong><strong>уйидаги</strong><strong> белгилар хос:</strong>\r\n<ul>\r\n 	<li>чанқоқлик;</li>\r\n 	<li>оғиз қуриши;</li>\r\n 	<li>чарчоқ, уйқучанлик;</li>\r\n 	<li>сийишлар сонининг ва сийдик ҳажмининг камайиши;</li>\r\n 	<li>сийдикнинг ранги тўқ бўлиши;</li>\r\n 	<li>бош оғриғи;</li>\r\n 	<li>терининг қуруқлиги;</li>\r\n 	<li>бош айланиши;</li>\r\n 	<li>кўз ёши суюқлигининг йўқлиги.</li>\r\n</ul>\r\n<strong>Қуйидагилар оғир дегидратация учун хос ҳисобланади:</strong>\r\n<ul>\r\n 	<li>сийишлар сонининг кескин камайиши ёки умуман тўхташи;</li>\r\n 	<li>ҳаракатланишга тўсқинлик қиладиган бош айланиши;</li>\r\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан тик ҳолатга ўтишда артериал босимнинг симоб устунидан &gt;20 мм  га тушиб кетиши);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>иситма;</li>\r\n 	<li>тери эластиклигининг пасайиши;</li>\r\n 	<li>летаргия, уйқучанлик;</li>\r\n 	<li>онгнинг чалкашиши;</li>\r\n 	<li>кома (оғир беҳушлик)</li>\r\n 	<li>талваса ҳуружлари;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nБир қараганда сувсизланиш унчалик хавфли ҳолат эмасдек кўринишига  қарамай, унинг асоратлари оғир бўлиши ва ҳатто ҳаётга таҳдид солиши мумкин.\r\n\r\n<strong>Дегидратация асоратлари ўз ичига қуйидагиларни олади:</strong>\r\n<ul>\r\n 	<li>психик ҳолатнинг ўзгаришлари;</li>\r\n 	<li>буйрак етишмовчилиги;</li>\r\n 	<li>“жигар шоки” ва “буйрак шоки” ривожланиши – гипоперфузия оқибатида бу органлар некрози;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензия;</li>\r\n 	<li>ўлим [1].</li>\r\n</ul>\r\n<strong>Қуйидагилар оғир хавфли дегидратациядан дарак берадиган қизил байроқчалар ҳисобланади:</strong>\r\n<ul>\r\n 	<li>ориентирни йўқотиш, онгнинг чалкашиши;</li>\r\n 	<li>кучли бош айланиши;</li>\r\n 	<li>сутка мобайнида сиймаслик;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>талвасалар (4).</li>\r\n</ul>\r\n<h2>Ташҳислаш</h2>\r\nДегидратацияни ташхислашнинг олтин стандарти мавжуд эмас, шунинг учун клиник кўриниш ташхис қўйишга ёрдам беради. Кўпинча сийдик ва қон плазмасининг осмолярлигини аниқлашдан фойдаланилади, лекин бу кўрсаткичга сувсизланишнинг сабаби ва жараённинг ўтиш жадаллиги анча таъсир қилади. Қон плазмаси осмолярлигининг меъёрий қиймати 280-300 мОсм/л, сийдикнинг осмолярлиги эса — 600-1200 мОсм/л дан иборат бўлади. Осмолярлик бу кўрсаткичлардан юқори бўлганида сувсизланишни гумон қилиш мумкин.\r\n\r\nШуни ёдда тутиш керакки,  сийдик ҳажмининг камайиши ва осмолярлигининг юқорилиги нафақат дегидратацияда, балки юрак етишмовчилиги, жигар циррози, нефротик синдром ва сурункали буйрак касалликларида ҳам бўлиши мумкин.\r\n\r\nТана вазнининг 7 кун мобайнида ≥3% га пасайиши ва мочевина азотининг креатининга нисбатининг 10 дан юқори ўсиши дегидратациянинг бошқа белгилари ҳисобланади [1].\r\n\r\nДегидратацияни аниқлаш имконини берадиган инструментал усул қуйи ғовак венанинг ботиш қобилиятини ульратовуш текшируви ҳисобланади. Нафас олишда вена диаметрининг &gt;50% га ўзгариши  томир ичидаги суюқлик ҳажмининг тушиши ва камайишидан далолат беради [5].  Бу текширувнинг натижасига  жигар циррози, сурункали юрак-қон томир касалликлари, ўпканинг сунъий вентиляцияси кабилар таъсир қилиши мумкин [6]. Дифференциал ташхислашга келганда, бунда бош вазифа  суюқлик йўқотилиши билан қон йўқотилишини фарқлаш ҳисобланади. Бу муҳим, чунки бу ҳолларда инфузион терапия тактикаси ва мақбул препаратлар турлича бўлади [1].\r\n<h2>Даволаш</h2>\r\nДегидратацияни даволаш сув йўқотилишининг сабабларини аниқлаш билан бир вақтда йўқотилган суюқлик ўрнини тўлдиришга йўналтирилган.\r\n\r\nАртериал босим ва юрак қисқаришлари сони кўрсаткичлари нормада бўлган енгил дегидратацияда орал регидратация, гипотензия ва тахикардия билан кечадиган оғир дегидратацияда эса  – вена ичига регидратация (кристаллоидларнинг мувозанатлаштирилган эритмаси, Рингер-лактат эритмаси, 0,9% ли натрий хлорид эритмаси) қўлланилади [7].\r\n\r\nАгар пациент суюқлик ича олса, комбинациялашган регидратация: вена ичига юбориш ва орал регидратация бирга қўлланилади. Шуни қайд қилиш зарурки, ҳаддан ортиқ регидратация (кўпинча вена ичига юбориладиган) периферик шишлар ва ўпка шишига олиб келиши мумкин [1].\r\n<h2>Дегидратацияга учраган пациентлар учун тавсиялар</h2>\r\n<ul>\r\n 	<li>сувни кичик қултумлаб ичинг;</li>\r\n 	<li>таркибида электролитлар (тузлар) бўлган ичимликларни ичинг. Сувсизланишни коррекция қилиш учун махсус спорт ичимликлари ва эритмаларини ичиш мумкин.</li>\r\n 	<li>музлатилган шарбат ёки бошқа ичимликларни шиминг;</li>\r\n 	<li>муз бўлакчаларини шиминг;</li>\r\n 	<li>агар дегидратация сув ичиш ва овқат ейишда оғиздаги оғриқлар билан юзага келган бўлса, сувни найча (трубочка) орқали ичинг.</li>\r\n</ul>\r\nКатталарга бир суткада 2-3 литр суюқлик ичиш тавсия этилади [9]. Беморларни жисмоний юкланишларга мувофиқ тарзда суюқлик захирасини тўлдиришга рағбатлантириш зарур.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталарда регидратация алгоритми [8]</strong></p>\r\n<em>Изоҳ. Бу алгоритм қайт қилиш ва/ёки диарея оқибатида келиб чиққан дегидратацияда қўллаш учун мўлжалланган ва ҳомиладорларнинг бир оз/ўртача кўнгил айниши ва қайт қилишида қўлланилиши мумкин. Ундан ҳомиладорларнинг оғир дегидратацияси ёки ҳаддан ортиқ қайт қилиш ҳолларида фойдаланманг.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Дегидратациянинг олдини олишга оид тавсиялар:</strong>\r\n<ul>\r\n 	<li>ўзингизнинг суюқлик ичиш режимингизни олдиндан режалаштиринг. Агар сизнинг кун тартибингиз (иш ёки дам олиш) жуда кўп терлаш, жисмоний фаоллик ёки иссиқлик таъсири билан боғлиқ бўлса, ўзингиз билан таркибида сув ва электролит (туз)лар бўлган сув олиб юринг;</li>\r\n 	<li>иссиқ кунларда, айниқса намлик юқори бўлганда жисмоний юкланишлардан  ва кўчада бўлишдан қочинг. Агар бу жуда зарур бўлса, кўчага чиқишни эрта тонгга ва қуёш ботгандан кейинга режалаштиринг.</li>\r\n 	<li>атрофингиздаги болалар ва кекса ёшдаги шахсларни сув ичишга рағбатлантиринг.Таркибида тузлар бўлган ичимликларни афзал кўринг.</li>\r\n 	<li>алкоголь истеъмол қилишдан қочинг, айниқса иссиқ кунларда, чунки алкоголь суюқлик йўқотилишини кучайтиради ва одамнинг дегидратациянинг эрта белгиларини сезиш қобилиятини бузади;</li>\r\n 	<li>кўпроқ очиқ рангдаги ва эркин кийимларни кийинг;</li>\r\n 	<li>шахсий елпиғичингиз ёки сувли спрейдан фойдаланинг</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n 	<li>кўчада бўлганингизда соя жойда бўлишга ҳаракат қилинг.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Тегишлича гидратация бўлиши учун маслаҳатлар (10)</strong></p>\r\n<strong>Кўчада иссиқ ҳавода спорт юкланишларида суюқликни қўллаш бўйича тавсиялар</strong>\r\n<ul>\r\n 	<li>юкланишлар бошланишидан олдин 2 соат ичида 2 стакан ва юкланишлар бошлангунича 15 дақиқа олдин сув ичинг</li>\r\n 	<li>юкланишларнинг ҳар 15-20 дақиқасида 0,5-1 стакан (агар бутилкадан ичаётган бўлсангиз 4-8 та ўртача қултум) суюқлик ичинг.</li>\r\n</ul>\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун фойдаланишга тайёр эритма ҳисобланади, таркибида зарур барча электролитлар ва сорбитол мавжуд.\r\n\r\nСорбитол организм ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади.\r\n\r\nReO таркибида консервантлар, бўёвчи моддалар мавжуд эмас ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">2-жадвал. ReO сувининг мувозанатлаштирилган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради (11).</li>\r\n</ul>\r\n<h3>Адабиётлар рўйхати</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Катталарда орал регидратация','','publish','open','open','','kattalarda-oral-regidratacziya','','','2021-08-30 13:14:06','2021-08-30 10:14:06','',0,'https://reo.ua/uncategorized-uz/oralnaya-regidratacziya-u-vzroslyh/',24,'post','',0),(1620,1,'2021-06-25 13:19:21','2021-06-25 10:19:21','','prew2','','inherit','open','closed','','prew2-2-2','','','2021-06-25 13:19:21','2021-06-25 10:19:21','',1619,'https://reo.ua/wp-content/uploads/2021/06/prew2.jpg',0,'attachment','image/jpeg',0),(1621,1,'2021-08-30 13:12:47','2021-08-30 10:12:47','<h2>Дегидратация: тушунчалар ва турлари</h2>\nДегидратация – бу патологик ҳолат бўлиб, бунда организм сувни истеъмол қилганига қараганда уни кўпроқ йўқотади.\n\nИчимлик суви бемалол бўлганида соғлом катта ёшдагиларда дегидратация кам учрайди, лекин у ҳар қандай одамда турли касалликлар ва ҳолатларнинг асорати сифатида, масалан, гипергликемияда  юзага келиши мумкин (1). Сув тери, ўпка, буйрак ва овқат ҳазм қилиш тизими орқали йўқотилиши мумкин (2).\n<h2> Дегидратацияда организм нафақат сув, балки электролитлар, энг аввало натрийни йўқотади.</h2>\n<strong>Суюқлик ва натрий йўқотилишининг нисбатига боғлиқ ҳолда дегидратациянинг учта шакли ажратиб кўрсатилади:</strong>\n<ul>\n 	<li>изотоник (суюқлик йўқотилиши=натрий йўқотилиши);</li>\n 	<li>гипертоник (суюқлик йўқотилиши &gt; натрий йўқотилиши);</li>\n 	<li>гипотоник (суюқлик йўқотилиши &lt; натрий йўқотилиши) [1].</li>\n</ul>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"353\">1-жадвал. Дегидратация асосий турларининг сабаблари (1)</th>\n</tr>\n<tr>\n<th width=\"127\"><strong>Изотони</strong><strong>к</strong><strong> дегидратация</strong></th>\n<th width=\"113\"><strong>Гипертони</strong><strong>к</strong><strong> дегидратация</strong></th>\n<th width=\"113\"><strong>Гипотони</strong><strong>к</strong><strong> дегидратация</strong></th>\n</tr>\n<tr>\n<td width=\"127\">• Қайт қилиш\n\n• Ич кетиши\n\n• Кўп терлаш\n\n• Куйишлар\n\n• Буйрак касалликлари\n\n• Гипергликемия\n\n•Гипоальдостеронизм</td>\n<td width=\"113\">• Иситма\n\n• Тез-тез нафас олиш\n\n• Қандсиз диабет</td>\n<td width=\"113\">• Диуретиклар қабул қилиш</td>\n</tr>\n</tbody>\n</table>\n<h2>Дегидратацияни шунингдек унга сабаб бўлган омил хусусиятларига боғлиқ ҳолда таснифлаш мумкин:</h2>\n<ul>\n 	<li>суюқликнинг овқат ҳазм қилиш тракти орқали ҳаддан ортиқ йўқотилиши: қайт қилиш, ич кетиши, ич сурадиган воситаларни қабул қилиш, ошқозонни ювиш, оқма яраларнинг мавжудлиги;</li>\n 	<li>суюқликнинг тери орқали ҳаддан ортиқ йўқотилиши: кучли тер ажралиб чиқиши, жисмоний юкланишлар, куйишлар, оғир дерматологик касалликлар;</li>\n 	<li>суюқликнинг сийдик билан ҳаддан ортиқ йўқотилиши: сийдик ҳайдовчи препаратларни қабул қилиш, ўткир ва сурункали буйрак касалликлари, сийдик чиқариш йўллари обструкцияси бартараф этилганидан сўнг сийдикнинг кучли ажралаб чиқиши, Аддисон касаллиги, гипоальдостеронизм, гипергликемия;</li>\n 	<li>суюқликнинг қорин ичида йўқотилиши:  панкреатит, асцит, перитонит;</li>\n 	<li>суюқлик йўқотилишининг ўрнини тўлдира олмаслик: фикрлаш ва руҳий ҳолатнинг бузилиши, иммобилизация, чанқоқни ҳис қилишнинг бузилиши, дори препаратлари дозасининг ошириб юборилиши ва оқибатда кома ривожланиши;</li>\n 	<li>Бошқа сабаблар: сепсис, гипертиReOз, бронхиал астма, ўпканинг сурункали обструктив касалликлари, наркотикларни истеъмол қилиш [1].</li>\n</ul>\n<h2 style=\"background: white; margin: 0cm 0cm 11.25pt 0cm;\"><span style=\"font-size: 19.0pt; line-height: 115%; font-family: \'Arial\',sans-serif; color: #4b9b47;\">Клиник картинаси</span></h2>\n<strong>Унча оғир бўлмаган ва ўртача дегидратацияга қ</strong><strong>уйидаги</strong><strong> белгилар хос:</strong>\n<ul>\n 	<li>чанқоқлик;</li>\n 	<li>оғиз қуриши;</li>\n 	<li>чарчоқ, уйқучанлик;</li>\n 	<li>сийишлар сонининг ва сийдик ҳажмининг камайиши;</li>\n 	<li>сийдикнинг ранги тўқ бўлиши;</li>\n 	<li>бош оғриғи;</li>\n 	<li>терининг қуруқлиги;</li>\n 	<li>бош айланиши;</li>\n 	<li>кўз ёши суюқлигининг йўқлиги.</li>\n</ul>\n<strong>Қуйидагилар оғир дегидратация учун хос ҳисобланади:</strong>\n<ul>\n 	<li>сийишлар сонининг кескин камайиши ёки умуман тўхташи;</li>\n 	<li>ҳаракатланишга тўсқинлик қиладиган бош айланиши;</li>\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан тик ҳолатга ўтишда артериал босимнинг симоб устунидан &gt;20 мм  га тушиб кетиши);</li>\n 	<li>тахикардия;</li>\n 	<li>иситма;</li>\n 	<li>тери эластиклигининг пасайиши;</li>\n 	<li>летаргия, уйқучанлик;</li>\n 	<li>онгнинг чалкашиши;</li>\n 	<li>кома (оғир беҳушлик)</li>\n 	<li>талваса ҳуружлари;</li>\n 	<li>шок [3].</li>\n</ul>\nБир қараганда сувсизланиш унчалик хавфли ҳолат эмасдек кўринишига  қарамай, унинг асоратлари оғир бўлиши ва ҳатто ҳаётга таҳдид солиши мумкин.\n\n<strong>Дегидратация асоратлари ўз ичига қуйидагиларни олади:</strong>\n<ul>\n 	<li>психик ҳолатнинг ўзгаришлари;</li>\n 	<li>буйрак етишмовчилиги;</li>\n 	<li>“жигар шоки” ва “буйрак шоки” ривожланиши – гипоперфузия оқибатида бу органлар некрози;</li>\n 	<li>лактатацидоз;</li>\n 	<li>гипотензия;</li>\n 	<li>ўлим [1].</li>\n</ul>\n<strong>Қуйидагилар оғир хавфли дегидратациядан дарак берадиган қизил байроқчалар ҳисобланади:</strong>\n<ul>\n 	<li>ориентирни йўқотиш, онгнинг чалкашиши;</li>\n 	<li>кучли бош айланиши;</li>\n 	<li>сутка мобайнида сиймаслик;</li>\n 	<li>тахикардия;</li>\n 	<li>талвасалар (4).</li>\n</ul>\n<h2>Ташҳислаш</h2>\nДегидратацияни ташхислашнинг олтин стандарти мавжуд эмас, шунинг учун клиник кўриниш ташхис қўйишга ёрдам беради. Кўпинча сийдик ва қон плазмасининг осмолярлигини аниқлашдан фойдаланилади, лекин бу кўрсаткичга сувсизланишнинг сабаби ва жараённинг ўтиш жадаллиги анча таъсир қилади. Қон плазмаси осмолярлигининг меъёрий қиймати 280-300 мОсм/л, сийдикнинг осмолярлиги эса — 600-1200 мОсм/л дан иборат бўлади. Осмолярлик бу кўрсаткичлардан юқори бўлганида сувсизланишни гумон қилиш мумкин.\n\nШуни ёдда тутиш керакки,  сийдик ҳажмининг камайиши ва осмолярлигининг юқорилиги нафақат дегидратацияда, балки юрак етишмовчилиги, жигар циррози, нефротик синдром ва сурункали буйрак касалликларида ҳам бўлиши мумкин.\n\nТана вазнининг 7 кун мобайнида ≥3% га пасайиши ва мочевина азотининг креатининга нисбатининг 10 дан юқори ўсиши дегидратациянинг бошқа белгилари ҳисобланади [1].\n\nДегидратацияни аниқлаш имконини берадиган инструментал усул қуйи ғовак венанинг ботиш қобилиятини ульратовуш текшируви ҳисобланади. Нафас олишда вена диаметрининг &gt;50% га ўзгариши  томир ичидаги суюқлик ҳажмининг тушиши ва камайишидан далолат беради [5].  Бу текширувнинг натижасига  жигар циррози, сурункали юрак-қон томир касалликлари, ўпканинг сунъий вентиляцияси кабилар таъсир қилиши мумкин [6]. Дифференциал ташхислашга келганда, бунда бош вазифа  суюқлик йўқотилиши билан қон йўқотилишини фарқлаш ҳисобланади. Бу муҳим, чунки бу ҳолларда инфузион терапия тактикаси ва мақбул препаратлар турлича бўлади [1].\n<h2>Даволаш</h2>\nДегидратацияни даволаш сув йўқотилишининг сабабларини аниқлаш билан бир вақтда йўқотилган суюқлик ўрнини тўлдиришга йўналтирилган.\n\nАртериал босим ва юрак қисқаришлари сони кўрсаткичлари нормада бўлган енгил дегидратацияда орал регидратация, гипотензия ва тахикардия билан кечадиган оғир дегидратацияда эса  – вена ичига регидратация (кристаллоидларнинг мувозанатлаштирилган эритмаси, Рингер-лактат эритмаси, 0,9% ли натрий хлорид эритмаси) қўлланилади [7].\n\nАгар пациент суюқлик ича олса, комбинациялашган регидратация: вена ичига юбориш ва орал регидратация бирга қўлланилади. Шуни қайд қилиш зарурки, ҳаддан ортиқ регидратация (кўпинча вена ичига юбориладиган) периферик шишлар ва ўпка шишига олиб келиши мумкин [1].\n<h2>Дегидратацияга учраган пациентлар учун тавсиялар</h2>\n<ul>\n 	<li>сувни кичик қултумлаб ичинг;</li>\n 	<li>таркибида электролитлар (тузлар) бўлган ичимликларни ичинг. Сувсизланишни коррекция қилиш учун махсус спорт ичимликлари ва эритмаларини ичиш мумкин.</li>\n 	<li>музлатилган шарбат ёки бошқа ичимликларни шиминг;</li>\n 	<li>муз бўлакчаларини шиминг;</li>\n 	<li>агар дегидратация сув ичиш ва овқат ейишда оғиздаги оғриқлар билан юзага келган бўлса, сувни найча (трубочка) орқали ичинг.</li>\n</ul>\nКатталарга бир суткада 2-3 литр суюқлик ичиш тавсия этилади [9]. Беморларни жисмоний юкланишларга мувофиқ тарзда суюқлик захирасини тўлдиришга рағбатлантириш зарур.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\n<p style=\"text-align: center;\"><strong>1-расм. Катталарда регидратация алгоритми [8]</strong></p>\n<em>Изоҳ. Бу алгоритм қайт қилиш ва/ёки диарея оқибатида келиб чиққан дегидратацияда қўллаш учун мўлжалланган ва ҳомиладорларнинг бир оз/ўртача кўнгил айниши ва қайт қилишида қўлланилиши мумкин. Ундан ҳомиладорларнинг оғир дегидратацияси ёки ҳаддан ортиқ қайт қилиш ҳолларида фойдаланманг.</em>\n<h2>Профилактика</h2>\n<strong>Дегидратациянинг олдини олишга оид тавсиялар:</strong>\n<ul>\n 	<li>ўзингизнинг суюқлик ичиш режимингизни олдиндан режалаштиринг. Агар сизнинг кун тартибингиз (иш ёки дам олиш) жуда кўп терлаш, жисмоний фаоллик ёки иссиқлик таъсири билан боғлиқ бўлса, ўзингиз билан таркибида сув ва электролит (туз)лар бўлган сув олиб юринг;</li>\n 	<li>иссиқ кунларда, айниқса намлик юқори бўлганда жисмоний юкланишлардан  ва кўчада бўлишдан қочинг. Агар бу жуда зарур бўлса, кўчага чиқишни эрта тонгга ва қуёш ботгандан кейинга режалаштиринг.</li>\n 	<li>атрофингиздаги болалар ва кекса ёшдаги шахсларни сув ичишга рағбатлантиринг.Таркибида тузлар бўлган ичимликларни афзал кўринг.</li>\n 	<li>алкоголь истеъмол қилишдан қочинг, айниқса иссиқ кунларда, чунки алкоголь суюқлик йўқотилишини кучайтиради ва одамнинг дегидратациянинг эрта белгиларини сезиш қобилиятини бузади;</li>\n 	<li>кўпроқ очиқ рангдаги ва эркин кийимларни кийинг;</li>\n 	<li>шахсий елпиғичингиз ёки сувли спрейдан фойдаланинг</li>\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\n 	<li>кўчада бўлганингизда соя жойда бўлишга ҳаракат қилинг.</li>\n</ul>\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\n<p style=\"text-align: center;\"><strong>2-расм. Тегишлича гидратация бўлиши учун маслаҳатлар (10)</strong></p>\n<strong>Кўчада иссиқ ҳавода спорт юкланишларида суюқликни қўллаш бўйича тавсиялар</strong>\n<ul>\n 	<li>юкланишлар бошланишидан олдин 2 соат ичида 2 стакан ва юкланишлар бошлангунича 15 дақиқа олдин сув ичинг</li>\n 	<li>юкланишларнинг ҳар 15-20 дақиқасида 0,5-1 стакан (агар бутилкадан ичаётган бўлсангиз 4-8 та ўртача қултум) суюқлик ичинг.</li>\n</ul>\n<h2>Тиббий мақсадлар учун ReO суви\n(«Юрия-Фарм»)\n</h2>\nВода для медицинских целей РеО является готовым к употреблению раствором для оральной регидратации, что содержит все необходимые электролиты и сорбитол.\n\nСорбитол является дополнительным источником энергии, которая усваивается клетками организма без участия инсулина.\n\nРeО не содержит консервантов, красителей и имеет приятный вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 2. Сбалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\">Составляющая</th>\n<th width=\"151\">Содержимое</th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Преимущества воды РеО:</h2>\n<ul>\n 	<li>имеет сбалансированный состав;</li>\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\n 	<li>не содержит консервантов, красителей и углеводов;</li>\n 	<li>имеет приятный вкус, её легко пить даже при ощущении тошноты;</li>\n 	<li>устраняет симптомы обезвоживания;</li>\n 	<li>нормализует диурез, снижает интоксикацию (11).</li>\n</ul>\n<h3>Список литературы</h3>\n<ol>\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\n</ol>','Катталарда орал регидратация','','inherit','closed','closed','','1619-autosave-v1','','','2021-08-30 13:12:47','2021-08-30 10:12:47','',1619,'https://reo.ua/?p=1621',0,'revision','',0),(1622,1,'2021-08-30 13:14:06','2021-08-30 10:14:06','<h2>Дегидратация: тушунчалар ва турлари</h2>\r\nДегидратация – бу патологик ҳолат бўлиб, бунда организм сувни истеъмол қилганига қараганда уни кўпроқ йўқотади.\r\n\r\nИчимлик суви бемалол бўлганида соғлом катта ёшдагиларда дегидратация кам учрайди, лекин у ҳар қандай одамда турли касалликлар ва ҳолатларнинг асорати сифатида, масалан, гипергликемияда  юзага келиши мумкин (1). Сув тери, ўпка, буйрак ва овқат ҳазм қилиш тизими орқали йўқотилиши мумкин (2).\r\n<h2> Дегидратацияда организм нафақат сув, балки электролитлар, энг аввало натрийни йўқотади.</h2>\r\n<strong>Суюқлик ва натрий йўқотилишининг нисбатига боғлиқ ҳолда дегидратациянинг учта шакли ажратиб кўрсатилади:</strong>\r\n<ul>\r\n 	<li>изотоник (суюқлик йўқотилиши=натрий йўқотилиши);</li>\r\n 	<li>гипертоник (суюқлик йўқотилиши &gt; натрий йўқотилиши);</li>\r\n 	<li>гипотоник (суюқлик йўқотилиши &lt; натрий йўқотилиши) [1].</li>\r\n</ul>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"353\">1-жадвал. Дегидратация асосий турларининг сабаблари (1)</th>\r\n</tr>\r\n<tr>\r\n<th width=\"127\"><strong>Изотони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипертони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n<th width=\"113\"><strong>Гипотони</strong><strong>к</strong><strong> дегидратация</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"127\">• Қайт қилиш\r\n\r\n• Ич кетиши\r\n\r\n• Кўп терлаш\r\n\r\n• Куйишлар\r\n\r\n• Буйрак касалликлари\r\n\r\n• Гипергликемия\r\n\r\n•Гипоальдостеронизм</td>\r\n<td width=\"113\">• Иситма\r\n\r\n• Тез-тез нафас олиш\r\n\r\n• Қандсиз диабет</td>\r\n<td width=\"113\">• Диуретиклар қабул қилиш</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Дегидратацияни шунингдек унга сабаб бўлган омил хусусиятларига боғлиқ ҳолда таснифлаш мумкин:</h2>\r\n<ul>\r\n 	<li>суюқликнинг овқат ҳазм қилиш тракти орқали ҳаддан ортиқ йўқотилиши: қайт қилиш, ич кетиши, ич сурадиган воситаларни қабул қилиш, ошқозонни ювиш, оқма яраларнинг мавжудлиги;</li>\r\n 	<li>суюқликнинг тери орқали ҳаддан ортиқ йўқотилиши: кучли тер ажралиб чиқиши, жисмоний юкланишлар, куйишлар, оғир дерматологик касалликлар;</li>\r\n 	<li>суюқликнинг сийдик билан ҳаддан ортиқ йўқотилиши: сийдик ҳайдовчи препаратларни қабул қилиш, ўткир ва сурункали буйрак касалликлари, сийдик чиқариш йўллари обструкцияси бартараф этилганидан сўнг сийдикнинг кучли ажралаб чиқиши, Аддисон касаллиги, гипоальдостеронизм, гипергликемия;</li>\r\n 	<li>суюқликнинг қорин ичида йўқотилиши:  панкреатит, асцит, перитонит;</li>\r\n 	<li>суюқлик йўқотилишининг ўрнини тўлдира олмаслик: фикрлаш ва руҳий ҳолатнинг бузилиши, иммобилизация, чанқоқни ҳис қилишнинг бузилиши, дори препаратлари дозасининг ошириб юборилиши ва оқибатда кома ривожланиши;</li>\r\n 	<li>Бошқа сабаблар: сепсис, гипертиReOз, бронхиал астма, ўпканинг сурункали обструктив касалликлари, наркотикларни истеъмол қилиш [1].</li>\r\n</ul>\r\n<h2 style=\"background: white; margin: 0cm 0cm 11.25pt 0cm;\"><span style=\"font-size: 19.0pt; line-height: 115%; font-family: \'Arial\',sans-serif; color: #4b9b47;\">Клиник картинаси</span></h2>\r\n<strong>Унча оғир бўлмаган ва ўртача дегидратацияга қ</strong><strong>уйидаги</strong><strong> белгилар хос:</strong>\r\n<ul>\r\n 	<li>чанқоқлик;</li>\r\n 	<li>оғиз қуриши;</li>\r\n 	<li>чарчоқ, уйқучанлик;</li>\r\n 	<li>сийишлар сонининг ва сийдик ҳажмининг камайиши;</li>\r\n 	<li>сийдикнинг ранги тўқ бўлиши;</li>\r\n 	<li>бош оғриғи;</li>\r\n 	<li>терининг қуруқлиги;</li>\r\n 	<li>бош айланиши;</li>\r\n 	<li>кўз ёши суюқлигининг йўқлиги.</li>\r\n</ul>\r\n<strong>Қуйидагилар оғир дегидратация учун хос ҳисобланади:</strong>\r\n<ul>\r\n 	<li>сийишлар сонининг кескин камайиши ёки умуман тўхташи;</li>\r\n 	<li>ҳаракатланишга тўсқинлик қиладиган бош айланиши;</li>\r\n 	<li>ортостатик гипотензия (горизонтал ҳолатдан тик ҳолатга ўтишда артериал босимнинг симоб устунидан &gt;20 мм  га тушиб кетиши);</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>иситма;</li>\r\n 	<li>тери эластиклигининг пасайиши;</li>\r\n 	<li>летаргия, уйқучанлик;</li>\r\n 	<li>онгнинг чалкашиши;</li>\r\n 	<li>кома (оғир беҳушлик)</li>\r\n 	<li>талваса ҳуружлари;</li>\r\n 	<li>шок [3].</li>\r\n</ul>\r\nБир қараганда сувсизланиш унчалик хавфли ҳолат эмасдек кўринишига  қарамай, унинг асоратлари оғир бўлиши ва ҳатто ҳаётга таҳдид солиши мумкин.\r\n\r\n<strong>Дегидратация асоратлари ўз ичига қуйидагиларни олади:</strong>\r\n<ul>\r\n 	<li>психик ҳолатнинг ўзгаришлари;</li>\r\n 	<li>буйрак етишмовчилиги;</li>\r\n 	<li>“жигар шоки” ва “буйрак шоки” ривожланиши – гипоперфузия оқибатида бу органлар некрози;</li>\r\n 	<li>лактатацидоз;</li>\r\n 	<li>гипотензия;</li>\r\n 	<li>ўлим [1].</li>\r\n</ul>\r\n<strong>Қуйидагилар оғир хавфли дегидратациядан дарак берадиган қизил байроқчалар ҳисобланади:</strong>\r\n<ul>\r\n 	<li>ориентирни йўқотиш, онгнинг чалкашиши;</li>\r\n 	<li>кучли бош айланиши;</li>\r\n 	<li>сутка мобайнида сиймаслик;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>талвасалар (4).</li>\r\n</ul>\r\n<h2>Ташҳислаш</h2>\r\nДегидратацияни ташхислашнинг олтин стандарти мавжуд эмас, шунинг учун клиник кўриниш ташхис қўйишга ёрдам беради. Кўпинча сийдик ва қон плазмасининг осмолярлигини аниқлашдан фойдаланилади, лекин бу кўрсаткичга сувсизланишнинг сабаби ва жараённинг ўтиш жадаллиги анча таъсир қилади. Қон плазмаси осмолярлигининг меъёрий қиймати 280-300 мОсм/л, сийдикнинг осмолярлиги эса — 600-1200 мОсм/л дан иборат бўлади. Осмолярлик бу кўрсаткичлардан юқори бўлганида сувсизланишни гумон қилиш мумкин.\r\n\r\nШуни ёдда тутиш керакки,  сийдик ҳажмининг камайиши ва осмолярлигининг юқорилиги нафақат дегидратацияда, балки юрак етишмовчилиги, жигар циррози, нефротик синдром ва сурункали буйрак касалликларида ҳам бўлиши мумкин.\r\n\r\nТана вазнининг 7 кун мобайнида ≥3% га пасайиши ва мочевина азотининг креатининга нисбатининг 10 дан юқори ўсиши дегидратациянинг бошқа белгилари ҳисобланади [1].\r\n\r\nДегидратацияни аниқлаш имконини берадиган инструментал усул қуйи ғовак венанинг ботиш қобилиятини ульратовуш текшируви ҳисобланади. Нафас олишда вена диаметрининг &gt;50% га ўзгариши  томир ичидаги суюқлик ҳажмининг тушиши ва камайишидан далолат беради [5].  Бу текширувнинг натижасига  жигар циррози, сурункали юрак-қон томир касалликлари, ўпканинг сунъий вентиляцияси кабилар таъсир қилиши мумкин [6]. Дифференциал ташхислашга келганда, бунда бош вазифа  суюқлик йўқотилиши билан қон йўқотилишини фарқлаш ҳисобланади. Бу муҳим, чунки бу ҳолларда инфузион терапия тактикаси ва мақбул препаратлар турлича бўлади [1].\r\n<h2>Даволаш</h2>\r\nДегидратацияни даволаш сув йўқотилишининг сабабларини аниқлаш билан бир вақтда йўқотилган суюқлик ўрнини тўлдиришга йўналтирилган.\r\n\r\nАртериал босим ва юрак қисқаришлари сони кўрсаткичлари нормада бўлган енгил дегидратацияда орал регидратация, гипотензия ва тахикардия билан кечадиган оғир дегидратацияда эса  – вена ичига регидратация (кристаллоидларнинг мувозанатлаштирилган эритмаси, Рингер-лактат эритмаси, 0,9% ли натрий хлорид эритмаси) қўлланилади [7].\r\n\r\nАгар пациент суюқлик ича олса, комбинациялашган регидратация: вена ичига юбориш ва орал регидратация бирга қўлланилади. Шуни қайд қилиш зарурки, ҳаддан ортиқ регидратация (кўпинча вена ичига юбориладиган) периферик шишлар ва ўпка шишига олиб келиши мумкин [1].\r\n<h2>Дегидратацияга учраган пациентлар учун тавсиялар</h2>\r\n<ul>\r\n 	<li>сувни кичик қултумлаб ичинг;</li>\r\n 	<li>таркибида электролитлар (тузлар) бўлган ичимликларни ичинг. Сувсизланишни коррекция қилиш учун махсус спорт ичимликлари ва эритмаларини ичиш мумкин.</li>\r\n 	<li>музлатилган шарбат ёки бошқа ичимликларни шиминг;</li>\r\n 	<li>муз бўлакчаларини шиминг;</li>\r\n 	<li>агар дегидратация сув ичиш ва овқат ейишда оғиздаги оғриқлар билан юзага келган бўлса, сувни найча (трубочка) орқали ичинг.</li>\r\n</ul>\r\nКатталарга бир суткада 2-3 литр суюқлик ичиш тавсия этилади [9]. Беморларни жисмоний юкланишларга мувофиқ тарзда суюқлик захирасини тўлдиришга рағбатлантириш зарур.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\"><img class=\"aligncenter wp-image-988 size-full\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png\" alt=\"\" width=\"1170\" height=\"2230\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталарда регидратация алгоритми [8]</strong></p>\r\n<em>Изоҳ. Бу алгоритм қайт қилиш ва/ёки диарея оқибатида келиб чиққан дегидратацияда қўллаш учун мўлжалланган ва ҳомиладорларнинг бир оз/ўртача кўнгил айниши ва қайт қилишида қўлланилиши мумкин. Ундан ҳомиладорларнинг оғир дегидратацияси ёки ҳаддан ортиқ қайт қилиш ҳолларида фойдаланманг.</em>\r\n<h2>Профилактика</h2>\r\n<strong>Дегидратациянинг олдини олишга оид тавсиялар:</strong>\r\n<ul>\r\n 	<li>ўзингизнинг суюқлик ичиш режимингизни олдиндан режалаштиринг. Агар сизнинг кун тартибингиз (иш ёки дам олиш) жуда кўп терлаш, жисмоний фаоллик ёки иссиқлик таъсири билан боғлиқ бўлса, ўзингиз билан таркибида сув ва электролит (туз)лар бўлган сув олиб юринг;</li>\r\n 	<li>иссиқ кунларда, айниқса намлик юқори бўлганда жисмоний юкланишлардан  ва кўчада бўлишдан қочинг. Агар бу жуда зарур бўлса, кўчага чиқишни эрта тонгга ва қуёш ботгандан кейинга режалаштиринг.</li>\r\n 	<li>атрофингиздаги болалар ва кекса ёшдаги шахсларни сув ичишга рағбатлантиринг.Таркибида тузлар бўлган ичимликларни афзал кўринг.</li>\r\n 	<li>алкоголь истеъмол қилишдан қочинг, айниқса иссиқ кунларда, чунки алкоголь суюқлик йўқотилишини кучайтиради ва одамнинг дегидратациянинг эрта белгиларини сезиш қобилиятини бузади;</li>\r\n 	<li>кўпроқ очиқ рангдаги ва эркин кийимларни кийинг;</li>\r\n 	<li>шахсий елпиғичингиз ёки сувли спрейдан фойдаланинг</li>\r\n 	<li>при пребывании на улице постарайтесь находиться в тени.</li>\r\n 	<li>кўчада бўлганингизда соя жойда бўлишга ҳаракат қилинг.</li>\r\n</ul>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png\"><img class=\"aligncenter wp-image-840\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4-621x1024.png\" alt=\"\" width=\"548\" height=\"903\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Тегишлича гидратация бўлиши учун маслаҳатлар (10)</strong></p>\r\n<strong>Кўчада иссиқ ҳавода спорт юкланишларида суюқликни қўллаш бўйича тавсиялар</strong>\r\n<ul>\r\n 	<li>юкланишлар бошланишидан олдин 2 соат ичида 2 стакан ва юкланишлар бошлангунича 15 дақиқа олдин сув ичинг</li>\r\n 	<li>юкланишларнинг ҳар 15-20 дақиқасида 0,5-1 стакан (агар бутилкадан ичаётган бўлсангиз 4-8 та ўртача қултум) суюқлик ичинг.</li>\r\n</ul>\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация учун фойдаланишга тайёр эритма ҳисобланади, таркибида зарур барча электролитлар ва сорбитол мавжуд.\r\n\r\nСорбитол организм ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади.\r\n\r\nReO таркибида консервантлар, бўёвчи моддалар мавжуд эмас ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">2-жадвал. ReO сувининг мувозанатлаштирилган таркиби</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради (11).</li>\r\n</ul>\r\n<h3>Адабиётлар рўйхати</h3>\r\n<ol>\r\n 	<li><em>Taylor , Jones E. Adult dehydration. Treasure Island (FL): StatPearls Publishing, 2021.</em></li>\r\n 	<li><em>Weinberg D., Minaker K.L. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, </em><em>American Medical Association. JAMA. 1995; 274 (19): 1552-1556.</em></li>\r\n 	<li><em>Davis P. What are symptoms of dehydration in adults? Emedicinehealth.com. 2020.</em></li>\r\n 	<li><em>Available at: https://www2.hse.ie/conditions/dehydration/dehydration.html.</em></li>\r\n 	<li><em>Lamarche</em> <em>,</em> <em>et</em> <em>al.</em> <em>Role</em> <em>of</em> <em>point-of-care</em> <em>ultrasonography in the evaluation and management of kidney disease. Fed. Pract. </em><em>2018; 35 (12): 27-33.</em></li>\r\n 	<li><em>Long E., et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory </em><em>variation</em> <em>in</em> <em>inferior</em> <em>vena</em> <em>cava</em> <em>diameter</em> <em>predict</em> <em>fluid</em> <em>responsiveness:</em> <em>a</em> <em>systematic</em> <em>review</em> <em>and</em> <em>meta-analysis.</em> <em>2017;</em> <em>47 (5): 550-559.</em></li>\r\n 	<li><em>Finfer S., et al., SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive </em><em>care N. Engl. J. Med. 2004; 350 (22): 2247-2256.</em></li>\r\n 	<li><em>Acute rehydration in adults MidCentral District Health Board. 2018.</em></li>\r\n 	<li><em>Gandy Water intake: validity of population assessment and recommendations. Eur. J. Nutr. 2015; 54: 11-16.</em></li>\r\n 	<li><em>Available</em> <em>at:</em> <em>https://</em><em>oregoneyes.net/active-aging-hydration-for-active-adults.</em></li>\r\n 	<li><em>11. Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. 2021; 4.</em></li>\r\n</ol>','Катталарда орал регидратация','','inherit','closed','closed','','1619-revision-v1','','','2021-08-30 13:14:06','2021-08-30 10:14:06','',1619,'https://reo.ua/?p=1622',0,'revision','',0),(1623,1,'2021-06-25 13:30:45','2021-06-25 10:30:45','','infograph-21','','inherit','open','closed','','infograph-21','','','2021-06-25 13:30:45','2021-06-25 10:30:45','',1619,'https://reo.ua/wp-content/uploads/2021/06/infograph-21.jpg',0,'attachment','image/jpeg',0),(1624,1,'2021-06-25 13:33:50','2021-06-25 10:33:50','','infograph-22','','inherit','open','closed','','infograph-22','','','2021-06-25 13:33:50','2021-06-25 10:33:50','',1619,'https://reo.ua/wp-content/uploads/2021/06/infograph-22.jpg',0,'attachment','image/jpeg',0),(1625,1,'2021-06-25 13:36:19','2021-06-25 10:36:19','','Оральна регідратація у дорослих_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-doroslih_doctor-star_2021','','','2021-06-25 13:36:19','2021-06-25 10:36:19','',1619,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-doroslih_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(1626,1,'2021-06-25 13:39:35','2021-06-25 10:39:35','','infograph-21','','inherit','open','closed','','infograph-21-2','','','2021-06-25 13:39:35','2021-06-25 10:39:35','',1619,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-1.jpg',0,'attachment','image/jpeg',0),(1627,1,'2021-07-06 18:00:14','2021-07-06 15:00:14','','Web_REO_T9 Регідрадація у дорослих_2','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-2','','','2021-07-06 18:00:14','2021-07-06 15:00:14','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2.png',0,'attachment','image/png',0),(1628,1,'2021-07-06 18:01:12','2021-07-06 15:01:12','','Web_REO_T9 Регідрадація у дорослих_4','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_4-2','','','2021-07-06 18:01:12','2021-07-06 15:01:12','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_4.png',0,'attachment','image/png',0),(1629,1,'2021-07-07 16:25:18','2021-07-07 13:25:18','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1','','','2021-07-07 16:25:18','2021-07-07 13:25:18','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1.png',0,'attachment','image/png',0),(1630,1,'2021-07-08 01:04:20','2021-07-07 22:04:20','','Web_REO_T9 Регідрадація у дорослих_1 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-1-3','','','2021-07-08 01:04:20','2021-07-07 22:04:20','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-1-1.png',0,'attachment','image/png',0),(1631,1,'2021-07-08 01:04:55','2021-07-07 22:04:55','','Web_REO_T9 Регідрадація у дорослих_2 (7)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-7-2','','','2021-07-08 01:04:55','2021-07-07 22:04:55','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-7.png',0,'attachment','image/png',0),(1632,1,'2021-07-08 13:19:10','2021-07-08 10:19:10','','Web_REO_T9 Регідрадація у дорослих_3','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3','','','2021-07-08 13:19:10','2021-07-08 10:19:10','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3.png',0,'attachment','image/png',0),(1633,1,'2021-07-08 13:32:38','2021-07-08 10:32:38','','Web_REO_T9 Регідрадація у дорослих_2 (9)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_2-9-2','','','2021-07-08 13:32:38','2021-07-08 10:32:38','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_2-9.png',0,'attachment','image/png',0),(1634,1,'2021-07-09 14:30:45','2021-07-09 11:30:45','','Web_REO_T9 Регідрадація у дорослих_1 (2)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_1-2','','','2021-07-09 14:30:45','2021-07-09 11:30:45','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png',0,'attachment','image/png',0),(1635,1,'2021-07-13 13:17:59','2021-07-13 10:17:59','','Web_REO_T9 Регідрадація у дорослих_3 (1)','','inherit','open','closed','','web_reo_t9-regidradacziya-u-doroslih_3-1','','','2021-07-13 13:17:59','2021-07-13 10:17:59','',1619,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_3-1.png',0,'attachment','image/png',0),(1636,1,'2021-06-25 13:03:00','2021-06-25 10:03:00','Сувсизланиш ёки дегидратация – организмда сув танқислиги билан кечувчи сув-туз мувозанатининг бузилишидир. Дегидратация сув ва электролитлар йўқотилиши ўз вақтида тўлдирилмаганида юзага келади, яъни уларнинг танқислиги кузатилади [1]. Дегидратация сабаблари қуйидагилар бўлиши мумкин: суюқлик ичишнинг камайиши, унинг сийдик, нажас, қусуқ массалари билан кўп чиқиб кетиши, қон йўқотилиши, организмдаги суюқлик дисбаланси (асцит, плеврада сув тўпланиши), суюқликнинг капилляр йўқотилиши (куйиш ва сепсисда) (расм) [2 билан адаптацияланган].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Болаларда дегидратацияни келтириб чиқарадиган сабаблар</strong></p>\r\n<p style=\"text-align: center;\"><em>Изоҳ. *Бундай ҳолларда оғриқ сабабли суюқлик ичиш чегараланади</em></p>\r\nБолалар дегидратацияга катталарга қараганда таъсирчан бўлади, чунки бола танаси юзасининг тана вазнига нисбати катталардагига қараганда анча кўпроқ бўлади [2, 3]. Ёш болаларда дегидратациянинг кўп учрайдиган сабаблари ич кетиши ва қайт қилиш ҳисобланади [4].\r\n\r\n<strong>Дегидратация хавф гуруҳларига кирадиган болалар </strong><strong>[5]:</strong>\r\n<ul>\r\n 	<li>1 ёшгача, энг аввало 5 ойликкача бўлган болалар;</li>\r\n 	<li>туғилганида тана вазни кам бўлган болалар;</li>\r\n 	<li>охирги 24 соатда 6 ёки ундан кўп марта ичи кетган болалар;</li>\r\n 	<li>охирги 24 соатда 3 ёки ундан кўп марта қайт қилган болалар;</li>\r\n 	<li>айни вақтда суюқлик ича олмайдиган болалар;</li>\r\n 	<li>касаллик вақтида эмизилиши тўхтатилган болалар;</li>\r\n 	<li>ёшига нисбатан етарли даражада тана вазнига етмаган болалар.</li>\r\n</ul>\r\n<h2>Дегидратация патогенези</h2>\r\nҚайт қилиш, ич кетиши, кучли тер ажралиши ёки бошқа йўл билан йўқотиладиган суюқлик таркибида муайян концентрацияда тузлар бўлади, шунинг учун суюқлик йўқотилиши ҳар доим тузларнинг йўқотилиши билан бирга кечади. Йўқотилган тузлар (электролитлар) нинг аниқ миқдори ва характери дегидратация сабабларига боғлиқ. Масалан, бикарбонатлар қайт қилишда эмас, балки диареяда анча кўп миқдорда йўқотилади.\r\n\r\nСуюқлик йўқотилиши барча органлар ва тўқималарнинг тўлиқ ишлашига тўсқинлик қилади, шу сабабдан одамнинг ўзини ҳис қилиши ёмонлашади. Ўз навбатида, тузлар (электролитлар)нинг йўқотилиши, ва аксинча, улар концентрациясининг сув йўқотилиши натижасида ортиб кетиши хавфли ҳисобланади, чунки талваса, юрак ритмининг бузилиши ва ҳатто юракнинг тўхтаб қолиши каби асоратларни келтириб чиқариши мумкин [6]. Бу  мувозанатлашган эритма ёрдамида ўз вақтида регидратация ўтказишга эҳтиёжни белгилаб беради.\r\n<h2>Дегидратациянинг клиник кўриниши ва даражалари</h2>\r\nДегидратация унинг суюқлик йўқотилишини тавсифлайдиган белгилари ва симптомларининг намоён бўлишига боғлиқ ҳолда даражаларга бўлинади. Илк босқичларда сувсизланиш белгилари ва симптомларини бола организмининг ўзи компенсациялаши мумкин. Кейинчалик организмнинг компенсатор имкониятлари тугайди, чанқоқ, жиззакилик ва безовталик, тери тургорининг пасайиши, кўз ва лиқилдоқнинг чуқур ботиши (чақалоқларда) юзага келади. Оғир дегидратация ҳолларида  бу белгилар янада яққол кўринади. Ҳатто онгнинг бузилиши, сийдик ажралиб чиқмаслиги, периферик цианоз билан характерланадиган гиповолемик шок юз бериши мумкин. Совуқ оёқ-қўллар, томир уришининг тезлашиши (баъзида томир уриши аниқланмаслиги мумкин), артериал босимнинг тушиб кетиши кузатилади.\r\n\r\nТегишлича регидратациянинг мавжуд эмаслиги ўлимга олиб келиши мумкин [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">1-жадвал. Дегидратация оғирлигини баҳолаш</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Мезон</strong></th>\r\n<th width=\"156\"><strong>Оғир бўлмаган</strong><strong> дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Ўртача дегидратация</strong>\r\n\r\n<strong>(5-9%)</strong></th>\r\n<th width=\"156\"><strong>Оғир</strong>\r\n\r\n<strong>дегидратация </strong><strong>(≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Онгнинг ҳолати</strong></td>\r\n<td width=\"156\">Фаол, муомалага қобил</td>\r\n<td width=\"156\">Летаргия, жиззакилик</td>\r\n<td width=\"156\">Онгнинг бузилиши</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Юрак уриши </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал ёки бир оз тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Нафас олиш </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Ошган, ацидоз ҳосил бўлган ҳолда чуқур нафас олиш</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериал босим</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери ранги</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Рангсиз, доғлар пайдо бўлган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>О</strong><strong>ёқлар</strong></td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Совуқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферик пульс</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Кучсизланган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Шиллиқ қават</strong></td>\r\n<td width=\"156\">Нам</td>\r\n<td width=\"156\">Қуруқ</td>\r\n<td width=\"156\">Қуруқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери тургори</strong></td>\r\n<td width=\"156\">Тери бурмалари тез текисланади</td>\r\n<td width=\"156\">Ўртача пасайган</td>\r\n<td width=\"156\">Пасайган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Капиллярларнинг тикланиш ва тўлиш вақти</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Анча ошган</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nДегидратациянинг қизил байроқчалари (шок ривожланиши ва юзага келиш хавфининг белгилари):\r\n<ul>\r\n 	<li>аҳволнинг кескин ёмонлашиши;</li>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>кўзларнинг ботиқлиги;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>тери тургорининг камайиши.</li>\r\n</ul>\r\n<strong>Дегидратация белгилари</strong>\r\n\r\n<strong>Тана вазнининг % да суюқлик танқислиги</strong>\r\n\r\n<strong>Тана вазниниг мл/кг да суюқлик танқислиги</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\"><strong>2-жадвал. Дегидратациянинг клиник белгилари ва суюқликнинг тахминий танқислиги (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Мавжуд эмас</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Дегидратациянинг баъзи белгилари мавжуд</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Оғир дегидратация белгилари мавжуд</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Масалан, дегидратациянинг баъзи бир белгилари бўлган вазни 5 кг ли болада суюқлик танқислиги 250-500 мл ни ташкил этади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\"><strong>3-жадвал. Дегидратацияни баҳолаш мезонлари ва ҳаракатлар тактикасини танлаш </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Баҳолаш мезонлари</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Умумий аҳволи</strong></td>\r\n<td width=\"152\"><strong>Меъёрида</strong><strong>, </strong><strong>ф</strong><strong>а</strong><strong>ол</strong></td>\r\n<td width=\"154\"><strong>Безовта</strong><strong>, </strong><strong>жиззаки</strong></td>\r\n<td width=\"152\"><strong>Онгнинг бузилиши</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Кўзлари</strong></td>\r\n<td width=\"152\">Меъёрида</td>\r\n<td width=\"154\">Ботиқ</td>\r\n<td width=\"152\">Ботиқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Чанқоқлик</strong></td>\r\n<td width=\"152\">Бемалол ичаяпти, чанқоқ  йўқ</td>\r\n<td width=\"154\">Ташналик билан ичади, чанқоқ бор</td>\r\n<td width=\"152\">Ича олмайди ёки жуда кам ичади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Билак суяги терисини чимчилаш</strong><strong> </strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Тери бурмалари тез текисланади</td>\r\n<td width=\"154\">Тери бурмалари секин текисланади</td>\r\n<td width=\"152\">Тери бурмалари жуда секин текисланади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Хулоса</strong></td>\r\n<td width=\"152\">Дегидратация белгилари йўқ, лекин дегидратациянинг олдини олиш зарур, чунки сув йўқотиш ҳоллари мавжуд</td>\r\n<td width=\"154\">Агар бу рўйхатдан ⩽2 белги бўлса, унча оғир бўлмаган ёки ўртача дегидратация мавжуд.</td>\r\n<td width=\"152\">Агар бу рўйхатдан ≥ 2 белги бўлса, оғир дегидратация мавжуд</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Ҳаракатлар тактикаси</strong></td>\r\n<td width=\"152\">А режа</td>\r\n<td width=\"154\">Агар мумкин бўлса болани тортиб кўринг ва В режага ўтинг</td>\r\n<td width=\"152\">Агар мумкин бўлса болани тортиб кўринг ва дарҳол         С режага ўтинг</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>А режа: орал регидратация</h2>\r\nБолага таркибида туз бўлган суюқликлар: орал регидратация учун махсус тузли эритмалар,  туз солинган ичимликлар бериш маъқул. Агар регидратацияни фақат оддий сув (гипотоник эритма) билан ўтказилса, қон плазмасида тузлар миқдорининг ҳаддан ортиқ пасайиб кетиши ва шишлар ҳосил бўлиш хавфи бўлади [9]. Шунингдек гуруч қайнатмаси (гуруч  қайнатилган сув),  янги мева шарбати (фреш), ичимлик сувини қўллаш мумкин.\r\n\r\nЎз навбатида, баъзи ичимликлар потенциал хавфли ҳисобланади. Масалан, таркибида қанд бўлган ичимликлар осмотик диарея ва гипернатриемияни келтириб чиқариши мумкин, шунинг учун  ширин газланган ичимликлар, тайёр шарбатлар, ширин чой истеъмол қилмасдан туриш зарур. Шунингдек болага диуретик ёки бўшаштирувчи таъсир кўрсатадиган кофе ёки ўсимлик чойларини ҳам бермаслик мақсадга мувофиқ.\r\n<h2>Қанча суюқлик бериш керак?</h2>\r\nУмуман олганда бола қанча ичишни ҳоҳласа, шунча суюқлик бериш керак. Диарея ҳолларида ҳар бир ич кетишидан сўнг 2 ёшдан кичик болага 50-100 мл (катта чашканинг 1/4-1/2 қисми), 2-10 ёш болага  100-200 мл (катта чашканинг 1/2-1 қисми), 10 ёшдан катта болага бола қанча ичишни ҳоҳласа шунча суюқлик беринг [1]. Агар дегидратациянинг сабаби бошқа бўлса, регидратацияда боланинг чанқоқни ҳис қилишига қараш керак.\r\n\r\nВ режа: тиббиёт муассасасида махсус эритмалар ёрдамида орал регидратация.\r\n\r\nАгар боланинг вазни маълум бўлса, зарур суюқлик миқдорини аниқлаш учун вазнни 75 мл га кўпайтириш зарур.Агар боланинг вазни маълум бўлмаса, ёшига қараб жадвалдан фойдаланилади. Бола кўпроқ суюқлик ичишни истаса ва ҳаддан ортиқ дегидратация белгилари бўлмаса (энг аввало, қовоқларнинг шиши) кўпроқ сув бериш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\"><strong>4-жадвал. Дастлабки 4 соатда орал дегидратация учун эритманинг тахминий миқдори (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Ёши</strong></th>\r\n<th width=\"89\"><strong>4 ойликкача</strong></th>\r\n<th width=\"89\"><strong>4-11 ойлик</strong></th>\r\n<th width=\"89\"><strong>12-23 ойлик</strong></th>\r\n<th width=\"89\"><strong>2-4 ёш</strong></th>\r\n<th width=\"89\"><strong>5-14 ёш</strong></th>\r\n<th width=\"89\"><strong>&gt;15 ёш</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вазни</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Боланинг ёшига фақат унинг вазнини билмаганда қаранг.\r\n\r\nОрал регидратация учун суюқликнинг тахминий миқдорини боланинг кг лардаги вазнини 75 га кўпайтириб мл ларда ҳисоблаш мумкин.\r\n\r\nАгар бола ҳисобланганидан кўпроқ суюқлик ичишни ҳоҳласа, кўпроқ суюқлик ичишга беринг\r\n\r\nЭритмани қошиқ билан ёки чашкадан бериш керак. Чақалоқлар учун пипетка ёки игнасиз шприцдан фойдаланиш мумкин. Кўпинча суюқликни тез ва кўп ичиришда қайт қилиш юз беради, лекин бу регидратацияга тўсқинлик қилмайди, чунки суюқликнинг катта қисми ўзлаштирилишга улгурган бўлади. Қайт қилиш юз берган ҳолларда 5-10 дақиқа кутиб туринг ва регидратацияни секинроқ суръатда давом эттиринг.  4 соатдан сўнг дегидратация даражасини 3-жадвалдан баҳоланг. Оғир дегидратация белгилари пайдо бўлганда С режага ўтинг. Дегидратация белгилари мавжуд бўлмаганда регидратацияни тўхтатиш мумкин. Бундай ҳолларда чанқоқлик йўқолади, сийиш тикланади, тери чимчилаб олинганидан кейин тез текисланади, бола тинчланади ва одатда ухлаб қолади [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\"><strong>5-жадвал. Вена ичига регидратациялаш схемаси (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Ёши</strong></th>\r\n<td width=\"208\">Дастлаб қуйидаги вақт ичида <span style=\"font-family: inherit; font-size: inherit;\">30 мл/кг инфузия тайинланг</span></td>\r\n<td width=\"208\">Кейин қуйидаги вақт ичида 70 мл/кг инфузия тайинланг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликкача</strong></th>\r\n<td width=\"208\">1 соат*</td>\r\n<td width=\"208\">5 соат</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликдан катта</strong></th>\r\n<td width=\"208\">30 дақиқа*</td>\r\n<td width=\"208\">2,5 соат</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Шифохонага ётқизилганидан сўнг дарҳол мувозанатлаштирилган эритмалар инфузиясини бошланг. Агар бола ича оладиган бўлса, инфузия билан бир вақтда орал регидратация учун тузли эритмани бериш зарур.  Беморнинг ҳолатини 1-2 соатда бир марта баҳолаб боринг. Агар боланинг аҳволи яхшиланмаса, суюқлик киритишни тезлаштиринг. Суюқлик ҳажми тўлиқ киритиб бўлинганидан сўнг (чақалоқларда – 6 соат, катта болаларда – 3 соат) беморнинг ҳолатини 3-жадвалга мувофиқ баҳоланг ва яна энг мақбул даволаш режасини (А, В ёки С) танланг. * Агар билакдаги артерияда томир уриши (пульс) кучсиз ёки аниқланмаётган бўлса, суюқлик киритишни яна бир марта такрорланг.\r\n<h2>Орал регидратация – енгил ва ўрта оғирликдаги дегидратацияда танлов усули</h2>\r\nЎз ичига 1811 пациент иштирокидаги 17 та тадқиқотни олган Кокран шарҳи маълумотларига кўра орал ва вена ичига регидратация самарадорлиги ўртасида фарқ йўқ. Орал регидратация енгил ва ўрта оғирликдаги дегидратацияга учраган болаларни даволашнинг биринчи линияси бўлиши, вена ичига регидратация эса орал регидратация муваффақиятсиз бўлганда тайинланиши керак [10].\r\n<h2>Тиббий мақсадлар учун ReO суви («Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация  учун тайёр эритма ҳисобланиб, таркибида барча муҳим электролитлар ва сорбитол мавжуд. Сорбитол – энергиянинг қўшимча манбаи бўлиб, организм ҳужайралари уни инсулин иштирокисиз ўзлаштиради. РeО таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга. Бу педиатрия амалиётида қўлланиладиган воситалар учун муҳим шарт ҳисобланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Дегидратация профилактикаси</h2>\r\nСувсизланиш билан бирга кечиши мумкин бўлган ҳолатларга юқори жисмоний фаоллик (спорт машғулотлари, фаол ўйинлар, югуриш), иситиладиган хоналарда ва ҳавоси қуруқ хоналарда узоқ бўлиш, фототерапия, полиурия, иситма, куйишлар, кучли тер ажралиши, нафас олиш ва юрак уриш тезлигининг ошиши,  ўрнатилган жарроҳлик дренажлари киради [12]. Бундай ҳолатларда боланинг ичаётган сувининг ҳажмини жиддий кузатиб бориш,  бола чанқоқни ҳис қилиши ёки қилмаслигидан қатъий назар, муайян вақт оралиқларида сув ичириб туриш мақбул ҳисобланади.\r\n\r\nБоланинг суюқликка эҳтиёжи қуйидаги тарзда ҳисобланади:\r\n<ul>\r\n 	<li>тана вазнининг дастлабки 10 кг га 4 мл/кг/йил;</li>\r\n 	<li>тана вазнининг ҳар бир кейинги 10 кг га +2 мл/кг/йил;</li>\r\n 	<li>&gt;20 кг вазн учун ҳар бир кг га +1 мл/кг/йил [4].</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Болаларда орал регидратация','','publish','open','open','','oralnaya-regidratacziya-u-detej','','','2021-08-30 16:15:53','2021-08-30 13:15:53','',0,'https://reo.ua/uncategorized-uz/oralnaya-regidratacziya-u-detej/',27,'post','',0),(1640,1,'2021-08-30 14:58:08','2021-08-30 11:58:08','Сувсизланиш ёки дегидратация – организмда сув танқислиги билан кечувчи сув-туз мувозанатининг бузилишидир. Дегидратация сув ва электролитлар йўқотилиши ўз вақтида тўлдирилмаганида юзага келади, яъни уларнинг танқислиги кузатилади [1]. Дегидратация сабаблари қуйидагилар бўлиши мумкин: суюқлик ичишнинг камайиши, унинг сийдик, нажас, қусуқ массалари билан кўп чиқиб кетиши, қон йўқотилиши, организмдаги суюқлик дисбаланси (асцит, плеврада сув тўпланиши), суюқликнинг капилляр йўқотилиши (куйиш ва сепсисда) (расм) [2 билан адаптацияланган].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Болаларда дегидратацияни келтириб чиқарадиган сабаблар</strong></p>\r\n<p style=\"text-align: center;\"><em>Изоҳ. *Бундай ҳолларда оғриқ сабабли суюқлик ичиш чегараланади</em></p>\r\nБолалар дегидратацияга катталарга қараганда таъсирчан бўлади, чунки бола танаси юзасининг тана вазнига нисбати катталардагига қараганда анча кўпроқ бўлади [2, 3]. Ёш болаларда дегидратациянинг кўп учрайдиган сабаблари ич кетиши ва қайт қилиш ҳисобланади [4].\r\n\r\n<strong>Дегидратация хавф гуруҳларига кирадиган болалар </strong><strong>[5]:</strong>\r\n<ul>\r\n 	<li>1 ёшгача, энг аввало 5 ойликкача бўлган болалар;</li>\r\n 	<li>туғилганида тана вазни кам бўлган болалар;</li>\r\n 	<li>охирги 24 соатда 6 ёки ундан кўп марта ичи кетган болалар;</li>\r\n 	<li>охирги 24 соатда 3 ёки ундан кўп марта қайт қилган болалар;</li>\r\n 	<li>айни вақтда суюқлик ича олмайдиган болалар;</li>\r\n 	<li>касаллик вақтида эмизилиши тўхтатилган болалар;</li>\r\n 	<li>ёшига нисбатан етарли даражада тана вазнига етмаган болалар.</li>\r\n</ul>\r\n<h2>Дегидратация патогенези</h2>\r\nҚайт қилиш, ич кетиши, кучли тер ажралиши ёки бошқа йўл билан йўқотиладиган суюқлик таркибида муайян концентрацияда тузлар бўлади, шунинг учун суюқлик йўқотилиши ҳар доим тузларнинг йўқотилиши билан бирга кечади. Йўқотилган тузлар (электролитлар) нинг аниқ миқдори ва характери дегидратация сабабларига боғлиқ. Масалан, бикарбонатлар қайт қилишда эмас, балки диареяда анча кўп миқдорда йўқотилади.\r\n\r\nСуюқлик йўқотилиши барча органлар ва тўқималарнинг тўлиқ ишлашига тўсқинлик қилади, шу сабабдан одамнинг ўзини ҳис қилиши ёмонлашади. Ўз навбатида, тузлар (электролитлар)нинг йўқотилиши, ва аксинча, улар концентрациясининг сув йўқотилиши натижасида ортиб кетиши хавфли ҳисобланади, чунки талваса, юрак ритмининг бузилиши ва ҳатто юракнинг тўхтаб қолиши каби асоратларни келтириб чиқариши мумкин [6]. Бу  мувозанатлашган эритма ёрдамида ўз вақтида регидратация ўтказишга эҳтиёжни белгилаб беради.\r\n<h2>Дегидратациянинг клиник кўриниши ва даражалари</h2>\r\nДегидратация унинг суюқлик йўқотилишини тавсифлайдиган белгилари ва симптомларининг намоён бўлишига боғлиқ ҳолда даражаларга бўлинади. Илк босқичларда сувсизланиш белгилари ва симптомларини бола организмининг ўзи компенсациялаши мумкин. Кейинчалик организмнинг компенсатор имкониятлари тугайди, чанқоқ, жиззакилик ва безовталик, тери тургорининг пасайиши, кўз ва лиқилдоқнинг чуқур ботиши (чақалоқларда) юзага келади. Оғир дегидратация ҳолларида  бу белгилар янада яққол кўринади. Ҳатто онгнинг бузилиши, сийдик ажралиб чиқмаслиги, периферик цианоз билан характерланадиган гиповолемик шок юз бериши мумкин. Совуқ оёқ-қўллар, томир уришининг тезлашиши (баъзида томир уриши аниқланмаслиги мумкин), артериал босимнинг тушиб кетиши кузатилади.\r\n\r\nТегишлича регидратациянинг мавжуд эмаслиги ўлимга олиб келиши мумкин [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">1-жадвал. Дегидратация оғирлигини баҳолаш</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Мезон</strong></th>\r\n<th width=\"156\"><strong>Оғир бўлмаган</strong><strong> дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Ўртача дегидратация</strong>\r\n\r\n<strong>(5-9%)</strong></th>\r\n<th width=\"156\"><strong>Оғир</strong>\r\n\r\n<strong>дегидратация </strong><strong>(≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Онгнинг ҳолати</strong></td>\r\n<td width=\"156\">Фаол, муомалага қобил</td>\r\n<td width=\"156\">Летаргия, жиззакилик</td>\r\n<td width=\"156\">Онгнинг бузилиши</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Юрак уриши </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал ёки бир оз тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Нафас олиш </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Ошган, ацидоз ҳосил бўлган ҳолда чуқур нафас олиш</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериал босим</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери ранги</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Рангсиз, доғлар пайдо бўлган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>О</strong><strong>ёқлар</strong></td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Совуқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферик пульс</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Кучсизланган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Шиллиқ қават</strong></td>\r\n<td width=\"156\">Нам</td>\r\n<td width=\"156\">Қуруқ</td>\r\n<td width=\"156\">Қуруқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери тургори</strong></td>\r\n<td width=\"156\">Тери бурмалари тез текисланади</td>\r\n<td width=\"156\">Ўртача пасайган</td>\r\n<td width=\"156\">Пасайган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Капиллярларнинг тикланиш ва тўлиш вақти</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Анча ошган</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nДегидратациянинг қизил байроқчалари (шок ривожланиши ва юзага келиш хавфининг белгилари):\r\n<ul>\r\n 	<li>аҳволнинг кескин ёмонлашиши;</li>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>кўзларнинг ботиқлиги;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>тери тургорининг камайиши.</li>\r\n</ul>\r\n<strong>Дегидратация белгилари</strong>\r\n\r\n<strong>Тана вазнининг % да суюқлик танқислиги</strong>\r\n\r\n<strong>Тана вазниниг мл/кг да суюқлик танқислиги</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\"><strong>2-жадвал. Дегидратациянинг клиник белгилари ва суюқликнинг тахминий танқислиги (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Мавжуд эмас</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Дегидратациянинг баъзи белгилари мавжуд</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Оғир дегидратация белгилари мавжуд</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Масалан, дегидратациянинг баъзи бир белгилари бўлган вазни 5 кг ли болада суюқлик танқислиги 250-500 мл ни ташкил этади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\"><strong>3-жадвал. Дегидратацияни баҳолаш мезонлари ва ҳаракатлар тактикасини танлаш </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Баҳолаш мезонлари</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Умумий аҳволи</strong></td>\r\n<td width=\"152\"><strong>Меъёрида</strong><strong>, </strong><strong>ф</strong><strong>а</strong><strong>ол</strong></td>\r\n<td width=\"154\"><strong>Безовта</strong><strong>, </strong><strong>жиззаки</strong></td>\r\n<td width=\"152\"><strong>Онгнинг бузилиши</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Кўзлари</strong></td>\r\n<td width=\"152\">Меъёрида</td>\r\n<td width=\"154\">Ботиқ</td>\r\n<td width=\"152\">Ботиқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Чанқоқлик</strong></td>\r\n<td width=\"152\">Бемалол ичаяпти, чанқоқ  йўқ</td>\r\n<td width=\"154\">Ташналик билан ичади, чанқоқ бор</td>\r\n<td width=\"152\">Ича олмайди ёки жуда кам ичади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Билак суяги терисини чимчилаш</strong><strong> </strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Тери бурмалари тез текисланади</td>\r\n<td width=\"154\">Тери бурмалари секин текисланади</td>\r\n<td width=\"152\">Тери бурмалари жуда секин текисланади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Хулоса</strong></td>\r\n<td width=\"152\">Дегидратация белгилари йўқ, лекин дегидратациянинг олдини олиш зарур, чунки сув йўқотиш ҳоллари мавжуд</td>\r\n<td width=\"154\">Агар бу рўйхатдан ⩽2 белги бўлса, унча оғир бўлмаган ёки ўртача дегидратация мавжуд.</td>\r\n<td width=\"152\">Агар бу рўйхатдан ≥ 2 белги бўлса, оғир дегидратация мавжуд</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Ҳаракатлар тактикаси</strong></td>\r\n<td width=\"152\">А режа</td>\r\n<td width=\"154\">Агар мумкин бўлса болани тортиб кўринг ва В режага ўтинг</td>\r\n<td width=\"152\">Агар мумкин бўлса болани тортиб кўринг ва дарҳол         С режага ўтинг</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>А режа: орал регидратация</h2>\r\nБолага таркибида туз бўлган суюқликлар: орал регидратация учун махсус тузли эритмалар,  туз солинган ичимликлар бериш маъқул. Агар регидратацияни фақат оддий сув (гипотоник эритма) билан ўтказилса, қон плазмасида тузлар миқдорининг ҳаддан ортиқ пасайиб кетиши ва шишлар ҳосил бўлиш хавфи бўлади [9]. Шунингдек гуруч қайнатмаси (гуруч  қайнатилган сув),  янги мева шарбати (фреш), ичимлик сувини қўллаш мумкин.\r\n\r\nЎз навбатида, баъзи ичимликлар потенциал хавфли ҳисобланади. Масалан, таркибида қанд бўлган ичимликлар осмотик диарея ва гипернатриемияни келтириб чиқариши мумкин, шунинг учун  ширин газланган ичимликлар, тайёр шарбатлар, ширин чой истеъмол қилмасдан туриш зарур. Шунингдек болага диуретик ёки бўшаштирувчи таъсир кўрсатадиган кофе ёки ўсимлик чойларини ҳам бермаслик мақсадга мувофиқ.\r\n<h2>Қанча суюқлик бериш керак?</h2>\r\nУмуман олганда бола қанча ичишни ҳоҳласа, шунча суюқлик бериш керак. Диарея ҳолларида ҳар бир ич кетишидан сўнг 2 ёшдан кичик болага 50-100 мл (катта чашканинг 1/4-1/2 қисми), 2-10 ёш болага  100-200 мл (катта чашканинг 1/2-1 қисми), 10 ёшдан катта болага бола қанча ичишни ҳоҳласа шунча суюқлик беринг [1]. Агар дегидратациянинг сабаби бошқа бўлса, регидратацияда боланинг чанқоқни ҳис қилишига қараш керак.\r\n\r\nВ режа: тиббиёт муассасасида махсус эритмалар ёрдамида орал регидратация.\r\n\r\nАгар боланинг вазни маълум бўлса, зарур суюқлик миқдорини аниқлаш учун вазнни 75 мл га кўпайтириш зарур.Агар боланинг вазни маълум бўлмаса, ёшига қараб жадвалдан фойдаланилади. Бола кўпроқ суюқлик ичишни истаса ва ҳаддан ортиқ дегидратация белгилари бўлмаса (энг аввало, қовоқларнинг шиши) кўпроқ сув бериш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\"><strong>4-жадвал. Дастлабки 4 соатда орал дегидратация учун эритманинг тахминий миқдори (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Ёши</strong></th>\r\n<th width=\"89\"><strong>4 ойликкача</strong></th>\r\n<th width=\"89\"><strong>4-11 ойлик</strong></th>\r\n<th width=\"89\"><strong>12-23 ойлик</strong></th>\r\n<th width=\"89\"><strong>2-4 ёш</strong></th>\r\n<th width=\"89\"><strong>5-14 ёш</strong></th>\r\n<th width=\"89\"><strong>&gt;15 ёш</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вазни</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Боланинг ёшига фақат унинг вазнини билмаганда қаранг.\r\n\r\nОрал регидратация учун суюқликнинг тахминий миқдорини боланинг кг лардаги вазнини 75 га кўпайтириб мл ларда ҳисоблаш мумкин.\r\n\r\nАгар бола ҳисобланганидан кўпроқ суюқлик ичишни ҳоҳласа, кўпроқ суюқлик ичишга беринг\r\n\r\nЭритмани қошиқ билан ёки чашкадан бериш керак. Чақалоқлар учун пипетка ёки игнасиз шприцдан фойдаланиш мумкин. Кўпинча суюқликни тез ва кўп ичиришда қайт қилиш юз беради, лекин бу регидратацияга тўсқинлик қилмайди, чунки суюқликнинг катта қисми ўзлаштирилишга улгурган бўлади. Қайт қилиш юз берган ҳолларда 5-10 дақиқа кутиб туринг ва регидратацияни секинроқ суръатда давом эттиринг.  4 соатдан сўнг дегидратация даражасини 3-жадвалдан баҳоланг. Оғир дегидратация белгилари пайдо бўлганда С режага ўтинг. Дегидратация белгилари мавжуд бўлмаганда регидратацияни тўхтатиш мумкин. Бундай ҳолларда чанқоқлик йўқолади, сийиш тикланади, тери чимчилаб олинганидан кейин тез текисланади, бола тинчланади ва одатда ухлаб қолади [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\"><strong>5-жадвал. Вена ичига регидратациялаш схемаси (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Ёши</strong></th>\r\n<td width=\"208\">Дастлаб қуйидаги вақт ичида <span style=\"font-family: inherit; font-size: inherit;\">30 мл/кг инфузия тайинланг</span></td>\r\n<td width=\"208\">Кейин қуйидаги вақт ичида 70 мл/кг инфузия тайинланг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликкача</strong></th>\r\n<td width=\"208\">1 соат*</td>\r\n<td width=\"208\">5 соат</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликдан катта</strong></th>\r\n<td width=\"208\">30 дақиқа*</td>\r\n<td width=\"208\">2,5 соат</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Шифохонага ётқизилганидан сўнг дарҳол мувозанатлаштирилган эритмалар инфузиясини бошланг. Агар бола ича оладиган бўлса, инфузия билан бир вақтда орал регидратация учун тузли эритмани бериш зарур.  Беморнинг ҳолатини 1-2 соатда бир марта баҳолаб боринг. Агар боланинг аҳволи яхшиланмаса, суюқлик киритишни тезлаштиринг. Суюқлик ҳажми тўлиқ киритиб бўлинганидан сўнг (чақалоқларда – 6 соат, катта болаларда – 3 соат) беморнинг ҳолатини 3-жадвалга мувофиқ баҳоланг ва яна энг мақбул даволаш режасини (А, В ёки С) танланг. * Агар билакдаги артерияда томир уриши (пульс) кучсиз ёки аниқланмаётган бўлса, суюқлик киритишни яна бир марта такрорланг.\r\n<h2>Орал регидратация – енгил ва ўрта оғирликдаги дегидратацияда танлов усули</h2>\r\nЎз ичига 1811 пациент иштирокидаги 17 та тадқиқотни олган Кокран шарҳи маълумотларига кўра орал ва вена ичига регидратация самарадорлиги ўртасида фарқ йўқ. Орал регидратация енгил ва ўрта оғирликдаги дегидратацияга учраган болаларни даволашнинг биринчи линияси бўлиши, вена ичига регидратация эса орал регидратация муваффақиятсиз бўлганда тайинланиши керак [10].\r\n<h2>Тиббий мақсадлар учун ReO суви («Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация  учун тайёр эритма ҳисобланиб, таркибида барча муҳим электролитлар ва сорбитол мавжуд. Сорбитол – энергиянинг қўшимча манбаи бўлиб, организм ҳужайралари уни инсулин иштирокисиз ўзлаштиради. РeО таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга. Бу педиатрия амалиётида қўлланиладиган воситалар учун муҳим шарт ҳисобланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Преимущества воды РеО:</h2>\r\n<ul>\r\n 	<li>имеет сбалансированный состав;</li>\r\n 	<li>помогает возобновить и поддержать водно-солевой баланс;</li>\r\n 	<li>не содержит консервантов, красителей и углеводов;</li>\r\n 	<li>имеет приятный вкус и ее легко пить даже при ощущении тошноты;</li>\r\n 	<li>устраняет симптомы обезвоживания;</li>\r\n 	<li>нормализует диурез, снижает интоксикацию.</li>\r\n</ul>\r\n<h2>Профилактика дегидратации</h2>\r\nК состояниям, которые потенциально могут сопровождаться обезвоживанием, принадлежат повышенная физическая активность (спортивные занятия, активные игры, бег), пребывание в отапливаемых помещениях и помещениях с сухим воздухом, фототерапия, полиурия, лихорадка, ожоги, усиленное потоотделение, повышение частоты дыхания и сердцебиения, установленные хирургические дренажи [12]. В таких случаях следует тщательным образом следить за объемами питья ребенка, оптимально – давать пить через регулярные промежутки времени независимо от ощущения жажды.\r\n\r\nПотребности ребенка в жидкости рассчитываются таким образом:\r\n<ul>\r\n 	<li>4 мл/кг/год на первые 10 кг массы тела;</li>\r\n 	<li>+2 мл/кг/год на каждые последующие 10 кг массы тела;</li>\r\n 	<li>+1 мл/кг/год на каждый кг за вес &gt;20 кг [4].</li>\r\n</ul>\r\n<h2>Список литературы:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Болаларда орал регидратация','','inherit','closed','closed','','1636-revision-v1','','','2021-08-30 14:58:08','2021-08-30 11:58:08','',1636,'https://reo.ua/?p=1640',0,'revision','',0),(1637,1,'2021-07-14 10:16:44','2021-07-14 07:16:44','','Оральная регидратация у взрослых','','inherit','open','closed','','oralnaya-regidratacziya-u-vzroslyh-2','','','2021-07-14 10:16:44','2021-07-14 07:16:44','',1636,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-vzroslyh.pdf',0,'attachment','application/pdf',0),(1638,1,'2021-06-25 13:02:55','2021-06-25 10:02:55','','prew','','inherit','open','closed','','prew-2-3','','','2021-06-25 13:02:55','2021-06-25 10:02:55','',1636,'https://reo.ua/wp-content/uploads/2021/06/prew.jpg',0,'attachment','image/jpeg',0),(1639,1,'2021-08-30 16:16:01','2021-08-30 13:16:01','Сувсизланиш ёки дегидратация – организмда сув танқислиги билан кечувчи сув-туз мувозанатининг бузилишидир. Дегидратация сув ва электролитлар йўқотилиши ўз вақтида тўлдирилмаганида юзага келади, яъни уларнинг танқислиги кузатилади [1]. Дегидратация сабаблари қуйидагилар бўлиши мумкин: суюқлик ичишнинг камайиши, унинг сийдик, нажас, қусуқ массалари билан кўп чиқиб кетиши, қон йўқотилиши, организмдаги суюқлик дисбаланси (асцит, плеврада сув тўпланиши), суюқликнинг капилляр йўқотилиши (куйиш ва сепсисда) (расм) [2 билан адаптацияланган].\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\n<p style=\"text-align: center;\"><strong>1-расм. Болаларда дегидратацияни келтириб чиқарадиган сабаблар</strong></p>\n<p style=\"text-align: center;\"><em>Изоҳ. *Бундай ҳолларда оғриқ сабабли суюқлик ичиш чегараланади</em></p>\nБолалар дегидратацияга катталарга қараганда таъсирчан бўлади, чунки бола танаси юзасининг тана вазнига нисбати катталардагига қараганда анча кўпроқ бўлади [2, 3]. Ёш болаларда дегидратациянинг кўп учрайдиган сабаблари ич кетиши ва қайт қилиш ҳисобланади [4].\n\n<strong>Дегидратация хавф гуруҳларига кирадиган болалар </strong><strong>[5]:</strong>\n<ul>\n 	<li>1 ёшгача, энг аввало 5 ойликкача бўлган болалар;</li>\n 	<li>туғилганида тана вазни кам бўлган болалар;</li>\n 	<li>охирги 24 соатда 6 ёки ундан кўп марта ичи кетган болалар;</li>\n 	<li>охирги 24 соатда 3 ёки ундан кўп марта қайт қилган болалар;</li>\n 	<li>айни вақтда суюқлик ича олмайдиган болалар;</li>\n 	<li>касаллик вақтида эмизилиши тўхтатилган болалар;</li>\n 	<li>ёшига нисбатан етарли даражада тана вазнига етмаган болалар.</li>\n</ul>\n<h2>Дегидратация патогенези</h2>\nҚайт қилиш, ич кетиши, кучли тер ажралиши ёки бошқа йўл билан йўқотиладиган суюқлик таркибида муайян концентрацияда тузлар бўлади, шунинг учун суюқлик йўқотилиши ҳар доим тузларнинг йўқотилиши билан бирга кечади. Йўқотилган тузлар (электролитлар) нинг аниқ миқдори ва характери дегидратация сабабларига боғлиқ. Масалан, бикарбонатлар қайт қилишда эмас, балки диареяда анча кўп миқдорда йўқотилади.\n\nСуюқлик йўқотилиши барча органлар ва тўқималарнинг тўлиқ ишлашига тўсқинлик қилади, шу сабабдан одамнинг ўзини ҳис қилиши ёмонлашади. Ўз навбатида, тузлар (электролитлар)нинг йўқотилиши, ва аксинча, улар концентрациясининг сув йўқотилиши натижасида ортиб кетиши хавфли ҳисобланади, чунки талваса, юрак ритмининг бузилиши ва ҳатто юракнинг тўхтаб қолиши каби асоратларни келтириб чиқариши мумкин [6]. Бу  мувозанатлашган эритма ёрдамида ўз вақтида регидратация ўтказишга эҳтиёжни белгилаб беради.\n<h2>Дегидратациянинг клиник кўриниши ва даражалари</h2>\nДегидратация унинг суюқлик йўқотилишини тавсифлайдиган белгилари ва симптомларининг намоён бўлишига боғлиқ ҳолда даражаларга бўлинади. Илк босқичларда сувсизланиш белгилари ва симптомларини бола организмининг ўзи компенсациялаши мумкин. Кейинчалик организмнинг компенсатор имкониятлари тугайди, чанқоқ, жиззакилик ва безовталик, тери тургорининг пасайиши, кўз ва лиқилдоқнинг чуқур ботиши (чақалоқларда) юзага келади. Оғир дегидратация ҳолларида  бу белгилар янада яққол кўринади. Ҳатто онгнинг бузилиши, сийдик ажралиб чиқмаслиги, периферик цианоз билан характерланадиган гиповолемик шок юз бериши мумкин. Совуқ оёқ-қўллар, томир уришининг тезлашиши (баъзида томир уриши аниқланмаслиги мумкин), артериал босимнинг тушиб кетиши кузатилади.\n\nТегишлича регидратациянинг мавжуд эмаслиги ўлимга олиб келиши мумкин [1].\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"623\">1-жадвал. Дегидратация оғирлигини баҳолаш</th>\n</tr>\n<tr>\n<th width=\"156\"><strong>Мезон</strong></th>\n<th width=\"156\"><strong>Оғир бўлмаган</strong><strong> дегидратация (5%)</strong></th>\n<th width=\"156\"><strong>Ўртача дегидратация</strong>\n\n<strong>(5-9%)</strong></th>\n<th width=\"156\"><strong>Оғир</strong>\n\n<strong>дегидратация </strong><strong>(≥10%)</strong></th>\n</tr>\n<tr>\n<td width=\"156\"><strong>Онгнинг ҳолати</strong></td>\n<td width=\"156\">Фаол, муомалага қобил</td>\n<td width=\"156\">Летаргия, жиззакилик</td>\n<td width=\"156\">Онгнинг бузилиши</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Юрак уриши </strong><strong>сони</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Нормал ёки бир оз тахикардия</td>\n<td width=\"156\">Тахикардия</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Нафас олиш </strong><strong>сони</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Ошган</td>\n<td width=\"156\">Ошган, ацидоз ҳосил бўлган ҳолда чуқур нафас олиш</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Артериал босим</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Гипотензия</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Тери ранги</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Рангсиз, доғлар пайдо бўлган</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>О</strong><strong>ёқлар</strong></td>\n<td width=\"156\">Илиқ</td>\n<td width=\"156\">Илиқ</td>\n<td width=\"156\">Холодные</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Периферический пульс </strong></td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Нормальный</td>\n<td width=\"156\">Совуқ</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Периферик пульс</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Кучсизланган</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Шиллиқ қават</strong></td>\n<td width=\"156\">Нам</td>\n<td width=\"156\">Қуруқ</td>\n<td width=\"156\">Қуруқ</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Тери тургори</strong></td>\n<td width=\"156\">Тери бурмалари тез текисланади</td>\n<td width=\"156\">Ўртача пасайган</td>\n<td width=\"156\">Пасайган</td>\n</tr>\n<tr>\n<td width=\"156\"><strong>Капиллярларнинг тикланиш ва тўлиш вақти</strong></td>\n<td width=\"156\">Нормал</td>\n<td width=\"156\">Ошган</td>\n<td width=\"156\">Анча ошган</td>\n</tr>\n</tbody>\n</table>\n(7)\n\nДегидратациянинг қизил байроқчалари (шок ривожланиши ва юзага келиш хавфининг белгилари):\n<ul>\n 	<li>аҳволнинг кескин ёмонлашиши;</li>\n 	<li>онгнинг бузилиши;</li>\n 	<li>кўзларнинг ботиқлиги;</li>\n 	<li>тахикардия;</li>\n 	<li>тахипноэ;</li>\n 	<li>тери тургорининг камайиши.</li>\n</ul>\n<strong>Дегидратация белгилари</strong>\n\n<strong>Тана вазнининг % да суюқлик танқислиги</strong>\n\n<strong>Тана вазниниг мл/кг да суюқлик танқислиги</strong>\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"622\"><strong>2-жадвал. Дегидратациянинг клиник белгилари ва суюқликнинг тахминий танқислиги (1)</strong></th>\n</tr>\n<tr>\n<td width=\"208\">Мавжуд эмас</td>\n<td width=\"208\">&lt; 5</td>\n<td width=\"208\">&lt;50</td>\n</tr>\n<tr>\n<td width=\"208\">Дегидратациянинг баъзи белгилари мавжуд</td>\n<td width=\"208\">5-10</td>\n<td width=\"208\">50-100</td>\n</tr>\n<tr>\n<td width=\"208\">Оғир дегидратация белгилари мавжуд</td>\n<td width=\"208\">&gt;10</td>\n<td width=\"208\">&gt;100</td>\n</tr>\n</tbody>\n</table>\nИзоҳ. Масалан, дегидратациянинг баъзи бир белгилари бўлган вазни 5 кг ли болада суюқлик танқислиги 250-500 мл ни ташкил этади.\n<table>\n<tbody>\n<tr>\n<th colspan=\"4\" width=\"621\"><strong>3-жадвал. Дегидратацияни баҳолаш мезонлари ва ҳаракатлар тактикасини танлаш </strong></th>\n</tr>\n<tr>\n<th width=\"164\"><strong>Баҳолаш мезонлари</strong></th>\n<th width=\"152\"><strong>А</strong></th>\n<th width=\"154\"><strong>В</strong></th>\n<th width=\"152\"><strong>С</strong></th>\n</tr>\n<tr>\n<td width=\"164\"><strong>Умумий аҳволи</strong></td>\n<td width=\"152\"><strong>Меъёрида</strong><strong>, </strong><strong>ф</strong><strong>а</strong><strong>ол</strong></td>\n<td width=\"154\"><strong>Безовта</strong><strong>, </strong><strong>жиззаки</strong></td>\n<td width=\"152\"><strong>Онгнинг бузилиши</strong></td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Кўзлари</strong></td>\n<td width=\"152\">Меъёрида</td>\n<td width=\"154\">Ботиқ</td>\n<td width=\"152\">Ботиқ</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Чанқоқлик</strong></td>\n<td width=\"152\">Бемалол ичаяпти, чанқоқ  йўқ</td>\n<td width=\"154\">Ташналик билан ичади, чанқоқ бор</td>\n<td width=\"152\">Ича олмайди ёки жуда кам ичади</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Билак суяги терисини чимчилаш</strong><strong> </strong>\n\n<strong> </strong></td>\n<td width=\"152\">Тери бурмалари тез текисланади</td>\n<td width=\"154\">Тери бурмалари секин текисланади</td>\n<td width=\"152\">Тери бурмалари жуда секин текисланади</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Хулоса</strong></td>\n<td width=\"152\">Дегидратация белгилари йўқ, лекин дегидратациянинг олдини олиш зарур, чунки сув йўқотиш ҳоллари мавжуд</td>\n<td width=\"154\">Агар бу рўйхатдан ⩽2 белги бўлса, унча оғир бўлмаган ёки ўртача дегидратация мавжуд.</td>\n<td width=\"152\">Агар бу рўйхатдан ≥ 2 белги бўлса, оғир дегидратация мавжуд</td>\n</tr>\n<tr>\n<td width=\"164\"><strong>Ҳаракатлар тактикаси</strong></td>\n<td width=\"152\">А режа</td>\n<td width=\"154\">Агар мумкин бўлса болани тортиб кўринг ва В режага ўтинг</td>\n<td width=\"152\">Агар мумкин бўлса болани тортиб кўринг ва дарҳол         С режага ўтинг</td>\n</tr>\n</tbody>\n</table>\n<h2>А режа: орал регидратация</h2>\nБолага таркибида туз бўлган суюқликлар: орал регидратация учун махсус тузли эритмалар,  туз солинган ичимликлар бериш маъқул. Агар регидратацияни фақат оддий сув (гипотоник эритма) билан ўтказилса, қон плазмасида тузлар миқдорининг ҳаддан ортиқ пасайиб кетиши ва шишлар ҳосил бўлиш хавфи бўлади [9]. Шунингдек гуруч қайнатмаси (гуруч  қайнатилган сув),  янги мева шарбати (фреш), ичимлик сувини қўллаш мумкин.\n\nЎз навбатида, баъзи ичимликлар потенциал хавфли ҳисобланади. Масалан, таркибида қанд бўлган ичимликлар осмотик диарея ва гипернатриемияни келтириб чиқариши мумкин, шунинг учун  ширин газланган ичимликлар, тайёр шарбатлар, ширин чой истеъмол қилмасдан туриш зарур. Шунингдек болага диуретик ёки бўшаштирувчи таъсир кўрсатадиган кофе ёки ўсимлик чойларини ҳам бермаслик мақсадга мувофиқ.\n<h2>Қанча суюқлик бериш керак?</h2>\nУмуман олганда бола қанча ичишни ҳоҳласа, шунча суюқлик бериш керак. Диарея ҳолларида ҳар бир ич кетишидан сўнг 2 ёшдан кичик болага 50-100 мл (катта чашканинг 1/4-1/2 қисми), 2-10 ёш болага  100-200 мл (катта чашканинг 1/2-1 қисми), 10 ёшдан катта болага бола қанча ичишни ҳоҳласа шунча суюқлик беринг [1]. Агар дегидратациянинг сабаби бошқа бўлса, регидратацияда боланинг чанқоқни ҳис қилишига қараш керак.\n\nВ режа: тиббиёт муассасасида махсус эритмалар ёрдамида орал регидратация.\n\nАгар боланинг вазни маълум бўлса, зарур суюқлик миқдорини аниқлаш учун вазнни 75 мл га кўпайтириш зарур.Агар боланинг вазни маълум бўлмаса, ёшига қараб жадвалдан фойдаланилади. Бола кўпроқ суюқлик ичишни истаса ва ҳаддан ортиқ дегидратация белгилари бўлмаса (энг аввало, қовоқларнинг шиши) кўпроқ сув бериш мумкин.\n<table>\n<tbody>\n<tr>\n<th colspan=\"7\" width=\"623\"><strong>4-жадвал. Дастлабки 4 соатда орал дегидратация учун эритманинг тахминий миқдори (1)</strong></th>\n</tr>\n<tr>\n<th width=\"89\"><strong>Ёши</strong></th>\n<th width=\"89\"><strong>4 ойликкача</strong></th>\n<th width=\"89\"><strong>4-11 ойлик</strong></th>\n<th width=\"89\"><strong>12-23 ойлик</strong></th>\n<th width=\"89\"><strong>2-4 ёш</strong></th>\n<th width=\"89\"><strong>5-14 ёш</strong></th>\n<th width=\"89\"><strong>&gt;15 ёш</strong></th>\n</tr>\n<tr>\n<th width=\"89\"><strong>Вазни</strong></th>\n<td width=\"89\">До 5 кг</td>\n<td width=\"89\">5-7,9 кг</td>\n<td width=\"89\">8-10,9 кг</td>\n<td width=\"89\">11-15,9 кг</td>\n<td width=\"89\">16-29,9 кг</td>\n<td width=\"89\">&gt;30 кг</td>\n</tr>\n<tr>\n<th width=\"89\"><strong>Мл</strong></th>\n<td width=\"89\">200-400</td>\n<td width=\"89\">400-600</td>\n<td width=\"89\">600-800</td>\n<td width=\"89\">800-1200</td>\n<td width=\"89\">1200-2200</td>\n<td width=\"89\">2200-4000</td>\n</tr>\n</tbody>\n</table>\nИзоҳ. Боланинг ёшига фақат унинг вазнини билмаганда қаранг.\n\nОрал регидратация учун суюқликнинг тахминий миқдорини боланинг кг лардаги вазнини 75 га кўпайтириб мл ларда ҳисоблаш мумкин.\n\nАгар бола ҳисобланганидан кўпроқ суюқлик ичишни ҳоҳласа, кўпроқ суюқлик ичишга беринг\n\nЭритмани қошиқ билан ёки чашкадан бериш керак. Чақалоқлар учун пипетка ёки игнасиз шприцдан фойдаланиш мумкин. Кўпинча суюқликни тез ва кўп ичиришда қайт қилиш юз беради, лекин бу регидратацияга тўсқинлик қилмайди, чунки суюқликнинг катта қисми ўзлаштирилишга улгурган бўлади. Қайт қилиш юз берган ҳолларда 5-10 дақиқа кутиб туринг ва регидратацияни секинроқ суръатда давом эттиринг.  4 соатдан сўнг дегидратация даражасини 3-жадвалдан баҳоланг. Оғир дегидратация белгилари пайдо бўлганда С режага ўтинг. Дегидратация белгилари мавжуд бўлмаганда регидратацияни тўхтатиш мумкин. Бундай ҳолларда чанқоқлик йўқолади, сийиш тикланади, тери чимчилаб олинганидан кейин тез текисланади, бола тинчланади ва одатда ухлаб қолади [1].\n<table>\n<tbody>\n<tr>\n<th colspan=\"3\" width=\"624\"><strong>5-жадвал. Вена ичига регидратациялаш схемаси (1)</strong></th>\n</tr>\n<tr>\n<th width=\"208\"><strong>Ёши</strong></th>\n<td width=\"208\">Дастлаб қуйидаги вақт ичида <span style=\"font-family: inherit; font-size: inherit;\">30 мл/кг инфузия тайинланг</span></td>\n<td width=\"208\">Кейин қуйидаги вақт ичида 70 мл/кг инфузия тайинланг</td>\n</tr>\n<tr>\n<th width=\"208\"><strong>12 ойликкача</strong></th>\n<td width=\"208\">1 соат*</td>\n<td width=\"208\">5 соат</td>\n</tr>\n<tr>\n<th width=\"208\"><strong>12 ойликдан катта</strong></th>\n<td width=\"208\">30 дақиқа*</td>\n<td width=\"208\">2,5 соат</td>\n</tr>\n</tbody>\n</table>\nИзоҳ. Шифохонага ётқизилганидан сўнг дарҳол мувозанатлаштирилган эритмалар инфузиясини бошланг. Агар бола ича оладиган бўлса, инфузия билан бир вақтда орал регидратация учун тузли эритмани бериш зарур.  Беморнинг ҳолатини 1-2 соатда бир марта баҳолаб боринг. Агар боланинг аҳволи яхшиланмаса, суюқлик киритишни тезлаштиринг. Суюқлик ҳажми тўлиқ киритиб бўлинганидан сўнг (чақалоқларда – 6 соат, катта болаларда – 3 соат) беморнинг ҳолатини 3-жадвалга мувофиқ баҳоланг ва яна энг мақбул даволаш режасини (А, В ёки С) танланг. * Агар билакдаги артерияда томир уриши (пульс) кучсиз ёки аниқланмаётган бўлса, суюқлик киритишни яна бир марта такрорланг.\n<h2>Орал регидратация – енгил ва ўрта оғирликдаги дегидратацияда танлов усули</h2>\nЎз ичига 1811 пациент иштирокидаги 17 та тадқиқотни олган Кокран шарҳи маълумотларига кўра орал ва вена ичига регидратация самарадорлиги ўртасида фарқ йўқ. Орал регидратация енгил ва ўрта оғирликдаги дегидратацияга учраган болаларни даволашнинг биринчи линияси бўлиши, вена ичига регидратация эса орал регидратация муваффақиятсиз бўлганда тайинланиши керак [10].\n<h2>Тиббий мақсадлар учун ReO суви («Юрия-Фарм»)</h2>\nТиббий мақсадлар учун ReO суви орал регидратация  учун тайёр эритма ҳисобланиб, таркибида барча муҳим электролитлар ва сорбитол мавжуд. Сорбитол – энергиянинг қўшимча манбаи бўлиб, организм ҳужайралари уни инсулин иштирокисиз ўзлаштиради. РeО таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга. Бу педиатрия амалиётида қўлланиладиган воситалар учун муҳим шарт ҳисобланади.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Компонент</strong></th>\n<th width=\"151\"><strong>Содержание</strong></th>\n</tr>\n<tr>\n<td width=\"151\">Na+</td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K+</td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca2+</td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl-</td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO3-</td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>ReO сувининг афзалликлари:</h2>\n<ul>\n 	<li>мувозанатлаштирилган таркибга эга;</li>\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради.</li>\n</ul>\n<h2>Дегидратация профилактикаси</h2>\nСувсизланиш билан бирга кечиши мумкин бўлган ҳолатларга юқори жисмоний фаоллик (спорт машғулотлари, фаол ўйинлар, югуриш), иситиладиган хоналарда ва ҳавоси қуруқ хоналарда узоқ бўлиш, фототерапия, полиурия, иситма, куйишлар, кучли тер ажралиши, нафас олиш ва юрак уриш тезлигининг ошиши,  ўрнатилган жарроҳлик дренажлари киради [12]. Бундай ҳолатларда боланинг ичаётган сувининг ҳажмини жиддий кузатиб бориш,  бола чанқоқни ҳис қилиши ёки қилмаслигидан қатъий назар, муайян вақт оралиқларида сув ичириб туриш мақбул ҳисобланади.\n\nБоланинг суюқликка эҳтиёжи қуйидаги тарзда ҳисобланади:\n<ul>\n 	<li>тана вазнининг дастлабки 10 кг га 4 мл/кг/йил;</li>\n 	<li>тана вазнининг ҳар бир кейинги 10 кг га +2 мл/кг/йил;</li>\n 	<li>&gt;20 кг вазн учун ҳар бир кг га +1 мл/кг/йил [4].</li>\n</ul>\n<h2>Адабиётлар рўйхати:</h2>\n<ol>\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\n</ol>','Болаларда орал регидратация','','inherit','closed','closed','','1636-autosave-v1','','','2021-08-30 16:16:01','2021-08-30 13:16:01','',1636,'https://reo.ua/?p=1639',0,'revision','',0),(1641,1,'2021-06-25 12:57:42','2021-06-25 09:57:42','','infograph-20','','inherit','open','closed','','infograph-20','','','2021-06-25 12:57:42','2021-06-25 09:57:42','',1636,'https://reo.ua/wp-content/uploads/2021/06/infograph-20.jpg',0,'attachment','image/jpeg',0),(1642,1,'2021-06-25 13:13:30','2021-06-25 10:13:30','','Оральна регідратація у дітей_Doctor Star_2021','','inherit','open','closed','','oralna-regidratacziya-u-ditej_doctor-star_2021','','','2021-06-25 13:13:30','2021-06-25 10:13:30','',1636,'https://reo.ua/wp-content/uploads/2021/06/oralna-regidratacziya-u-ditej_doctor-star_2021.pdf',0,'attachment','application/pdf',0),(1643,1,'2021-07-08 11:13:31','2021-07-08 08:13:31','','Web_REO_T11 Регідрадація у дітей_укр','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_ukr','','','2021-07-08 11:13:31','2021-07-08 08:13:31','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_ukr.png',0,'attachment','image/png',0),(1644,1,'2021-07-08 11:23:53','2021-07-08 08:23:53','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-2','','','2021-07-08 11:23:53','2021-07-08 08:23:53','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2.png',0,'attachment','image/png',0),(1645,1,'2021-07-09 10:04:45','2021-07-09 07:04:45','','Web_REO_T11 Регідрадація у дітей_2 (1)','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-1-2','','','2021-07-09 10:04:45','2021-07-09 07:04:45','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png',0,'attachment','image/png',0),(1646,1,'2021-07-08 11:47:11','2021-07-08 08:47:11','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-2-2','','','2021-07-08 11:47:11','2021-07-08 08:47:11','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1.png',0,'attachment','image/png',0),(1647,1,'2021-07-08 11:49:45','2021-07-08 08:49:45','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-3-2','','','2021-07-08 11:49:45','2021-07-08 08:49:45','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-2.png',0,'attachment','image/png',0),(1648,1,'2021-07-08 13:13:34','2021-07-08 10:13:34','','Web_REO_T11 Регідрадація у дітей_2','','inherit','open','closed','','web_reo_t11-regidradacziya-u-ditej_2-4-2','','','2021-07-08 13:13:34','2021-07-08 10:13:34','',1636,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-3.png',0,'attachment','image/png',0),(1649,1,'2021-07-14 10:16:50','2021-07-14 07:16:50','','Оральная регидратация у детей','','inherit','open','closed','','oralnaya-regidratacziya-u-detej-2','','','2021-07-14 10:16:50','2021-07-14 07:16:50','',1636,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-detej.pdf',0,'attachment','application/pdf',0),(1650,1,'2021-07-14 10:16:56','2021-07-14 07:16:56','','Оральная регидратация у лиц пожилого возраста','','inherit','open','closed','','oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta-2','','','2021-07-14 10:16:56','2021-07-14 07:16:56','',1636,'https://reo.ua/wp-content/uploads/2021/06/oralnaya-regidratacziya-u-licz-pozhilogo-vozrasta.pdf',0,'attachment','application/pdf',0),(1651,1,'2021-08-30 16:15:53','2021-08-30 13:15:53','Сувсизланиш ёки дегидратация – организмда сув танқислиги билан кечувчи сув-туз мувозанатининг бузилишидир. Дегидратация сув ва электролитлар йўқотилиши ўз вақтида тўлдирилмаганида юзага келади, яъни уларнинг танқислиги кузатилади [1]. Дегидратация сабаблари қуйидагилар бўлиши мумкин: суюқлик ичишнинг камайиши, унинг сийдик, нажас, қусуқ массалари билан кўп чиқиб кетиши, қон йўқотилиши, организмдаги суюқлик дисбаланси (асцит, плеврада сув тўпланиши), суюқликнинг капилляр йўқотилиши (куйиш ва сепсисда) (расм) [2 билан адаптацияланган].\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1.png\"><img class=\"aligncenter size-large wp-image-1022\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t11-regidradacziya-u-ditej_2-1-1-1024x334.png\" alt=\"\" width=\"1024\" height=\"334\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Болаларда дегидратацияни келтириб чиқарадиган сабаблар</strong></p>\r\n<p style=\"text-align: center;\"><em>Изоҳ. *Бундай ҳолларда оғриқ сабабли суюқлик ичиш чегараланади</em></p>\r\nБолалар дегидратацияга катталарга қараганда таъсирчан бўлади, чунки бола танаси юзасининг тана вазнига нисбати катталардагига қараганда анча кўпроқ бўлади [2, 3]. Ёш болаларда дегидратациянинг кўп учрайдиган сабаблари ич кетиши ва қайт қилиш ҳисобланади [4].\r\n\r\n<strong>Дегидратация хавф гуруҳларига кирадиган болалар </strong><strong>[5]:</strong>\r\n<ul>\r\n 	<li>1 ёшгача, энг аввало 5 ойликкача бўлган болалар;</li>\r\n 	<li>туғилганида тана вазни кам бўлган болалар;</li>\r\n 	<li>охирги 24 соатда 6 ёки ундан кўп марта ичи кетган болалар;</li>\r\n 	<li>охирги 24 соатда 3 ёки ундан кўп марта қайт қилган болалар;</li>\r\n 	<li>айни вақтда суюқлик ича олмайдиган болалар;</li>\r\n 	<li>касаллик вақтида эмизилиши тўхтатилган болалар;</li>\r\n 	<li>ёшига нисбатан етарли даражада тана вазнига етмаган болалар.</li>\r\n</ul>\r\n<h2>Дегидратация патогенези</h2>\r\nҚайт қилиш, ич кетиши, кучли тер ажралиши ёки бошқа йўл билан йўқотиладиган суюқлик таркибида муайян концентрацияда тузлар бўлади, шунинг учун суюқлик йўқотилиши ҳар доим тузларнинг йўқотилиши билан бирга кечади. Йўқотилган тузлар (электролитлар) нинг аниқ миқдори ва характери дегидратация сабабларига боғлиқ. Масалан, бикарбонатлар қайт қилишда эмас, балки диареяда анча кўп миқдорда йўқотилади.\r\n\r\nСуюқлик йўқотилиши барча органлар ва тўқималарнинг тўлиқ ишлашига тўсқинлик қилади, шу сабабдан одамнинг ўзини ҳис қилиши ёмонлашади. Ўз навбатида, тузлар (электролитлар)нинг йўқотилиши, ва аксинча, улар концентрациясининг сув йўқотилиши натижасида ортиб кетиши хавфли ҳисобланади, чунки талваса, юрак ритмининг бузилиши ва ҳатто юракнинг тўхтаб қолиши каби асоратларни келтириб чиқариши мумкин [6]. Бу  мувозанатлашган эритма ёрдамида ўз вақтида регидратация ўтказишга эҳтиёжни белгилаб беради.\r\n<h2>Дегидратациянинг клиник кўриниши ва даражалари</h2>\r\nДегидратация унинг суюқлик йўқотилишини тавсифлайдиган белгилари ва симптомларининг намоён бўлишига боғлиқ ҳолда даражаларга бўлинади. Илк босқичларда сувсизланиш белгилари ва симптомларини бола организмининг ўзи компенсациялаши мумкин. Кейинчалик организмнинг компенсатор имкониятлари тугайди, чанқоқ, жиззакилик ва безовталик, тери тургорининг пасайиши, кўз ва лиқилдоқнинг чуқур ботиши (чақалоқларда) юзага келади. Оғир дегидратация ҳолларида  бу белгилар янада яққол кўринади. Ҳатто онгнинг бузилиши, сийдик ажралиб чиқмаслиги, периферик цианоз билан характерланадиган гиповолемик шок юз бериши мумкин. Совуқ оёқ-қўллар, томир уришининг тезлашиши (баъзида томир уриши аниқланмаслиги мумкин), артериал босимнинг тушиб кетиши кузатилади.\r\n\r\nТегишлича регидратациянинг мавжуд эмаслиги ўлимга олиб келиши мумкин [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"623\">1-жадвал. Дегидратация оғирлигини баҳолаш</th>\r\n</tr>\r\n<tr>\r\n<th width=\"156\"><strong>Мезон</strong></th>\r\n<th width=\"156\"><strong>Оғир бўлмаган</strong><strong> дегидратация (5%)</strong></th>\r\n<th width=\"156\"><strong>Ўртача дегидратация</strong>\r\n\r\n<strong>(5-9%)</strong></th>\r\n<th width=\"156\"><strong>Оғир</strong>\r\n\r\n<strong>дегидратация </strong><strong>(≥10%)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Онгнинг ҳолати</strong></td>\r\n<td width=\"156\">Фаол, муомалага қобил</td>\r\n<td width=\"156\">Летаргия, жиззакилик</td>\r\n<td width=\"156\">Онгнинг бузилиши</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Юрак уриши </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал ёки бир оз тахикардия</td>\r\n<td width=\"156\">Тахикардия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Нафас олиш </strong><strong>сони</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Ошган, ацидоз ҳосил бўлган ҳолда чуқур нафас олиш</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Артериал босим</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Гипотензия</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери ранги</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Рангсиз, доғлар пайдо бўлган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>О</strong><strong>ёқлар</strong></td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Илиқ</td>\r\n<td width=\"156\">Холодные</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферический пульс </strong></td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Нормальный</td>\r\n<td width=\"156\">Совуқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Периферик пульс</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Кучсизланган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Шиллиқ қават</strong></td>\r\n<td width=\"156\">Нам</td>\r\n<td width=\"156\">Қуруқ</td>\r\n<td width=\"156\">Қуруқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Тери тургори</strong></td>\r\n<td width=\"156\">Тери бурмалари тез текисланади</td>\r\n<td width=\"156\">Ўртача пасайган</td>\r\n<td width=\"156\">Пасайган</td>\r\n</tr>\r\n<tr>\r\n<td width=\"156\"><strong>Капиллярларнинг тикланиш ва тўлиш вақти</strong></td>\r\n<td width=\"156\">Нормал</td>\r\n<td width=\"156\">Ошган</td>\r\n<td width=\"156\">Анча ошган</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n(7)\r\n\r\nДегидратациянинг қизил байроқчалари (шок ривожланиши ва юзага келиш хавфининг белгилари):\r\n<ul>\r\n 	<li>аҳволнинг кескин ёмонлашиши;</li>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>кўзларнинг ботиқлиги;</li>\r\n 	<li>тахикардия;</li>\r\n 	<li>тахипноэ;</li>\r\n 	<li>тери тургорининг камайиши.</li>\r\n</ul>\r\n<strong>Дегидратация белгилари</strong>\r\n\r\n<strong>Тана вазнининг % да суюқлик танқислиги</strong>\r\n\r\n<strong>Тана вазниниг мл/кг да суюқлик танқислиги</strong>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"622\"><strong>2-жадвал. Дегидратациянинг клиник белгилари ва суюқликнинг тахминий танқислиги (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Мавжуд эмас</td>\r\n<td width=\"208\">&lt; 5</td>\r\n<td width=\"208\">&lt;50</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Дегидратациянинг баъзи белгилари мавжуд</td>\r\n<td width=\"208\">5-10</td>\r\n<td width=\"208\">50-100</td>\r\n</tr>\r\n<tr>\r\n<td width=\"208\">Оғир дегидратация белгилари мавжуд</td>\r\n<td width=\"208\">&gt;10</td>\r\n<td width=\"208\">&gt;100</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Масалан, дегидратациянинг баъзи бир белгилари бўлган вазни 5 кг ли болада суюқлик танқислиги 250-500 мл ни ташкил этади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\" width=\"621\"><strong>3-жадвал. Дегидратацияни баҳолаш мезонлари ва ҳаракатлар тактикасини танлаш </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"164\"><strong>Баҳолаш мезонлари</strong></th>\r\n<th width=\"152\"><strong>А</strong></th>\r\n<th width=\"154\"><strong>В</strong></th>\r\n<th width=\"152\"><strong>С</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Умумий аҳволи</strong></td>\r\n<td width=\"152\"><strong>Меъёрида</strong><strong>, </strong><strong>ф</strong><strong>а</strong><strong>ол</strong></td>\r\n<td width=\"154\"><strong>Безовта</strong><strong>, </strong><strong>жиззаки</strong></td>\r\n<td width=\"152\"><strong>Онгнинг бузилиши</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Кўзлари</strong></td>\r\n<td width=\"152\">Меъёрида</td>\r\n<td width=\"154\">Ботиқ</td>\r\n<td width=\"152\">Ботиқ</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Чанқоқлик</strong></td>\r\n<td width=\"152\">Бемалол ичаяпти, чанқоқ  йўқ</td>\r\n<td width=\"154\">Ташналик билан ичади, чанқоқ бор</td>\r\n<td width=\"152\">Ича олмайди ёки жуда кам ичади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Билак суяги терисини чимчилаш</strong><strong> </strong>\r\n\r\n<strong> </strong></td>\r\n<td width=\"152\">Тери бурмалари тез текисланади</td>\r\n<td width=\"154\">Тери бурмалари секин текисланади</td>\r\n<td width=\"152\">Тери бурмалари жуда секин текисланади</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Хулоса</strong></td>\r\n<td width=\"152\">Дегидратация белгилари йўқ, лекин дегидратациянинг олдини олиш зарур, чунки сув йўқотиш ҳоллари мавжуд</td>\r\n<td width=\"154\">Агар бу рўйхатдан ⩽2 белги бўлса, унча оғир бўлмаган ёки ўртача дегидратация мавжуд.</td>\r\n<td width=\"152\">Агар бу рўйхатдан ≥ 2 белги бўлса, оғир дегидратация мавжуд</td>\r\n</tr>\r\n<tr>\r\n<td width=\"164\"><strong>Ҳаракатлар тактикаси</strong></td>\r\n<td width=\"152\">А режа</td>\r\n<td width=\"154\">Агар мумкин бўлса болани тортиб кўринг ва В режага ўтинг</td>\r\n<td width=\"152\">Агар мумкин бўлса болани тортиб кўринг ва дарҳол         С режага ўтинг</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>А режа: орал регидратация</h2>\r\nБолага таркибида туз бўлган суюқликлар: орал регидратация учун махсус тузли эритмалар,  туз солинган ичимликлар бериш маъқул. Агар регидратацияни фақат оддий сув (гипотоник эритма) билан ўтказилса, қон плазмасида тузлар миқдорининг ҳаддан ортиқ пасайиб кетиши ва шишлар ҳосил бўлиш хавфи бўлади [9]. Шунингдек гуруч қайнатмаси (гуруч  қайнатилган сув),  янги мева шарбати (фреш), ичимлик сувини қўллаш мумкин.\r\n\r\nЎз навбатида, баъзи ичимликлар потенциал хавфли ҳисобланади. Масалан, таркибида қанд бўлган ичимликлар осмотик диарея ва гипернатриемияни келтириб чиқариши мумкин, шунинг учун  ширин газланган ичимликлар, тайёр шарбатлар, ширин чой истеъмол қилмасдан туриш зарур. Шунингдек болага диуретик ёки бўшаштирувчи таъсир кўрсатадиган кофе ёки ўсимлик чойларини ҳам бермаслик мақсадга мувофиқ.\r\n<h2>Қанча суюқлик бериш керак?</h2>\r\nУмуман олганда бола қанча ичишни ҳоҳласа, шунча суюқлик бериш керак. Диарея ҳолларида ҳар бир ич кетишидан сўнг 2 ёшдан кичик болага 50-100 мл (катта чашканинг 1/4-1/2 қисми), 2-10 ёш болага  100-200 мл (катта чашканинг 1/2-1 қисми), 10 ёшдан катта болага бола қанча ичишни ҳоҳласа шунча суюқлик беринг [1]. Агар дегидратациянинг сабаби бошқа бўлса, регидратацияда боланинг чанқоқни ҳис қилишига қараш керак.\r\n\r\nВ режа: тиббиёт муассасасида махсус эритмалар ёрдамида орал регидратация.\r\n\r\nАгар боланинг вазни маълум бўлса, зарур суюқлик миқдорини аниқлаш учун вазнни 75 мл га кўпайтириш зарур.Агар боланинг вазни маълум бўлмаса, ёшига қараб жадвалдан фойдаланилади. Бола кўпроқ суюқлик ичишни истаса ва ҳаддан ортиқ дегидратация белгилари бўлмаса (энг аввало, қовоқларнинг шиши) кўпроқ сув бериш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"7\" width=\"623\"><strong>4-жадвал. Дастлабки 4 соатда орал дегидратация учун эритманинг тахминий миқдори (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Ёши</strong></th>\r\n<th width=\"89\"><strong>4 ойликкача</strong></th>\r\n<th width=\"89\"><strong>4-11 ойлик</strong></th>\r\n<th width=\"89\"><strong>12-23 ойлик</strong></th>\r\n<th width=\"89\"><strong>2-4 ёш</strong></th>\r\n<th width=\"89\"><strong>5-14 ёш</strong></th>\r\n<th width=\"89\"><strong>&gt;15 ёш</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Вазни</strong></th>\r\n<td width=\"89\">До 5 кг</td>\r\n<td width=\"89\">5-7,9 кг</td>\r\n<td width=\"89\">8-10,9 кг</td>\r\n<td width=\"89\">11-15,9 кг</td>\r\n<td width=\"89\">16-29,9 кг</td>\r\n<td width=\"89\">&gt;30 кг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"89\"><strong>Мл</strong></th>\r\n<td width=\"89\">200-400</td>\r\n<td width=\"89\">400-600</td>\r\n<td width=\"89\">600-800</td>\r\n<td width=\"89\">800-1200</td>\r\n<td width=\"89\">1200-2200</td>\r\n<td width=\"89\">2200-4000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Боланинг ёшига фақат унинг вазнини билмаганда қаранг.\r\n\r\nОрал регидратация учун суюқликнинг тахминий миқдорини боланинг кг лардаги вазнини 75 га кўпайтириб мл ларда ҳисоблаш мумкин.\r\n\r\nАгар бола ҳисобланганидан кўпроқ суюқлик ичишни ҳоҳласа, кўпроқ суюқлик ичишга беринг\r\n\r\nЭритмани қошиқ билан ёки чашкадан бериш керак. Чақалоқлар учун пипетка ёки игнасиз шприцдан фойдаланиш мумкин. Кўпинча суюқликни тез ва кўп ичиришда қайт қилиш юз беради, лекин бу регидратацияга тўсқинлик қилмайди, чунки суюқликнинг катта қисми ўзлаштирилишга улгурган бўлади. Қайт қилиш юз берган ҳолларда 5-10 дақиқа кутиб туринг ва регидратацияни секинроқ суръатда давом эттиринг.  4 соатдан сўнг дегидратация даражасини 3-жадвалдан баҳоланг. Оғир дегидратация белгилари пайдо бўлганда С режага ўтинг. Дегидратация белгилари мавжуд бўлмаганда регидратацияни тўхтатиш мумкин. Бундай ҳолларда чанқоқлик йўқолади, сийиш тикланади, тери чимчилаб олинганидан кейин тез текисланади, бола тинчланади ва одатда ухлаб қолади [1].\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"3\" width=\"624\"><strong>5-жадвал. Вена ичига регидратациялаш схемаси (1)</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>Ёши</strong></th>\r\n<td width=\"208\">Дастлаб қуйидаги вақт ичида <span style=\"font-family: inherit; font-size: inherit;\">30 мл/кг инфузия тайинланг</span></td>\r\n<td width=\"208\">Кейин қуйидаги вақт ичида 70 мл/кг инфузия тайинланг</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликкача</strong></th>\r\n<td width=\"208\">1 соат*</td>\r\n<td width=\"208\">5 соат</td>\r\n</tr>\r\n<tr>\r\n<th width=\"208\"><strong>12 ойликдан катта</strong></th>\r\n<td width=\"208\">30 дақиқа*</td>\r\n<td width=\"208\">2,5 соат</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nИзоҳ. Шифохонага ётқизилганидан сўнг дарҳол мувозанатлаштирилган эритмалар инфузиясини бошланг. Агар бола ича оладиган бўлса, инфузия билан бир вақтда орал регидратация учун тузли эритмани бериш зарур.  Беморнинг ҳолатини 1-2 соатда бир марта баҳолаб боринг. Агар боланинг аҳволи яхшиланмаса, суюқлик киритишни тезлаштиринг. Суюқлик ҳажми тўлиқ киритиб бўлинганидан сўнг (чақалоқларда – 6 соат, катта болаларда – 3 соат) беморнинг ҳолатини 3-жадвалга мувофиқ баҳоланг ва яна энг мақбул даволаш режасини (А, В ёки С) танланг. * Агар билакдаги артерияда томир уриши (пульс) кучсиз ёки аниқланмаётган бўлса, суюқлик киритишни яна бир марта такрорланг.\r\n<h2>Орал регидратация – енгил ва ўрта оғирликдаги дегидратацияда танлов усули</h2>\r\nЎз ичига 1811 пациент иштирокидаги 17 та тадқиқотни олган Кокран шарҳи маълумотларига кўра орал ва вена ичига регидратация самарадорлиги ўртасида фарқ йўқ. Орал регидратация енгил ва ўрта оғирликдаги дегидратацияга учраган болаларни даволашнинг биринчи линияси бўлиши, вена ичига регидратация эса орал регидратация муваффақиятсиз бўлганда тайинланиши керак [10].\r\n<h2>Тиббий мақсадлар учун ReO суви («Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви орал регидратация  учун тайёр эритма ҳисобланиб, таркибида барча муҳим электролитлар ва сорбитол мавжуд. Сорбитол – энергиянинг қўшимча манбаи бўлиб, организм ҳужайралари уни инсулин иштирокисиз ўзлаштиради. РeО таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга. Бу педиатрия амалиётида қўлланиладиган воситалар учун муҳим шарт ҳисобланади.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\">Табл. 6. Збалансированный состав воды РеО</th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Компонент</strong></th>\r\n<th width=\"151\"><strong>Содержание</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na+</td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K+</td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca2+</td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl-</td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO3-</td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм3): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёвчи моддалар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга, уни ҳатто кўнгил айниганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>диурезни нормаллаштиради, интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Дегидратация профилактикаси</h2>\r\nСувсизланиш билан бирга кечиши мумкин бўлган ҳолатларга юқори жисмоний фаоллик (спорт машғулотлари, фаол ўйинлар, югуриш), иситиладиган хоналарда ва ҳавоси қуруқ хоналарда узоқ бўлиш, фототерапия, полиурия, иситма, куйишлар, кучли тер ажралиши, нафас олиш ва юрак уриш тезлигининг ошиши,  ўрнатилган жарроҳлик дренажлари киради [12]. Бундай ҳолатларда боланинг ичаётган сувининг ҳажмини жиддий кузатиб бориш,  бола чанқоқни ҳис қилиши ёки қилмаслигидан қатъий назар, муайян вақт оралиқларида сув ичириб туриш мақбул ҳисобланади.\r\n\r\nБоланинг суюқликка эҳтиёжи қуйидаги тарзда ҳисобланади:\r\n<ul>\r\n 	<li>тана вазнининг дастлабки 10 кг га 4 мл/кг/йил;</li>\r\n 	<li>тана вазнининг ҳар бир кейинги 10 кг га +2 мл/кг/йил;</li>\r\n 	<li>&gt;20 кг вазн учун ҳар бир кг га +1 мл/кг/йил [4].</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати:</h2>\r\n<ol>\r\n 	<li><em>The treatment of A manual for physicians and other senior health workers. WHO, 2005.</em></li>\r\n 	<li><em>Willacy Dehydration in children. Patient Info. 2019.</em></li>\r\n 	<li><em>Berkowitz D. Pediatrics: A primary care approach. 3</em><em>rd </em><em>ed. Toronto, ON: W.B. Saunders, 2008.</em></li>\r\n 	<li><em>Somers J., Endom E.E. Maintenance fluid therapy in children. UptoDate Online. 2008; 16.3.</em></li>\r\n 	<li><em> Diarrhoea and vomiting in children overview. Pathway last updated 02.11.2020.</em></li>\r\n 	<li><em>Part 1: Life-threatening electrolyte abnormalities. Circulation. 2005; 112: IV-121 – IV-125.</em></li>\r\n 	<li><em>The Royal Children’s Hospital Clinical Practice Guidelines. Dehydration. Last updated: September 2020. </em><em>https://</em><em>www.rch.org.au/clinicalguide/guideline_index/Dehydration.</em></li>\r\n 	<li><em>NICE Gastroenteritis. 2019.</em></li>\r\n 	<li><em>Available at: https://</em><em>msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/</em> <em>dehydration-in-children#:~:text=The%20resuscitation%20phase%20should%20reduce,body%20weight)%20may%20 </em><em>be%20required.</em></li>\r\n 	<li><em>Hartling L., et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. </em><em>Cochrane Database of Systematic 2006; 3: CD004390.</em></li>\r\n 	<li><em>Кирпач Г. RеО вода для медичних цілей – гармонія води та електролітів у пляшці. Современная фармация. </em><em>2021; </em></li>\r\n 	<li><em>Anigilaje E.A. Management of diarrhoeal dehydration in childhood: a review for clinicians in developing countries. </em><em>Front 2018; 6: 28.</em></li>\r\n</ol>','Болаларда орал регидратация','','inherit','closed','closed','','1636-revision-v1','','','2021-08-30 16:15:53','2021-08-30 13:15:53','',1636,'https://reo.ua/?p=1651',0,'revision','',0),(1652,1,'2021-07-19 17:25:37','2021-07-19 14:25:37','“<em>Сувга Ерда ҳаёт  суви бўлиш учун сеҳрли ҳукмронлик берилган</em>”.\r\n<em>Леонардо Да В</em><em>и</em><em>нч</em><em>и </em>\r\n\r\nСув инсон ҳаётида муҳим роль ўйнайди...\r\n\r\nОрганизмнинг ҳар бир тизими, ҳужайралардан бошлаб ҳаётий муҳим органларгача сувсиз ишлай олмайди.\r\n<h2>Организмга нима учун шунча сув талаб этилади?</h2>\r\nБизнинг организм – бу тирик лаборатория, унда ҳар сонияда юзлаб кимёвий реакциялар юзага келади. Уларнинг нормал кечиши сув иштирокисиз бўлмайди. Сув организмдаги барча жараёнларда иштирок этади. Мана улардан бир нечта энг муҳимлари [2]:\r\n<ul>\r\n 	<li>тана ҳароратини бошқариш;</li>\r\n 	<li>кўз, нафас олиш ва ошқозон-ичак шиллиқ қаватини намлантириш ва ҳимоя қилиш;</li>\r\n 	<li>озуқа моддаларини ва кислородни ҳужайраларга ташиш;</li>\r\n 	<li>бўғимларни мойлаш;</li>\r\n 	<li>зарарли моддаларни зарарсизлантириш, жигар ва буйрак орқали чиқариб ташлаш;</li>\r\n 	<li>минераллар ва озуқа моддаларини тана уларни ўзлаштира олиши учун эритиш.</li>\r\n</ul>\r\n<h2>БУ МУҲИМ!</h2>\r\nТана умумий вазнининг 8% дан ортиқ миқдорда сув йўқотилганда ўлим юз бериши мумкин.\r\n\r\n***\r\n\r\nИнсон организми  сувни тўплай ва сақлай олмайди. Биз сувни доимо тери, ўпка, буйраклар ва ичаклар орқали йўқотамиз.\r\n\r\nЙўқотилган суюқликни тиклаш ва тегишлича гидратация организмнинг соғлиғи ва ишлашининг гаровидир [1].\r\n<h2>Қизиқарли ФАКТ!</h2>\r\nЎртача статистик катта ёшдаги одамнинг танаси 60% сувдан иборат.\r\n\r\nБунда алоҳида органлардаги суюқлик миқдори фарқланади. Масалан,  суякларимизнинг фақат учдан бир қисми сувдан иборат бўлгани ҳолда, ўпкамиз 83% сувдан иборат [1].\r\n<h2>СУВСИЗЛАНИШДА ОРГАНИЗМДА НИМАЛАР ЮЗ БЕРАДИ?</h2>\r\nОрганизмнинг 1% дан ортиқ суюқликни йўқотиши терморегуляциянинг бузилишига, иш қобилияти ва иштаҳанинг пасайишига олиб келади. Агар дегидратация давом этиб, сув танқислиги 4% ва ундан кўпроқни ташкил этадиган бўлса, диққатни жамлашда қийинчиликлар, бош оғриғи, жаҳлдорлик, уйқучанлик юзага келади, тана ҳарорати ва нафас олиш тезлиги ошади [3].\r\n\r\nРивожланиб борувчи сувсизланиш юрак-қон томир тизимига ҳам салбий таъсир кўрсатади.Сув йўқотилиши юрак қисқаришлари тезлигининг ошиши ва артериал босимнинг бузилиши билан бирга кечади. Енгил сувсизланиш (тана вазнининг 2% йўқотилиши) босимни меъёрида ушлаб туриш учун жавоб берадиган барорецепторларнинг сезгирлигини пасайтиради [4].\r\n\r\nАртериал босим пасайганида  юракка кам қон тушади. Натижада юрак иш унуми пасаяди ва органларга кислород ва озуқа моддалари кам тушади [5]. Шунингдек ўртача сувсизланиш митрал клапан пролапсини кучайтиради, бу юрак бўлмасининг босими ва тўлдириш ҳажми пастлиги сабабли юзага келади.\r\n\r\nАтроф-муҳит температураси юқорилигида тана вазнининг 10% дан ошадиган миқдорда сув йўқотилиши инсульт, шок ва полиорган етишмовчилигининг жиддий хавфи билан кечади [8].\r\n\r\nСурункали сувсизланиш инфекциялар, айниқса сийдик чиқариш йўллари  инфекциялари ривожланиш хавфини оширади. Шу билан бир вақтда ичилган суюқлик ҳажмини ошириш такрорий инфекциялар юзага келиш сонини камайтиради.\r\n\r\nБир қанча тадқиқотлар одатда кам сув ичадиган одамларда  сийдик қопи саратони юзага келишининг  юқори хавфи ҳақида хабар беради.\r\n\r\nМасалан, тадқиқотлардан бирида 47909 нафар эркакда умумий суткалик суюқлик истеъмоли баҳоланди. Кузатувлардан 10 йил кейин суткасига 1,3 л дан кам сув ичган эркакларда суткасига 2,5 л дан кўп сув ичган эркакларга нисбатан сийдик қопининг саратони  юзага келиш хавфи анча (p = 0,002) юқорилиги аниқланди [11].\r\n<h2>Сувсизланишнинг қандай турлари бўлади?</h2>\r\nСувсизланишнинг бир нечта турлари мавжуд:\r\n<ul>\r\n 	<li>Изотоник, бунда сув ва натрий биргаликда йўқотилади.</li>\r\n 	<li>Сувнинг изотоник йўқотилишининг сабаблари қайт қилиш, диарея, кўп терлаш, куйиш, буйрак касалликлари, гипергликемия ва гипоальдостеронизм ҳисобланади.</li>\r\n 	<li>Гипертоник, бунда сув йўқотилиши натрий йўқотилишидан ортиқ бўлади. Гипертоник дегидратацияда натрий ва қон зардобининг осмолярлиги ҳар доим юқори бўлади. Бу ҳолат иситма, нафас қисиши ва қандсиз диабетда юзага келади.</li>\r\n 	<li>Гипотоник, бунда  организм сувга нисбатан натрийни кўпроқ йўқотади. Кўпинча бу сийдик ҳайдовчи препаратларни қабул қилиш билан боғлиқ.</li>\r\n</ul>\r\n<h2>СУВСИЗЛАНИШ КИМЛАРДА КЎПРОҚ УЧРАЙДИ?</h2>\r\nМутлақо ҳеч ким дегидратациядан ҳимояланмаган, лекин баъзи бир вазиятларда ва беморларнинг муайян гуруҳларида бу ҳолат кўпроқ учрайди ва оғир оқибатлар билан кечиши мумкин.\r\n<h2>Болалар</h2>\r\nБутун дунё бўйлаб чақалоқлар ва кичик ёшдаги болаларнинг касалланиши ва ўлимининг кўп учрайдиган сабабларидан бири бўлиб дегидратация ҳисобланади.\r\n\r\nБолалардаги сувсизланиш ҳолатларининг аксарияти ўткир гастроэнтерит оқибати ҳисобланади.\r\n\r\nЧақалоқлар ва кичик ёшдаги болалар диарея ва сувсизланишга айниқса мойил бўлади.\r\n\r\nБунинг сабаби болалардаги метаболизмнинг юқори даражаси, ўз эҳтиёжлари ҳақида айта олмаслиги ёки мустақил сув ича олмаслиги ҳисобланади. Болаларда сувсизланишнинг бошқа сабаблари диабетик кетоцидоз (ДКА), қандсиз диабет, ацетономик синдром, куйишлар, қуёш ёки иссиқ уриши, ҳаддан ортиқ тер ажралиши бўлиши мумкин [13].\r\n<h2>Кекса ёшдаги одамлар</h2>\r\nҲар қандай катта ёшдаги одамда дегидратация гипергликемия фонида ривожланиши мумкин.\r\n\r\nДегидратация ҳам касаллик сабаби, ҳам унинг оқибати бўлиши мумкин.\r\n\r\nКекса одамларда дегидратация ривожланиши эҳтимоли ёш ва ўрта ёшдаги одамларга нисбатан 20-30% юқори.\r\n\r\nБу жисмоний фаолликнинг камайиши, чанқоқни камроқ сезиш, қандли диабет  ва буйрак касалликлари билан боғлиқ [14, 15].\r\n<h2>Ҳомиладорлар</h2>\r\nҲомиладорларнинг ярмидан кўпроғи ҳомиладорликнинг 4-ҳафтасида бошланиб, 16-ҳафтасида йўқоладиган кўнгил айниши ва қайт қилишдан азият чекади.\r\n\r\n200 нафар аёлдан 1 тасида бу ҳолат ҳомиладорларнинг тўхтатиб бўлмайдиган қайт қилишигача ривожланади (Hyperemesis gravidarum). Бу ҳолат давомли ва кучли кўнгил айниши ва қайт қилиш, сувсизланиш ва вазн йўқотилиши билан тавсифланади [16].\r\n<h2>Спортчилар ва жисмоний меҳнат билан шуғулланадиган одамлар</h2>\r\nЖисмоний машқлар вақтида юқори метаболизм тана ҳароратининг кўтарилишига сабаб бўлади. Танани қизиб кетишдан сақлаш учун бизнинг организмимиз сувни жадал буғлата бошлайди ва сувсизланишни келтириб чиқаради [17].\r\n<h2>Иситмаси бор пациентлар</h2>\r\nТана ҳароратининг кўтарилиши бизнинг теримиз ва ўпкамизни сувни жадал буғлантиришга мажбур қилади. Бундан ташқари, иситма кўпинча иштаҳа йўқолиши билан кечади, демак организм озиқ-овқат маҳсулотлари билан суюқлик олмай қўяди [18].\r\n<h2>Диарея ва қайт қилишдан азият чекаётган беморлар</h2>\r\nГастроэнтерит – дунёда сувсизланишнинг энг кўп учрайдиган сабаби.\r\n\r\nАгар у яққол қайт қилиш ва диарея билан кечадиган бўлса, сувсизланиш  жуда тез ривожланиб кетиши мумкин [19, 20].\r\n<h2>Алкоголдан заҳарланиш ҳолатидаги одамлар</h2>\r\nДегидратация алкоголь истеъмол қилинганидан кейинги карахтлик симптомларини келтириб чиқарадиган сабаблардан бири ҳисобланади.\r\n\r\nТадқиқот натижалари етарлича миқдорда сув ичиш уйқусиз ўтказилган ўтиришлардан сўнг тикланишни тезлаштиришини тасдиқлади.\r\n<h2>Бу муҳим!</h2>\r\nИхтисослашмаган матбуот маълумотларига кўра америкаликларнинг 75% сурункали сувсизланишга учраган.\r\n\r\nКекса ёшдаги пациентлар ўртасида дегидратациянинг тарқалиши 17%-28% атрофида ўзгариб туради [12].\r\n<h2>МУҲИМ!</h2>\r\nРотавирус  чақалоқлар ва эрта ёшдаги болаларда дегидратация ва оғир диареянинг дунёда энг кенг тарқалган сабаби ҳисобланади [21].\r\n<h2>Қизиқарли ФАКТ!</h2>\r\nҲомиладорликдаги кўнгил айниши ва қайт қилишнинг сабаби аниқ маълум эмас, лекин у аёл организмида хорионик гонадотропин концентрациясининг ошиши билан боғлиқ бўлиши мумкин [16].\r\n<h2>Сизда сувсизланиш юз бераётганини қандай тушуниш мумкин ?</h2>\r\nСувсизланишнинг белгилари ва симптомлари ёшга боғлиқ ҳолда фарқ қилиши мумкин. Масалан, чақалоқлар ва кичик ёшдаги болаларда дегидратация қуйидагича намоён бўлади [23]:\r\n<ul>\r\n 	<li>оғиз бўшлиғи шиллиқ қавати ва тилнинг қуруқлиги;</li>\r\n 	<li>йиғлаганда кўз ёшининг бўлмаслиги;</li>\r\n 	<li>уч соат ва ундан кўпроқ вақт давомида тагликнинг қуруқ бўлиши;</li>\r\n 	<li>кўзлар, ёноқлар ва бош суяги тепа қисмининг ботиқлиги;</li>\r\n 	<li>ланжлик ёки жаҳлдорлик.</li>\r\n</ul>\r\nКатталар кучли чанқоқ, кам сийиш, сийдикнинг тўқ ранги, чарчоқ, бош айланиши ва бошдаги қоронғилашишлардан шикоят қиладилар.\r\n<h2>Сувсизланишни қандай даволаш мумкин?</h2>\r\nҲар қандай сабабларга кўра келиб чиқадиган сувсизланишни даволашнинг асоси орал регидратацион терапия (ОРТ) ҳисобланади.  Сувнинг сўрилишини осонлаштириш учун регидратация учун идеал эритма  таркибида тўғри нисбатларда микроэлементлар бўлиши керак, улардан энг муҳими натрий ҳисобланади. Натрий  ва бошқа микроэлементлар суюқлик билан ичакдан қон томирларига пассив ташилиши мумкин.\r\n\r\nБир қатор тадқиқотларда тегишли эритма билан тезликда перорал регидратация ўтказиш  худди эритмаларни инфузия шаклида венага юбориш каби самарали бўлиши исботланган. Бунда сув-туз эритмалари билан  оғиз орқали ўтказиладиган регидратация инвазив эмас ва инфузион терапияда юзага келиши мумкин бўлган бир қатор нохуш реакциялар билан кечмайди.\r\n\r\n«Юрия-Фарм» фармацевтика компаниясининг тиббий мақсадлар учун ReO суви перорал регидратация ўтказиш учун мувозанатлаштирилган сув-электролит таркибига эга, самарали ва хавфсиз. Бу ҳақиқий клиник амалиёти шароитларидаги кўп йиллик фойдаланиш тажрибаси билан тасдиқланган.\r\n<h2><strong>Тиббий мақсадлар учун </strong><strong>ReO сувини </strong><strong>қ</strong><strong>а</strong><strong>чон</strong><strong> ичиш керак?</strong></h2>\r\nReO суви организмнинг сувсизланиши ва интоксикацияси билан кечадиган ҳолатларда тавсия этилади, хусусан:\r\n<ul>\r\n 	<li>жисмоний юкланишларда</li>\r\n 	<li>иссиқ ҳавода;</li>\r\n 	<li>алкоголдан заҳарланишда;</li>\r\n 	<li>иситмада;</li>\r\n 	<li>овқатдан заҳарланишларда;</li>\r\n 	<li>диареяда;</li>\r\n 	<li>болалардаги ўткир ичак инфекцияларида;</li>\r\n 	<li>ҳомиладорлар токсикозида.</li>\r\n</ul>\r\n<h2>ReO сувини қандай ичиш керак?</h2>\r\nЕнгил ва ўртача сувсизланишни орал регидратацион терапия (ОРТ) орқали ReO сувидан фойдаланиб самарали даволаш мумкин. Қайт қилиш, одатда, ОРТ га қарши кўрсатма ҳисобланмайди (ичак тутилиши ва ўткир қорин синдромидан ташқари).\r\n\r\nЎткир ичак инфекциялари, шунингдек қайт қилиш ва диарея билан кечадиган бошқа бузилишларда, айниқса болаларда, суюқлик танқислигини 4 соат мобайнида тўлдириш зарур. Ошқозон чўзилишини ва рефлектор қайт қилишни имкон қадар камайтириш учун ReO сувини кичик ҳажмларда  тез-тез ичириш керак. Одатда ҳар дақиқада 5 мл ReO суви яхши қабул қилинади. Организмнинг сув захиралари тиклангани сари қайт қилиш кўпинча камаяди, шунинг учун кейинроқ суюқликнинг каттароқ ҳажмларидан фойдаланиш мумкин бўлади [18].\r\n<h2>Сувсизланиш 2 босқичда даволанади [24]:</h2>\r\n<ul>\r\n 	<li>1 босқич – регидратация. У йўқотилган суюқлик захираларини тезроқ тиклашга йўналтирилган бўлиб, 3-4 соат давом этади. ReO сувининг зарурий ҳажми беморнинг ёши ва тана вазнига боғлиқ ва қуйидагини ташкил этади:</li>\r\n</ul>\r\n— чақалоқлар ва вазни 30 кг гача бўлган болалар учун – 4 соат мобайнида 50-100 мл/кг ReO суви;\r\n\r\n— катталар ва вазни 30 кг гача бўлган ўсмирлар учун – 4 соат мобайнида 2-4 л ReO суви.\r\n<ul>\r\n 	<li>2 босқич – бир маромда ушлаб турувчи. Бу босқичнинг мақсади – сувсизланишни бартараф этиш. Бунда сув ҳажми, беморнинг ёши ва тана вазнидан ташқари, қайт қилишлар ва суюқ ич кетишлари сонига боғлиқ бўлади ва ва қуйидагини ташкил этади:</li>\r\n</ul>\r\n— агар тана вазни 10 кг дан кам бўлса, ҳар бир диарея ёки қайт қилишдан кейин 60-120 мл ReO суви;- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\r\n\r\nТана вазни 30 кг дан ортиқ бўлган ўсмирлар ва катталар қанча ҳоҳласалар шунча суюқлик ичишлари мумкин.\r\n\r\nҚадимдаёқ Цельс, касалликларнинг олдини олиш ва улардан даво топиш – бу ҳаммаси сувда,  деб айтган эди. Сув танани мустаҳкамлайди ва руҳ тетиклигини сақлаб туради. Бугунги кунда тўғри сувни танлаш  ҳар қачонгиданда осон. ReO суви шунчаки яхши таъм хусусиятлари билан тавсифланмайди, у шунингдек кўнгил айниб турганида ҳам осон ичилади. ReO суви  мувозанатлаштирилган сув-туз таркиби туфайли сув ва электролитларнинг максимал тез сўрилишини таъминлайди ва организмни, келиб чиқиш сабабларидан қатъий назар, дегидратациядан халос этади.\r\n<h2>Адабиёт манбалари:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n</ol>\r\n<ol start=\"2\">\r\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\r\n</ol>\r\n<ol start=\"3\">\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n</ol>\r\n<ol start=\"4\">\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n</ol>\r\n<ol start=\"5\">\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n</ol>\r\n<ol start=\"6\">\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n</ol>\r\n<ol start=\"7\">\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\r\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"9\">\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n</ol>\r\n<ol start=\"10\">\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n</ol>\r\n<ol start=\"11\">\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n</ol>\r\n<ol start=\"12\">\r\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n</ol>\r\n<ol start=\"13\">\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n</ol>\r\n<ol start=\"14\">\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n</ol>\r\n<ol start=\"15\">\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factorscontributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n</ol>\r\n<ol start=\"94\">\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n</ol>\r\n<ol start=\"16\">\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n</ol>\r\n<ol start=\"17\">\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n</ol>\r\n<ol start=\"18\">\r\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n</ol>\r\n<ol start=\"19\">\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"20\">\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine Committee. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19345549/</li>\r\n</ol>\r\n<ol start=\"21\">\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN. Clinical and laboratory assessment of dehydration severity in children withacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n</ol>\r\n<ol start=\"22\">\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n</ol>\r\n<ol start=\"23\">\r\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n</ol>\r\n<ol start=\"24\">\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases</li>\r\n</ol>','ReO - сув ва электролитларнинг шишадаги уйғунлиги','','publish','open','open','','reo-suv-va-elektrolitlarning-shishadagi-uj%d2%93unligi','','','2021-08-30 16:28:46','2021-08-30 13:28:46','',0,'https://reo.ua/uncategorized-uz/reo-garmoniya-vody-i-elektrolitov-v-butylke/',1,'post','',0),(1653,1,'2021-07-19 17:26:00','2021-07-19 14:26:00','','РеО гармонія води та електролітів у пляшці','','inherit','open','closed','','reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi-2-2','','','2021-07-19 17:26:00','2021-07-19 14:26:00','',1652,'https://reo.ua/wp-content/uploads/2021/07/reo-garmoniya-vodi-ta-elektrolitiv-u-plyashczi.pdf',0,'attachment','application/pdf',0),(1654,1,'2021-08-30 16:27:31','2021-08-30 13:27:31','“<em>Сувга Ерда ҳаёт  суви бўлиш учун сеҳрли ҳукмронлик берилган</em>”.\n<em>Леонардо Да В</em><em>и</em><em>нч</em><em>и </em>\n\nСув инсон ҳаётида муҳим роль ўйнайди...\n\nОрганизмнинг ҳар бир тизими, ҳужайралардан бошлаб ҳаётий муҳим органларгача сувсиз ишлай олмайди.\n<h2>Организмга нима учун шунча сув талаб этилади?</h2>\nБизнинг организм – бу тирик лаборатория, унда ҳар сонияда юзлаб кимёвий реакциялар юзага келади. Уларнинг нормал кечиши сув иштирокисиз бўлмайди. Сув организмдаги барча жараёнларда иштирок этади. Мана улардан бир нечта энг муҳимлари [2]:\n<ul>\n 	<li>тана ҳароратини бошқариш;</li>\n 	<li>кўз, нафас олиш ва ошқозон-ичак шиллиқ қаватини намлантириш ва ҳимоя қилиш;</li>\n 	<li>озуқа моддаларини ва кислородни ҳужайраларга ташиш;</li>\n 	<li>бўғимларни мойлаш;</li>\n 	<li>зарарли моддаларни зарарсизлантириш, жигар ва буйрак орқали чиқариб ташлаш;</li>\n 	<li>минераллар ва озуқа моддаларини тана уларни ўзлаштира олиши учун эритиш.</li>\n</ul>\n<h2>БУ МУҲИМ!</h2>\nТана умумий вазнининг 8% дан ортиқ миқдорда сув йўқотилганда ўлим юз бериши мумкин.\n\n***\n\nИнсон организми  сувни тўплай ва сақлай олмайди. Биз сувни доимо тери, ўпка, буйраклар ва ичаклар орқали йўқотамиз.\n\nЙўқотилган суюқликни тиклаш ва тегишлича гидратация организмнинг соғлиғи ва ишлашининг гаровидир [1].\n<h2>Қизиқарли ФАКТ!</h2>\nЎртача статистик катта ёшдаги одамнинг танаси 60% сувдан иборат.\n\nБунда алоҳида органлардаги суюқлик миқдори фарқланади. Масалан,  суякларимизнинг фақат учдан бир қисми сувдан иборат бўлгани ҳолда, ўпкамиз 83% сувдан иборат [1].\n<h2>СУВСИЗЛАНИШДА ОРГАНИЗМДА НИМАЛАР ЮЗ БЕРАДИ?</h2>\nОрганизмнинг 1% дан ортиқ суюқликни йўқотиши терморегуляциянинг бузилишига, иш қобилияти ва иштаҳанинг пасайишига олиб келади. Агар дегидратация давом этиб, сув танқислиги 4% ва ундан кўпроқни ташкил этадиган бўлса, диққатни жамлашда қийинчиликлар, бош оғриғи, жаҳлдорлик, уйқучанлик юзага келади, тана ҳарорати ва нафас олиш тезлиги ошади [3].\n\nРивожланиб борувчи сувсизланиш юрак-қон томир тизимига ҳам салбий таъсир кўрсатади.Сув йўқотилиши юрак қисқаришлари тезлигининг ошиши ва артериал босимнинг бузилиши билан бирга кечади. Енгил сувсизланиш (тана вазнининг 2% йўқотилиши) босимни меъёрида ушлаб туриш учун жавоб берадиган барорецепторларнинг сезгирлигини пасайтиради [4].\n\nАртериал босим пасайганида  юракка кам қон тушади. Натижада юрак иш унуми пасаяди ва органларга кислород ва озуқа моддалари кам тушади [5]. Шунингдек ўртача сувсизланиш митрал клапан пролапсини кучайтиради, бу юрак бўлмасининг босими ва тўлдириш ҳажми пастлиги сабабли юзага келади.\n\nАтроф-муҳит температураси юқорилигида тана вазнининг 10% дан ошадиган миқдорда сув йўқотилиши инсульт, шок ва полиорган етишмовчилигининг жиддий хавфи билан кечади [8].\n\nСурункали сувсизланиш инфекциялар, айниқса сийдик чиқариш йўллари  инфекциялари ривожланиш хавфини оширади. Шу билан бир вақтда ичилган суюқлик ҳажмини ошириш такрорий инфекциялар юзага келиш сонини камайтиради.\n\nБир қанча тадқиқотлар одатда кам сув ичадиган одамларда  сийдик қопи саратони юзага келишининг  юқори хавфи ҳақида хабар беради.\n\nМасалан, тадқиқотлардан бирида 47909 нафар эркакда умумий суткалик суюқлик истеъмоли баҳоланди. Кузатувлардан 10 йил кейин суткасига 1,3 л дан кам сув ичган эркакларда суткасига 2,5 л дан кўп сув ичган эркакларга нисбатан сийдик қопининг саратони  юзага келиш хавфи анча (p = 0,002) юқорилиги аниқланди [11].\n<h2>Сувсизланишнинг қандай турлари бўлади?</h2>\nСувсизланишнинг бир нечта турлари мавжуд:\n<ul>\n 	<li>Изотоник, бунда сув ва натрий биргаликда йўқотилади.</li>\n 	<li>Сувнинг изотоник йўқотилишининг сабаблари қайт қилиш, диарея, кўп терлаш, куйиш, буйрак касалликлари, гипергликемия ва гипоальдостеронизм ҳисобланади.</li>\n 	<li>Гипертоник, бунда сув йўқотилиши натрий йўқотилишидан ортиқ бўлади. Гипертоник дегидратацияда натрий ва қон зардобининг осмолярлиги ҳар доим юқори бўлади. Бу ҳолат иситма, нафас қисиши ва қандсиз диабетда юзага келади.</li>\n 	<li>Гипотоник, бунда  организм сувга нисбатан натрийни кўпроқ йўқотади. Кўпинча бу сийдик ҳайдовчи препаратларни қабул қилиш билан боғлиқ.</li>\n</ul>\n<h2>СУВСИЗЛАНИШ КИМЛАРДА КЎПРОҚ УЧРАЙДИ?</h2>\nМутлақо ҳеч ким дегидратациядан ҳимояланмаган, лекин баъзи бир вазиятларда ва беморларнинг муайян гуруҳларида бу ҳолат кўпроқ учрайди ва оғир оқибатлар билан кечиши мумкин.\n<h2>Болалар</h2>\nБутун дунё бўйлаб чақалоқлар ва кичик ёшдаги болаларнинг касалланиши ва ўлимининг кўп учрайдиган сабабларидан бири бўлиб дегидратация ҳисобланади.\n\nБолалардаги сувсизланиш ҳолатларининг аксарияти ўткир гастроэнтерит оқибати ҳисобланади.\n\nЧақалоқлар ва кичик ёшдаги болалар диарея ва сувсизланишга айниқса мойил бўлади.\n\nБунинг сабаби болалардаги метаболизмнинг юқори даражаси, ўз эҳтиёжлари ҳақида айта олмаслиги ёки мустақил сув ича олмаслиги ҳисобланади. Болаларда сувсизланишнинг бошқа сабаблари диабетик кетоцидоз (ДКА), қандсиз диабет, ацетономик синдром, куйишлар, қуёш ёки иссиқ уриши, ҳаддан ортиқ тер ажралиши бўлиши мумкин [13].\n<h2>Кекса ёшдаги одамлар</h2>\nҲар қандай катта ёшдаги одамда дегидратация гипергликемия фонида ривожланиши мумкин.\n\nДегидратация ҳам касаллик сабаби, ҳам унинг оқибати бўлиши мумкин.\n\nКекса одамларда дегидратация ривожланиши эҳтимоли ёш ва ўрта ёшдаги одамларга нисбатан 20-30% юқори.\n\nБу жисмоний фаолликнинг камайиши, чанқоқни камроқ сезиш, қандли диабет  ва буйрак касалликлари билан боғлиқ [14, 15].\n<h2>Ҳомиладорлар</h2>\nҲомиладорларнинг ярмидан кўпроғи ҳомиладорликнинг 4-ҳафтасида бошланиб, 16-ҳафтасида йўқоладиган кўнгил айниши ва қайт қилишдан азият чекади.\n\n200 нафар аёлдан 1 тасида бу ҳолат ҳомиладорларнинг тўхтатиб бўлмайдиган қайт қилишигача ривожланади (Hyperemesis gravidarum). Бу ҳолат давомли ва кучли кўнгил айниши ва қайт қилиш, сувсизланиш ва вазн йўқотилиши билан тавсифланади [16].\n<h2>Спортчилар ва жисмоний меҳнат билан шуғулланадиган одамлар</h2>\nЖисмоний машқлар вақтида юқори метаболизм тана ҳароратининг кўтарилишига сабаб бўлади. Танани қизиб кетишдан сақлаш учун бизнинг организмимиз сувни жадал буғлата бошлайди ва сувсизланишни келтириб чиқаради [17].\n<h2>Иситмаси бор пациентлар</h2>\nТана ҳароратининг кўтарилиши бизнинг теримиз ва ўпкамизни сувни жадал буғлантиришга мажбур қилади. Бундан ташқари, иситма кўпинча иштаҳа йўқолиши билан кечади, демак организм озиқ-овқат маҳсулотлари билан суюқлик олмай қўяди [18].\n<h2>Диарея ва қайт қилишдан азият чекаётган беморлар</h2>\nГастроэнтерит – дунёда сувсизланишнинг энг кўп учрайдиган сабаби.\n\nАгар у яққол қайт қилиш ва диарея билан кечадиган бўлса, сувсизланиш  жуда тез ривожланиб кетиши мумкин [19, 20].\n<h2>Алкоголдан заҳарланиш ҳолатидаги одамлар</h2>\nДегидратация алкоголь истеъмол қилинганидан кейинги карахтлик симптомларини келтириб чиқарадиган сабаблардан бири ҳисобланади.\n\nТадқиқот натижалари етарлича миқдорда сув ичиш уйқусиз ўтказилган ўтиришлардан сўнг тикланишни тезлаштиришини тасдиқлади.\n<h2>Бу муҳим!</h2>\nИхтисослашмаган матбуот маълумотларига кўра америкаликларнинг 75% сурункали сувсизланишга учраган.\n\nКекса ёшдаги пациентлар ўртасида дегидратациянинг тарқалиши 17%-28% атрофида ўзгариб туради [12].\n<h2>МУҲИМ!</h2>\nРотавирус  чақалоқлар ва эрта ёшдаги болаларда дегидратация ва оғир диареянинг дунёда энг кенг тарқалган сабаби ҳисобланади [21].\n<h2>Қизиқарли ФАКТ!</h2>\nҲомиладорликдаги кўнгил айниши ва қайт қилишнинг сабаби аниқ маълум эмас, лекин у аёл организмида хорионик гонадотропин концентрациясининг ошиши билан боғлиқ бўлиши мумкин [16].\n<h2>Сизда сувсизланиш юз бераётганини қандай тушуниш мумкин ?</h2>\nСувсизланишнинг белгилари ва симптомлари ёшга боғлиқ ҳолда фарқ қилиши мумкин. Масалан, чақалоқлар ва кичик ёшдаги болаларда дегидратация қуйидагича намоён бўлади [23]:\n<ul>\n 	<li>оғиз бўшлиғи шиллиқ қавати ва тилнинг қуруқлиги;</li>\n 	<li>йиғлаганда кўз ёшининг бўлмаслиги;</li>\n 	<li>уч соат ва ундан кўпроқ вақт давомида тагликнинг қуруқ бўлиши;</li>\n 	<li>кўзлар, ёноқлар ва бош суяги тепа қисмининг ботиқлиги;</li>\n 	<li>ланжлик ёки жаҳлдорлик.</li>\n</ul>\nКатталар кучли чанқоқ, кам сийиш, сийдикнинг тўқ ранги, чарчоқ, бош айланиши ва бошдаги қоронғилашишлардан шикоят қиладилар.\n<h2>Сувсизланишни қандай даволаш мумкин?</h2>\nҲар қандай сабабларга кўра келиб чиқадиган сувсизланишни даволашнинг асоси орал регидратацион терапия (ОРТ) ҳисобланади.  Сувнинг сўрилишини осонлаштириш учун регидратация учун идеал эритма  таркибида тўғри нисбатларда микроэлементлар бўлиши керак, улардан энг муҳими натрий ҳисобланади. Натрий  ва бошқа микроэлементлар суюқлик билан ичакдан қон томирларига пассив ташилиши мумкин.\n\nБир қатор тадқиқотларда тегишли эритма билан тезликда перорал регидратация ўтказиш  худди эритмаларни инфузия шаклида венага юбориш каби самарали бўлиши исботланган. Бунда сув-туз эритмалари билан  оғиз орқали ўтказиладиган регидратация инвазив эмас ва инфузион терапияда юзага келиши мумкин бўлган бир қатор нохуш реакциялар билан кечмайди.\n\n«Юрия-Фарм» фармацевтика компаниясининг тиббий мақсадлар учун ReO суви перорал регидратация ўтказиш учун мувозанатлаштирилган сув-электролит таркибига эга, самарали ва хавфсиз. Бу ҳақиқий клиник амалиёти шароитларидаги кўп йиллик фойдаланиш тажрибаси билан тасдиқланган.\n<h2><strong>Тиббий мақсадлар учун </strong><strong>ReO сувини </strong><strong>қ</strong><strong>а</strong><strong>чон</strong><strong> ичиш керак?</strong></h2>\nReO суви организмнинг сувсизланиши ва интоксикацияси билан кечадиган ҳолатларда тавсия этилади, хусусан:\n<ul>\n 	<li>жисмоний юкланишларда</li>\n 	<li>иссиқ ҳавода;</li>\n 	<li>алкоголдан заҳарланишда;</li>\n 	<li>иситмада;</li>\n 	<li>овқатдан заҳарланишларда;</li>\n 	<li>диареяда;</li>\n 	<li>болалардаги ўткир ичак инфекцияларида;</li>\n 	<li>ҳомиладорлар токсикозида.</li>\n</ul>\n<h2>Как следует пить воду РеО?</h2>\nЛегкое или умеренное обезвоживание обычно можно эффективно вылечить с помощью оральной регидратационной терапии (ОРТ), используя воду RеO. Рвота, как правило, не является противопоказанием к ОРТ, кроме случаев кишечной непроходимости и острого живота. При острых кишечных инфекциях и других расстройствах, которые сопровождаются рвотой и диареей, особенно у детей, дефицит жидкости следует восполнять в течение 4 часов. Воду RеO следует вводить в небольших объемах очень часто, чтобы минимизировать растягивание желудка и рефлекторную рвоту. Как правило, 5 мл воды для медицинских целей ReO ежеминутно переносятся хорошо. По мере возобновления водных запасов организма рвота часто уменьшается, поэтому могут быть использованы большие объемы жидкости [18].\n<h2>Лечение обезвоживания проводится в 2 этапа [24]:</h2>\n<ul>\n 	<li>1 этап – регидратация. Он направлен на быстрое возобновление запасов потерянной жидкости и длится 3-4 часа. Необходимый объем воды ReO зависит от возраста и массы тела больного и составляет:</li>\n</ul>\n- для младенцев и детей весом до 30 кг – 50-100 мл/кг воды РеО в течение 4 часов;\n\n- для взрослых и подростков весом более 30 кг – 2-4 л воды РеО в течение 4 часов.\n<ul>\n 	<li>2 этап – поддерживающий. Цель этого этапа – предотвратить обезвоживание. Длится данный этап до выздоровления пациента. При этом объем воды ReO, кроме возраста и массы больного, зависит от количества эпизодов рвоты и жидкого стула и составляет:</li>\n</ul>\n- по 60-120 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела менее 10 кг;\n- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\n\nПодростки и взрослые массой тела больше 30 кг могут пить столько жидкости, сколько они желают.\n\nЕще Цельс говорил, что в воде – исцеление и предупреждение заболеваний. Она укрепляет тело и хранит бодрость духа. Сегодня выбор правильной воды стал как никогда легким. Вода ReO не просто характеризуется отличными вкусовыми свойствами, но также ее легко пить даже при ощущении тошноты. Благодаря сбалансированному водно-солевому составу вода ReO обеспечивает максимально быстрое всасывание воды и электролитов и спасает организм от дегидратации независимо от ее причины.\n<h2>Литературные источники:</h2>\n<ol>\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\n</ol>\n<ol start=\"2\">\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\n</ol>\n<ol start=\"3\">\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\n</ol>\n<ol start=\"4\">\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\n</ol>\n<ol start=\"5\">\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\n</ol>\n<ol start=\"6\">\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\n</ol>\n<ol start=\"7\">\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\n</ol>\n<ol start=\"8\">\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\n</ol>\n<ol start=\"9\">\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\n</ol>\n<ol start=\"10\">\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\n</ol>\n<ol start=\"11\">\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\n</ol>\n<ol start=\"12\">\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\n</ol>\n<ol start=\"13\">\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\n</ol>\n<ol start=\"14\">\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\n</ol>\n<ol start=\"15\">\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factorscontributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\n</ol>\n<ol start=\"94\">\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\n</ol>\n<ol start=\"16\">\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\n</ol>\n<ol start=\"17\">\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\n</ol>\n<ol start=\"18\">\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\n</ol>\n<ol start=\"19\">\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-</li>\n</ol>\n<ol start=\"8\">\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\n</ol>\n<ol start=\"20\">\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine Committee. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19345549/</li>\n</ol>\n<ol start=\"21\">\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN. Clinical and laboratory assessment of dehydration severity in children withacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\n</ol>\n<ol start=\"22\">\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\n</ol>\n<ol start=\"23\">\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\n</ol>\n<ol start=\"24\">\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases</li>\n</ol>','ReO - сув ва электролитларнинг шишадаги уйғунлиги','','inherit','closed','closed','','1652-autosave-v1','','','2021-08-30 16:27:31','2021-08-30 13:27:31','',1652,'https://reo.ua/?p=1654',0,'revision','',0),(1655,1,'2021-08-30 16:28:46','2021-08-30 13:28:46','“<em>Сувга Ерда ҳаёт  суви бўлиш учун сеҳрли ҳукмронлик берилган</em>”.\r\n<em>Леонардо Да В</em><em>и</em><em>нч</em><em>и </em>\r\n\r\nСув инсон ҳаётида муҳим роль ўйнайди...\r\n\r\nОрганизмнинг ҳар бир тизими, ҳужайралардан бошлаб ҳаётий муҳим органларгача сувсиз ишлай олмайди.\r\n<h2>Организмга нима учун шунча сув талаб этилади?</h2>\r\nБизнинг организм – бу тирик лаборатория, унда ҳар сонияда юзлаб кимёвий реакциялар юзага келади. Уларнинг нормал кечиши сув иштирокисиз бўлмайди. Сув организмдаги барча жараёнларда иштирок этади. Мана улардан бир нечта энг муҳимлари [2]:\r\n<ul>\r\n 	<li>тана ҳароратини бошқариш;</li>\r\n 	<li>кўз, нафас олиш ва ошқозон-ичак шиллиқ қаватини намлантириш ва ҳимоя қилиш;</li>\r\n 	<li>озуқа моддаларини ва кислородни ҳужайраларга ташиш;</li>\r\n 	<li>бўғимларни мойлаш;</li>\r\n 	<li>зарарли моддаларни зарарсизлантириш, жигар ва буйрак орқали чиқариб ташлаш;</li>\r\n 	<li>минераллар ва озуқа моддаларини тана уларни ўзлаштира олиши учун эритиш.</li>\r\n</ul>\r\n<h2>БУ МУҲИМ!</h2>\r\nТана умумий вазнининг 8% дан ортиқ миқдорда сув йўқотилганда ўлим юз бериши мумкин.\r\n\r\n***\r\n\r\nИнсон организми  сувни тўплай ва сақлай олмайди. Биз сувни доимо тери, ўпка, буйраклар ва ичаклар орқали йўқотамиз.\r\n\r\nЙўқотилган суюқликни тиклаш ва тегишлича гидратация организмнинг соғлиғи ва ишлашининг гаровидир [1].\r\n<h2>Қизиқарли ФАКТ!</h2>\r\nЎртача статистик катта ёшдаги одамнинг танаси 60% сувдан иборат.\r\n\r\nБунда алоҳида органлардаги суюқлик миқдори фарқланади. Масалан,  суякларимизнинг фақат учдан бир қисми сувдан иборат бўлгани ҳолда, ўпкамиз 83% сувдан иборат [1].\r\n<h2>СУВСИЗЛАНИШДА ОРГАНИЗМДА НИМАЛАР ЮЗ БЕРАДИ?</h2>\r\nОрганизмнинг 1% дан ортиқ суюқликни йўқотиши терморегуляциянинг бузилишига, иш қобилияти ва иштаҳанинг пасайишига олиб келади. Агар дегидратация давом этиб, сув танқислиги 4% ва ундан кўпроқни ташкил этадиган бўлса, диққатни жамлашда қийинчиликлар, бош оғриғи, жаҳлдорлик, уйқучанлик юзага келади, тана ҳарорати ва нафас олиш тезлиги ошади [3].\r\n\r\nРивожланиб борувчи сувсизланиш юрак-қон томир тизимига ҳам салбий таъсир кўрсатади.Сув йўқотилиши юрак қисқаришлари тезлигининг ошиши ва артериал босимнинг бузилиши билан бирга кечади. Енгил сувсизланиш (тана вазнининг 2% йўқотилиши) босимни меъёрида ушлаб туриш учун жавоб берадиган барорецепторларнинг сезгирлигини пасайтиради [4].\r\n\r\nАртериал босим пасайганида  юракка кам қон тушади. Натижада юрак иш унуми пасаяди ва органларга кислород ва озуқа моддалари кам тушади [5]. Шунингдек ўртача сувсизланиш митрал клапан пролапсини кучайтиради, бу юрак бўлмасининг босими ва тўлдириш ҳажми пастлиги сабабли юзага келади.\r\n\r\nАтроф-муҳит температураси юқорилигида тана вазнининг 10% дан ошадиган миқдорда сув йўқотилиши инсульт, шок ва полиорган етишмовчилигининг жиддий хавфи билан кечади [8].\r\n\r\nСурункали сувсизланиш инфекциялар, айниқса сийдик чиқариш йўллари  инфекциялари ривожланиш хавфини оширади. Шу билан бир вақтда ичилган суюқлик ҳажмини ошириш такрорий инфекциялар юзага келиш сонини камайтиради.\r\n\r\nБир қанча тадқиқотлар одатда кам сув ичадиган одамларда  сийдик қопи саратони юзага келишининг  юқори хавфи ҳақида хабар беради.\r\n\r\nМасалан, тадқиқотлардан бирида 47909 нафар эркакда умумий суткалик суюқлик истеъмоли баҳоланди. Кузатувлардан 10 йил кейин суткасига 1,3 л дан кам сув ичган эркакларда суткасига 2,5 л дан кўп сув ичган эркакларга нисбатан сийдик қопининг саратони  юзага келиш хавфи анча (p = 0,002) юқорилиги аниқланди [11].\r\n<h2>Сувсизланишнинг қандай турлари бўлади?</h2>\r\nСувсизланишнинг бир нечта турлари мавжуд:\r\n<ul>\r\n 	<li>Изотоник, бунда сув ва натрий биргаликда йўқотилади.</li>\r\n 	<li>Сувнинг изотоник йўқотилишининг сабаблари қайт қилиш, диарея, кўп терлаш, куйиш, буйрак касалликлари, гипергликемия ва гипоальдостеронизм ҳисобланади.</li>\r\n 	<li>Гипертоник, бунда сув йўқотилиши натрий йўқотилишидан ортиқ бўлади. Гипертоник дегидратацияда натрий ва қон зардобининг осмолярлиги ҳар доим юқори бўлади. Бу ҳолат иситма, нафас қисиши ва қандсиз диабетда юзага келади.</li>\r\n 	<li>Гипотоник, бунда  организм сувга нисбатан натрийни кўпроқ йўқотади. Кўпинча бу сийдик ҳайдовчи препаратларни қабул қилиш билан боғлиқ.</li>\r\n</ul>\r\n<h2>СУВСИЗЛАНИШ КИМЛАРДА КЎПРОҚ УЧРАЙДИ?</h2>\r\nМутлақо ҳеч ким дегидратациядан ҳимояланмаган, лекин баъзи бир вазиятларда ва беморларнинг муайян гуруҳларида бу ҳолат кўпроқ учрайди ва оғир оқибатлар билан кечиши мумкин.\r\n<h2>Болалар</h2>\r\nБутун дунё бўйлаб чақалоқлар ва кичик ёшдаги болаларнинг касалланиши ва ўлимининг кўп учрайдиган сабабларидан бири бўлиб дегидратация ҳисобланади.\r\n\r\nБолалардаги сувсизланиш ҳолатларининг аксарияти ўткир гастроэнтерит оқибати ҳисобланади.\r\n\r\nЧақалоқлар ва кичик ёшдаги болалар диарея ва сувсизланишга айниқса мойил бўлади.\r\n\r\nБунинг сабаби болалардаги метаболизмнинг юқори даражаси, ўз эҳтиёжлари ҳақида айта олмаслиги ёки мустақил сув ича олмаслиги ҳисобланади. Болаларда сувсизланишнинг бошқа сабаблари диабетик кетоцидоз (ДКА), қандсиз диабет, ацетономик синдром, куйишлар, қуёш ёки иссиқ уриши, ҳаддан ортиқ тер ажралиши бўлиши мумкин [13].\r\n<h2>Кекса ёшдаги одамлар</h2>\r\nҲар қандай катта ёшдаги одамда дегидратация гипергликемия фонида ривожланиши мумкин.\r\n\r\nДегидратация ҳам касаллик сабаби, ҳам унинг оқибати бўлиши мумкин.\r\n\r\nКекса одамларда дегидратация ривожланиши эҳтимоли ёш ва ўрта ёшдаги одамларга нисбатан 20-30% юқори.\r\n\r\nБу жисмоний фаолликнинг камайиши, чанқоқни камроқ сезиш, қандли диабет  ва буйрак касалликлари билан боғлиқ [14, 15].\r\n<h2>Ҳомиладорлар</h2>\r\nҲомиладорларнинг ярмидан кўпроғи ҳомиладорликнинг 4-ҳафтасида бошланиб, 16-ҳафтасида йўқоладиган кўнгил айниши ва қайт қилишдан азият чекади.\r\n\r\n200 нафар аёлдан 1 тасида бу ҳолат ҳомиладорларнинг тўхтатиб бўлмайдиган қайт қилишигача ривожланади (Hyperemesis gravidarum). Бу ҳолат давомли ва кучли кўнгил айниши ва қайт қилиш, сувсизланиш ва вазн йўқотилиши билан тавсифланади [16].\r\n<h2>Спортчилар ва жисмоний меҳнат билан шуғулланадиган одамлар</h2>\r\nЖисмоний машқлар вақтида юқори метаболизм тана ҳароратининг кўтарилишига сабаб бўлади. Танани қизиб кетишдан сақлаш учун бизнинг организмимиз сувни жадал буғлата бошлайди ва сувсизланишни келтириб чиқаради [17].\r\n<h2>Иситмаси бор пациентлар</h2>\r\nТана ҳароратининг кўтарилиши бизнинг теримиз ва ўпкамизни сувни жадал буғлантиришга мажбур қилади. Бундан ташқари, иситма кўпинча иштаҳа йўқолиши билан кечади, демак организм озиқ-овқат маҳсулотлари билан суюқлик олмай қўяди [18].\r\n<h2>Диарея ва қайт қилишдан азият чекаётган беморлар</h2>\r\nГастроэнтерит – дунёда сувсизланишнинг энг кўп учрайдиган сабаби.\r\n\r\nАгар у яққол қайт қилиш ва диарея билан кечадиган бўлса, сувсизланиш  жуда тез ривожланиб кетиши мумкин [19, 20].\r\n<h2>Алкоголдан заҳарланиш ҳолатидаги одамлар</h2>\r\nДегидратация алкоголь истеъмол қилинганидан кейинги карахтлик симптомларини келтириб чиқарадиган сабаблардан бири ҳисобланади.\r\n\r\nТадқиқот натижалари етарлича миқдорда сув ичиш уйқусиз ўтказилган ўтиришлардан сўнг тикланишни тезлаштиришини тасдиқлади.\r\n<h2>Бу муҳим!</h2>\r\nИхтисослашмаган матбуот маълумотларига кўра америкаликларнинг 75% сурункали сувсизланишга учраган.\r\n\r\nКекса ёшдаги пациентлар ўртасида дегидратациянинг тарқалиши 17%-28% атрофида ўзгариб туради [12].\r\n<h2>МУҲИМ!</h2>\r\nРотавирус  чақалоқлар ва эрта ёшдаги болаларда дегидратация ва оғир диареянинг дунёда энг кенг тарқалган сабаби ҳисобланади [21].\r\n<h2>Қизиқарли ФАКТ!</h2>\r\nҲомиладорликдаги кўнгил айниши ва қайт қилишнинг сабаби аниқ маълум эмас, лекин у аёл организмида хорионик гонадотропин концентрациясининг ошиши билан боғлиқ бўлиши мумкин [16].\r\n<h2>Сизда сувсизланиш юз бераётганини қандай тушуниш мумкин ?</h2>\r\nСувсизланишнинг белгилари ва симптомлари ёшга боғлиқ ҳолда фарқ қилиши мумкин. Масалан, чақалоқлар ва кичик ёшдаги болаларда дегидратация қуйидагича намоён бўлади [23]:\r\n<ul>\r\n 	<li>оғиз бўшлиғи шиллиқ қавати ва тилнинг қуруқлиги;</li>\r\n 	<li>йиғлаганда кўз ёшининг бўлмаслиги;</li>\r\n 	<li>уч соат ва ундан кўпроқ вақт давомида тагликнинг қуруқ бўлиши;</li>\r\n 	<li>кўзлар, ёноқлар ва бош суяги тепа қисмининг ботиқлиги;</li>\r\n 	<li>ланжлик ёки жаҳлдорлик.</li>\r\n</ul>\r\nКатталар кучли чанқоқ, кам сийиш, сийдикнинг тўқ ранги, чарчоқ, бош айланиши ва бошдаги қоронғилашишлардан шикоят қиладилар.\r\n<h2>Сувсизланишни қандай даволаш мумкин?</h2>\r\nҲар қандай сабабларга кўра келиб чиқадиган сувсизланишни даволашнинг асоси орал регидратацион терапия (ОРТ) ҳисобланади.  Сувнинг сўрилишини осонлаштириш учун регидратация учун идеал эритма  таркибида тўғри нисбатларда микроэлементлар бўлиши керак, улардан энг муҳими натрий ҳисобланади. Натрий  ва бошқа микроэлементлар суюқлик билан ичакдан қон томирларига пассив ташилиши мумкин.\r\n\r\nБир қатор тадқиқотларда тегишли эритма билан тезликда перорал регидратация ўтказиш  худди эритмаларни инфузия шаклида венага юбориш каби самарали бўлиши исботланган. Бунда сув-туз эритмалари билан  оғиз орқали ўтказиладиган регидратация инвазив эмас ва инфузион терапияда юзага келиши мумкин бўлган бир қатор нохуш реакциялар билан кечмайди.\r\n\r\n«Юрия-Фарм» фармацевтика компаниясининг тиббий мақсадлар учун ReO суви перорал регидратация ўтказиш учун мувозанатлаштирилган сув-электролит таркибига эга, самарали ва хавфсиз. Бу ҳақиқий клиник амалиёти шароитларидаги кўп йиллик фойдаланиш тажрибаси билан тасдиқланган.\r\n<h2><strong>Тиббий мақсадлар учун </strong><strong>ReO сувини </strong><strong>қ</strong><strong>а</strong><strong>чон</strong><strong> ичиш керак?</strong></h2>\r\nReO суви организмнинг сувсизланиши ва интоксикацияси билан кечадиган ҳолатларда тавсия этилади, хусусан:\r\n<ul>\r\n 	<li>жисмоний юкланишларда</li>\r\n 	<li>иссиқ ҳавода;</li>\r\n 	<li>алкоголдан заҳарланишда;</li>\r\n 	<li>иситмада;</li>\r\n 	<li>овқатдан заҳарланишларда;</li>\r\n 	<li>диареяда;</li>\r\n 	<li>болалардаги ўткир ичак инфекцияларида;</li>\r\n 	<li>ҳомиладорлар токсикозида.</li>\r\n</ul>\r\n<h2>ReO сувини қандай ичиш керак?</h2>\r\nЕнгил ва ўртача сувсизланишни орал регидратацион терапия (ОРТ) орқали ReO сувидан фойдаланиб самарали даволаш мумкин. Қайт қилиш, одатда, ОРТ га қарши кўрсатма ҳисобланмайди (ичак тутилиши ва ўткир қорин синдромидан ташқари).\r\n\r\nЎткир ичак инфекциялари, шунингдек қайт қилиш ва диарея билан кечадиган бошқа бузилишларда, айниқса болаларда, суюқлик танқислигини 4 соат мобайнида тўлдириш зарур. Ошқозон чўзилишини ва рефлектор қайт қилишни имкон қадар камайтириш учун ReO сувини кичик ҳажмларда  тез-тез ичириш керак. Одатда ҳар дақиқада 5 мл ReO суви яхши қабул қилинади. Организмнинг сув захиралари тиклангани сари қайт қилиш кўпинча камаяди, шунинг учун кейинроқ суюқликнинг каттароқ ҳажмларидан фойдаланиш мумкин бўлади [18].\r\n<h2>Сувсизланиш 2 босқичда даволанади [24]:</h2>\r\n<ul>\r\n 	<li>1 босқич – регидратация. У йўқотилган суюқлик захираларини тезроқ тиклашга йўналтирилган бўлиб, 3-4 соат давом этади. ReO сувининг зарурий ҳажми беморнинг ёши ва тана вазнига боғлиқ ва қуйидагини ташкил этади:</li>\r\n</ul>\r\n— чақалоқлар ва вазни 30 кг гача бўлган болалар учун – 4 соат мобайнида 50-100 мл/кг ReO суви;\r\n\r\n— катталар ва вазни 30 кг гача бўлган ўсмирлар учун – 4 соат мобайнида 2-4 л ReO суви.\r\n<ul>\r\n 	<li>2 босқич – бир маромда ушлаб турувчи. Бу босқичнинг мақсади – сувсизланишни бартараф этиш. Бунда сув ҳажми, беморнинг ёши ва тана вазнидан ташқари, қайт қилишлар ва суюқ ич кетишлари сонига боғлиқ бўлади ва ва қуйидагини ташкил этади:</li>\r\n</ul>\r\n— агар тана вазни 10 кг дан кам бўлса, ҳар бир диарея ёки қайт қилишдан кейин 60-120 мл ReO суви;- по 120-240 мл воды ReO после каждого эпизода диареи или рвоты, если масса тела – 10-30 кг\r\n\r\nТана вазни 30 кг дан ортиқ бўлган ўсмирлар ва катталар қанча ҳоҳласалар шунча суюқлик ичишлари мумкин.\r\n\r\nҚадимдаёқ Цельс, касалликларнинг олдини олиш ва улардан даво топиш – бу ҳаммаси сувда,  деб айтган эди. Сув танани мустаҳкамлайди ва руҳ тетиклигини сақлаб туради. Бугунги кунда тўғри сувни танлаш  ҳар қачонгиданда осон. ReO суви шунчаки яхши таъм хусусиятлари билан тавсифланмайди, у шунингдек кўнгил айниб турганида ҳам осон ичилади. ReO суви  мувозанатлаштирилган сув-туз таркиби туфайли сув ва электролитларнинг максимал тез сўрилишини таъминлайди ва организмни, келиб чиқиш сабабларидан қатъий назар, дегидратациядан халос этади.\r\n<h2>Адабиёт манбалари:</h2>\r\n<ol>\r\n 	<li>The European Federation of Bottled Water (EFBW). Importance of Water. Режим доступу: https://www.efbw.org/index.php?id=46</li>\r\n</ol>\r\n<ol start=\"2\">\r\n 	<li>Mayo Clinic. Water: Essential to your body.Режим доступу: https:// www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ water-essential-to-your-body</li>\r\n</ol>\r\n<ol start=\"3\">\r\n 	<li>Grandjean AC, Reimers KJ and Buyckx ME, 2003. Hydration: issues for the 21st century. Nutrition Reviews, 61, 261-271. Режим доступу: https://academic.oup.com/nutritionreviews/article/61/8/261/1920531</li>\r\n</ol>\r\n<ol start=\"4\">\r\n 	<li>Charkoudian N, Halliwill JR, Morgan BJ, Eisenach JH and Joyner MJ, 2003. Influences of hydration on post-exercise cardiovascular control in humans. The Journal of Physiology, 552, 635-644. Режим доступу: https://mayoclinic.pure.elsevier.com/en/publications/ influences-of-hydration-on-post-exercise-cardiovascular-control-i</li>\r\n</ol>\r\n<ol start=\"5\">\r\n 	<li>Montain SJ, Sawka MN, Latzka WA and Valeri CR, 1998. Thermal and cardiovascular strain from hypohydration: influence of exercise intensity. International Journal of Sports Medicine, 19, 87-91. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/9562215/</li>\r\n</ol>\r\n<ol start=\"6\">\r\n 	<li>Aufderheide S, Lax D and Goldberg SJ, 1995. Gender differences in dehydration-induced mitral valve prolapse. American Heart Journal, 129, 83-86. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7817930/</li>\r\n</ol>\r\n<ol start=\"7\">\r\n 	<li>Sawka MN, Young AJ, Francesconi RP, Muza SR and Pandolf KB,</li>\r\n 	<li>Thermoregulatory and blood responses during exercise at graded hypohydration levels. Journal of Applied Physiology, 59, 1394-1401. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/4066570/</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>Bouchama A and Knochel JP, 2002. Heat stroke. New England Journal of Medicine, 346, 1978-1988. Режим доступу: https://www.nejm.org/ doi/10.1056/NEJMra011089?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"9\">\r\n 	<li>Shroff R, Hignett R, Pierce C, Marks S and van’t Hoff W, 2006. Lifethreatening hypernatraemic dehydration in breastfed babies. Archives of Disease in Childhood, 91, 1025-1026. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083010/</li>\r\n</ol>\r\n<ol start=\"10\">\r\n 	<li>Eckford SD, Keane DP, Lamond E, Jackson SR and Abrams P, 1995. Hydration monitoring in the prevention of recurrent idiopathic urinarytract infections in pre-menopausal women. British Journal of Urology, 76, 90-93. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/7648069/</li>\r\n</ol>\r\n<ol start=\"11\">\r\n 	<li>Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC and Giovannucci EL, 1999. Fluid intake and the risk of bladder cancer in men. New England Journal of Medicine, 340, 1390-1397. Режим доступу: https://europepmc.org/article/med/10228189</li>\r\n</ol>\r\n<ol start=\"12\">\r\n 	<li>Taylor K, Jones EB. Adult Dehydration. [Updated 2020 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK555956/</li>\r\n</ol>\r\n<ol start=\"13\">\r\n 	<li>Vega RM, Avva U. Pediatric Dehydration. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Режим доступу: https://www.ncbi.nlm.nih.gov/books/NBK436022/</li>\r\n</ol>\r\n<ol start=\"14\">\r\n 	<li>Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. Режим доступу: https://www.healio.com/nursing/journals/jgn/2015-9-41-9/ %7B3046aa15-d703-4e8d-832e-f1830347be31 %7D/dehydration-in-the-older-adult</li>\r\n</ol>\r\n<ol start=\"15\">\r\n 	<li>Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factorscontributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-</li>\r\n</ol>\r\n<ol start=\"94\">\r\n 	<li>Режим доступу: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1999.tb05198.x?sid=nlm %3Apubmed</li>\r\n</ol>\r\n<ol start=\"16\">\r\n 	<li>Festin M. (2014). Nausea and vomiting in early pregnancy. BMJ clinical evidence, 2014, 1405. Режим доступу: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959188/</li>\r\n</ol>\r\n<ol start=\"17\">\r\n 	<li>Evans GH, James LJ, Shirreffs SM, Maughan RJ. Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration. J Appl Physiol (1985). 2017 Apr 1;122(4):945-951. doi: 10.1152/japplphysiol.00745.2016. Epub 2017 Jan 26. PMID: 28126906. Режим доступу: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00745.2016?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori %3Arid %3Acrossref.org</li>\r\n</ol>\r\n<ol start=\"18\">\r\n 	<li>Lennox H. Huang. Dehydration. Режим доступу: https://emedicine.medscape.com/article/906999-overview#a7</li>\r\n</ol>\r\n<ol start=\"19\">\r\n 	<li>Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000 Jun 6;132(11):897-902. doi: 10.7326/0003-4819-132-11-200006060-</li>\r\n</ol>\r\n<ol start=\"8\">\r\n 	<li>PMID: 10836917. Режим доступу: https://www.acpjournals.org/doi/10.7326/0003-4819-132-11-200006060-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub %20 %200pubmed</li>\r\n</ol>\r\n<ol start=\"20\">\r\n 	<li>Colletti JE, Brown KM, Sharieff GQ, Barata IA, Ishimine P, ACEP Pediatric Emergency Medicine Committee. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010 Jun. 38(5):686-98. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19345549/</li>\r\n</ol>\r\n<ol start=\"21\">\r\n 	<li>Parkin PC, Macarthur C, Khambalia A, Goldman RD, Friedman JN. Clinical and laboratory assessment of dehydration severity in children withacute gastroenteritis. Clin Pediatr (Phila). 2010 Mar. 49(3):235-9. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/19487761/</li>\r\n</ol>\r\n<ol start=\"22\">\r\n 	<li>Koster C, Klingelhofer D, Groneberg DA, Schwarzer M. Rotavirus — Global research density equalizing mapping and gender analysis. Vaccine. 2016 Jan 2. 34(1):90-100. Режим доступу: https://pubmed.ncbi.nlm.nih.gov/26611203/</li>\r\n</ol>\r\n<ol start=\"23\">\r\n 	<li>Dehydration. Режим доступу: https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086</li>\r\n</ol>\r\n<ol start=\"24\">\r\n 	<li>Shane, Andi L et al. “2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.” Clinical infectious diseases : an official publication of the Infectious Diseases</li>\r\n</ol>','ReO - сув ва электролитларнинг шишадаги уйғунлиги','','inherit','closed','closed','','1652-revision-v1','','','2021-08-30 16:28:46','2021-08-30 13:28:46','',1652,'https://reo.ua/?p=1655',0,'revision','',0),(1656,1,'2021-07-14 17:31:29','2021-07-14 14:31:29','Кўплаб мамлакатларда минерал сувни фақат дорихоналардан сотиб олиш мумкин. Шу тариқа унинг буюк врачлар Архигинес, Гиппократ, Гален қадим замонлардаёқ  ўйлаган шифобахш хоссалари таъкидланади. Ҳозир ҳам унинг шифобахш хоссалари камаймаган – аксинча, тадқиқотлар керакли сувни тўғри вақтда ва тўғри кўрсатмалар бўйича тўғри ичиш натижасида унинг янги афзалликларини кўрсатмоқда.\r\n\r\nЛекин шундай савол туғилади: қандай ҳолатларда ташриф буюрувчиларга дорихона сувини тавсия этиш мумкин?\r\n\r\nОрганизмнинг регидратацияси ва дезинтоксикацияси учун махсус мўлжалланган ReO суви мисолида қачон ушбу маҳсулотни ичиш мақсадга мувофиқ эканини кўриб чиқамиз.\r\n<h2>Ҳаёт матрицаси</h2>\r\nСув – водород ва кислороднинг табиатда энг кенг тарқалган бирикмаси. Бу кўплаб моддаларнинг универсал эритувчиси, шунинг учун табиатда кимёвий жиҳатдан соф сув мавжуд эмас.\r\n\r\nОрганизм таркибидаги сув сифат жиҳатидан оддий сувдан фарқ қилади, чунки бу сув структурланган бўлади.\r\n\r\nСувнинг бундай кристалл структуралари – ҳаёт матрицаси. Уларнинг мавжудлиги  муҳим биофизик жараёнлар ва биокимёвий реакцияларнинг ўтишига имкон беради. Организмга етарли миқдорда сув тушмаслиги ёки унинг ҳаддан ортиқ йўқотилиши сувсизланишга олиб келади.\r\n\r\nСувсизланиш сабаблари бўлиб нафақат овқатдан заҳарланиш вақтидаги диарея ва қайт қилиш, балки ҳомиладорлар токсикози; жадал жисмоний юкланишлар; алкоголдан заҳарланиш; иситма, ўткир ичак инфекциялари  ҳам сабаб бўлиши мумкин.\r\n\r\nҲар қандай ҳолатда ҳам  сув ва туз танқислиги организм учун салбий оқибатларга олиб келади.\r\n\r\nЖССТ экспертларининг маълумотларига кўра, узоқ давом этадиган қайт қилиш ёки диареядаги организмнинг  сувсизланиши, болалар касалланиши ва ўлимининг кўп учрайдиган сабаби, шунингдек  организмга озуқа моддаларининг етарлича тушмаслиги оқибатидаги озиб кетишнинг  муҳим сабаби  ҳисобланади.\r\n\r\nКатталарда дегидратация кўпинча қон қуюқлашишига ва тромблар ҳосил бўлиш хавфи ошишига олиб келади; юрак ритмининг бузилиши ва артериал қон босимининг пасайиши билан бирга кечади, шунинг учун организмда суюқлик ва электролитлар танқислигини ўз вақтида ва тўғри тўлдириш жуда муҳим.\r\n\r\nЎрни келганда айтиш керакки, дунёдаги ҳар иккинчи инсон у ёки бу даражада сувсизликдан азият чекади. Шунинг учун муаммо жуда долзарб ҳисобланади.\r\n\r\nАммо шуни ёдда тутинг: фармацевтик ёрдам доирасида биз фақат оғир бўлмаган ҳолатларда маслаҳат беришимиз мумкин.\r\n\r\nКучли сувсизланишнинг хавфли симптомлари (умумий аҳволнинг ёмонлашиши, оғизда тупук йўқлиги, рангпарлик, киртайган кўзлар, одатдагидан бошқача нафас олиш, кўз ёшларсиз йиғлаш)  мавжуд бўлса дарҳол тез ёрдам чақириш зарур.\r\n<h2>Мувозанатлаштирилган таркиб</h2>\r\nЭътиборингизни шунга қаратамизки, сув ичиш нафақат суюқлик даражасини тиклаши, балки йўқотилган тузлар ўрнини тўлдириши, шунингдек организмнинг энергияга бўлган эҳтиёжини ҳам қоплаши зарур.\r\n\r\nШуни ёддан чиқармаслик зарурки, суюқлик ва электролитларнинг йўқотилиши қоннинг рН кўрсаткичи кислотали томонга ўтишига, натижада муҳим орган ва тизимлар ишининг бузилишига олиб келади.\r\n\r\nШунинг учун ҳам интоксикация вақтида “шунчаки сув ичиш” – бу  чора эмас. Сув ёрдам беради. Лекин ҳар қандай сув эмас.\r\n\r\nСувсизланишни бартараф этиш учун яхши тавсиялардан бири – бу ReO махсус суви бўлиб, у мувозанатлаштирилган сув-туз таркибига эга, таркибида консервантлар, бўёвчи моддалар ва углеводлар мавжуд эмас.\r\n\r\nТиббий мақсадлар учун ReO суви таркибида организм сувсизланиш вақтида жадал йўқотадиган микроэлементларнинг оптимал таркиби, биринчи навбатда  натрий ва калий мавжуд.  Шунингдек ReO да кальций, магний, гидрокарбонатлар ва хлоридларнинг организм учун зарур улуши бор. Шундай қилиб, сув кислота-ишқор мувозанатини тезда тиклашга ёрдам беради.\r\n<h2>Сифати ва таъм хусусиятлари</h2>\r\nЎрни келганда шуни айтиш керакки, кучсиз газланган ReO суви – бу тиббий мақсадлар учун биринчи сув бўлиб, сув ва электролитларнинг юқори даражада тез сўрилиши учун ишлаб чиқилган.\r\n\r\nСув заҳарли моддалар концентрациясини пасайтиради ва дегидратация белгиларини бартараф этади. Бу жараёнда унинг минераллашиш даражаси – 2500-3000 мг/дм<sup>3</sup> муҳим аҳамиятга эга бўлиб, у кам минераллашган сув ҳисобланади. Гап шундаки, кам минераллашган шифобахш сув юқори даражада минераллашган сувга нисбатан анча мураккаб таъсир кўрсатади.\r\n\r\nБу ерда шундай қоида ишлайди: эритма қанчалик мураккаб бўлса, шунчалик катта миқдордаги тузлар ионларга парчаланади, айнан улар организмга таъсир кўрсатади. Кам минераллашган сувлар ўртача ёки юқори даражада минераллашган сувларга нисбатан ошқозонда анча кўпроқ вақт туриб қолади, ингичка ичакда деярли тўлиқ сўрилади, чунки ионларни сўрилиш жараёни учун тайёр ҳолда олади ва минерал сувнинг ионларга парчаланиши учун қўшимча энергия ёки вақт сарфини талаб қилмайди.\r\n\r\nАйнан шунинг учун тиббий мақсадлар учун ReO суви сувсизланиш белгиларини тезда бартараф этади ва одамнинг ўзини ҳис қилишини тез яхшилашга ёрдам беради.\r\n\r\nСув организмнинг дегидратация ва интоксикация билан кечадиган ҳолатларида тавсия этилган бўлиб, улар орасида ҳомиладорлардаги токсикоз, жисмоний юкланишлар, болалардаги ичак инфекциялари, алкоголдан заҳарланиш, диарея, иситма каби ҳолатлар мавжуд.\r\n\r\nReO суви ёқимли нимшўр таъмга эга бўлиб, уни ҳатто кўнгил айниб турганида ҳам ичиш осон.\r\n\r\nСувнинг аъло таъм сифатлари уни нафақат катталар, балки болалар ҳам  жуда яхши қабул қилишини таъминлайди.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\"><strong>Жадвал. Тиббий мақсадлар учун ReO суви таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Концентрацияси</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Тиббий мақсадлар учун ReO сувини кимга  тавсия қилиш мумкин?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\r\n\r\nReO — оддий сувдан яхшироқ!','Дорихона сувини танлаш','','publish','open','open','','dorihona-suvini-tanlash','','','2021-08-30 16:34:01','2021-08-30 13:34:01','',0,'https://reo.ua/uncategorized-uz/aptechna-pitna-voda-shho-poraditi/',11,'post','',0),(1657,1,'2021-07-14 17:29:08','2021-07-14 14:29:08','','3. Вибір аптечної води. Що порадити відвідувачу аптеки_укр_ИСХОДНИК','','inherit','open','closed','','3-vibir-aptechno%d1%97-vodi-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik-2-2','','','2021-07-14 17:29:08','2021-07-14 14:29:08','',1656,'https://reo.ua/wp-content/uploads/2021/07/3.-vibir-aptechnoї-vodi.-shho-poraditi-vidviduvachu-apteki_ukr_ishodnik.pdf',0,'attachment','application/pdf',0),(1658,1,'2021-07-14 17:37:49','2021-07-14 14:37:49','','prev','','inherit','open','closed','','prev-2-2','','','2021-07-14 17:37:49','2021-07-14 14:37:49','',1656,'https://reo.ua/wp-content/uploads/2021/07/prev.png',0,'attachment','image/png',0),(1659,1,'2021-08-30 16:32:05','2021-08-30 13:32:05','Кўплаб мамлакатларда минерал сувни фақат дорихоналардан сотиб олиш мумкин. Шу тариқа унинг буюк врачлар Архигинес, Гиппократ, Гален қадим замонлардаёқ  ўйлаган шифобахш хоссалари таъкидланади. Ҳозир ҳам унинг шифобахш хоссалари камаймаган – аксинча, тадқиқотлар керакли сувни тўғри вақтда ва тўғри кўрсатмалар бўйича тўғри ичиш натижасида унинг янги афзалликларини кўрсатмоқда.\n\nЛекин шундай савол туғилади: қандай ҳолатларда ташриф буюрувчиларга дорихона сувини тавсия этиш мумкин?\n\nОрганизмнинг регидратацияси ва дезинтоксикацияси учун махсус мўлжалланган ReO суви мисолида қачон ушбу маҳсулотни ичиш мақсадга мувофиқ эканини кўриб чиқамиз.\n<h2>Ҳаёт матрицаси</h2>\nСув – водород ва кислороднинг табиатда энг кенг тарқалган бирикмаси. Бу кўплаб моддаларнинг универсал эритувчиси, шунинг учун табиатда кимёвий жиҳатдан соф сув мавжуд эмас.\n\nОрганизм таркибидаги сув сифат жиҳатидан оддий сувдан фарқ қилади, чунки бу сув структурланган бўлади.\n\nСувнинг бундай кристалл структуралари – ҳаёт матрицаси. Уларнинг мавжудлиги  муҳим биофизик жараёнлар ва биокимёвий реакцияларнинг ўтишига имкон беради. Организмга етарли миқдорда сув тушмаслиги ёки унинг ҳаддан ортиқ йўқотилиши сувсизланишга олиб келади.\n\nСувсизланиш сабаблари бўлиб нафақат овқатдан заҳарланиш вақтидаги диарея ва қайт қилиш, балки ҳомиладорлар токсикози; жадал жисмоний юкланишлар; алкоголдан заҳарланиш; иситма, ўткир ичак инфекциялари  ҳам сабаб бўлиши мумкин.\n\nҲар қандай ҳолатда ҳам  сув ва туз танқислиги организм учун салбий оқибатларга олиб келади.\n\nЖССТ экспертларининг маълумотларига кўра, узоқ давом этадиган қайт қилиш ёки диареядаги организмнинг  сувсизланиши, болалар касалланиши ва ўлимининг кўп учрайдиган сабаби, шунингдек  организмга озуқа моддаларининг етарлича тушмаслиги оқибатидаги озиб кетишнинг  муҳим сабаби  ҳисобланади.\n\nКатталарда дегидратация кўпинча қон қуюқлашишига ва тромблар ҳосил бўлиш хавфи ошишига олиб келади; юрак ритмининг бузилиши ва артериал қон босимининг пасайиши билан бирга кечади, шунинг учун организмда суюқлик ва электролитлар танқислигини ўз вақтида ва тўғри тўлдириш жуда муҳим.\n\nЎрни келганда айтиш керакки, дунёдаги ҳар иккинчи инсон у ёки бу даражада сувсизликдан азият чекади. Шунинг учун муаммо жуда долзарб ҳисобланади.\n\nНо необходимо помнить: в границах фармацевтической помощи мы можем давать совет лишь в неосложненных случаях.\n\nЕсли имеют место угрожающие симптомы сильного обезвоживания (ухудшение общего самочувствия, отсутствие слюны, бледность, запавшие глаза, аномальное дыхание, плач без слез), необходимо срочно вызвать скорую помощь.\n<h2>Сбалансированный состав</h2>\nОбращаем ваше внимание на то, что питье должно не только восстанавливать уровень жидкости, но и компенсировать потерю солей, а также покрывать энергетические потребности организма.\n\nНе стоит забывать о том, что потеря жидкости и электролитов приводит к нарушению рН крови в кислую сторону и в результате к нарушению работы важнейших органов и систем.\nВот почему «просто пить» во время интоксикации – это не выход. Вода поможет. Но не любая.\n\nХорошая рекомендация для устранения обезвоживания – специальная вода РеО, которая имеет хорошо сбалансированный водно-солевой состав, не содержит консервантов, красителей и углеводов.\n\nВ составе воды для медицинских целей РеО содержится оптимальный состав микроэлементов, в первую очередь натрия и калия, которые интенсивно теряет организм во время обезвоживания. Также в этой воде есть необходимые организму порции кальция, магния, гидрокарбонатов и хлоридов. Таким образом, вода помогает быстро возобновить кислотно-щелочной баланс.\n<h2>Качество и вкусовые свойства</h2>\nКстати говоря, слабогазированная вода РеО – это первая вода для медицинских целей, которую разработали для максимально быстрого всасывания воды и электролитов.\nВода снижает концентрацию токсических продуктов и устраняет признаки дегидратации. Важное значение в этом процессе имеет уровень ее минерализации – 2500-3000 мг/дм 3, что делает ее водой малой минерализации. Дело в том, что маломинерализованная лечебная вода оказывает более сложное действие, чем вода с высокой минерализацией. Работает правило: чем более сложным является раствор, тем большее количество солей распадается на ионы, а именно они влияют на организм. Маломинерализованные воды на более длительное время задерживаются в желудке, чем воды средней или высокой минерализации, всасываются практически полностью в тонкой кишке, не требуют дополнительных затрат энергии или времени для распада минеральной воды на ионы, получая их уже готовыми для процесса всасывания.\n\nИменно поэтому вода для медицинских целей РеО так быстро устраняет признаки обезвоживания и помогает улучшить самочувствие человека.\n\nВода рекомендована при состояниях, которые сопровождаются дегидратацией и интоксикацией организма, среди которых – токсикоз у беременных, физические нагрузки, острые кишечные инфекции у детей, алкогольная интоксикация, отравления, диарея, лихорадка.\n\nВода РеО имеет приятный солоноватый вкус, ее легко пить и можно принимать даже при тошноте.\n\nОтличные вкусовые качества воды обеспечивают более комфортное отпаивание не только у взрослых, но и у детей.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\" width=\"302\">Табл. Состав воды для медицинских целей РеО</th>\n</tr>\n<tr>\n<th width=\"151\"><strong>Компонент</strong></th>\n<th width=\"151\">Концентрация</th>\n</tr>\n<tr>\n<td width=\"151\">Na<sup>+</sup></td>\n<td width=\"151\">900 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">K<sup>+</sup></td>\n<td width=\"151\">160 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Mg<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Ca<sup>2+</sup></td>\n<td width=\"151\">50 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Cl<sup>-</sup></td>\n<td width=\"151\">1600 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\n<td width=\"151\">300 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Сорбитол</td>\n<td width=\"151\">90 мг/л</td>\n</tr>\n<tr>\n<td width=\"151\">Углекислота</td>\n<td width=\"151\">0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Кому стоит посоветовать воду для медицинских целей ReO?</h2>\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\n\nReO - больше, чем вода!','Дорихона сувини танлаш','','inherit','closed','closed','','1656-autosave-v1','','','2021-08-30 16:32:05','2021-08-30 13:32:05','',1656,'https://reo.ua/?p=1659',0,'revision','',0),(1660,1,'2021-08-30 16:34:01','2021-08-30 13:34:01','Кўплаб мамлакатларда минерал сувни фақат дорихоналардан сотиб олиш мумкин. Шу тариқа унинг буюк врачлар Архигинес, Гиппократ, Гален қадим замонлардаёқ  ўйлаган шифобахш хоссалари таъкидланади. Ҳозир ҳам унинг шифобахш хоссалари камаймаган – аксинча, тадқиқотлар керакли сувни тўғри вақтда ва тўғри кўрсатмалар бўйича тўғри ичиш натижасида унинг янги афзалликларини кўрсатмоқда.\r\n\r\nЛекин шундай савол туғилади: қандай ҳолатларда ташриф буюрувчиларга дорихона сувини тавсия этиш мумкин?\r\n\r\nОрганизмнинг регидратацияси ва дезинтоксикацияси учун махсус мўлжалланган ReO суви мисолида қачон ушбу маҳсулотни ичиш мақсадга мувофиқ эканини кўриб чиқамиз.\r\n<h2>Ҳаёт матрицаси</h2>\r\nСув – водород ва кислороднинг табиатда энг кенг тарқалган бирикмаси. Бу кўплаб моддаларнинг универсал эритувчиси, шунинг учун табиатда кимёвий жиҳатдан соф сув мавжуд эмас.\r\n\r\nОрганизм таркибидаги сув сифат жиҳатидан оддий сувдан фарқ қилади, чунки бу сув структурланган бўлади.\r\n\r\nСувнинг бундай кристалл структуралари – ҳаёт матрицаси. Уларнинг мавжудлиги  муҳим биофизик жараёнлар ва биокимёвий реакцияларнинг ўтишига имкон беради. Организмга етарли миқдорда сув тушмаслиги ёки унинг ҳаддан ортиқ йўқотилиши сувсизланишга олиб келади.\r\n\r\nСувсизланиш сабаблари бўлиб нафақат овқатдан заҳарланиш вақтидаги диарея ва қайт қилиш, балки ҳомиладорлар токсикози; жадал жисмоний юкланишлар; алкоголдан заҳарланиш; иситма, ўткир ичак инфекциялари  ҳам сабаб бўлиши мумкин.\r\n\r\nҲар қандай ҳолатда ҳам  сув ва туз танқислиги организм учун салбий оқибатларга олиб келади.\r\n\r\nЖССТ экспертларининг маълумотларига кўра, узоқ давом этадиган қайт қилиш ёки диареядаги организмнинг  сувсизланиши, болалар касалланиши ва ўлимининг кўп учрайдиган сабаби, шунингдек  организмга озуқа моддаларининг етарлича тушмаслиги оқибатидаги озиб кетишнинг  муҳим сабаби  ҳисобланади.\r\n\r\nКатталарда дегидратация кўпинча қон қуюқлашишига ва тромблар ҳосил бўлиш хавфи ошишига олиб келади; юрак ритмининг бузилиши ва артериал қон босимининг пасайиши билан бирга кечади, шунинг учун организмда суюқлик ва электролитлар танқислигини ўз вақтида ва тўғри тўлдириш жуда муҳим.\r\n\r\nЎрни келганда айтиш керакки, дунёдаги ҳар иккинчи инсон у ёки бу даражада сувсизликдан азият чекади. Шунинг учун муаммо жуда долзарб ҳисобланади.\r\n\r\nАммо шуни ёдда тутинг: фармацевтик ёрдам доирасида биз фақат оғир бўлмаган ҳолатларда маслаҳат беришимиз мумкин.\r\n\r\nКучли сувсизланишнинг хавфли симптомлари (умумий аҳволнинг ёмонлашиши, оғизда тупук йўқлиги, рангпарлик, киртайган кўзлар, одатдагидан бошқача нафас олиш, кўз ёшларсиз йиғлаш)  мавжуд бўлса дарҳол тез ёрдам чақириш зарур.\r\n<h2>Мувозанатлаштирилган таркиб</h2>\r\nЭътиборингизни шунга қаратамизки, сув ичиш нафақат суюқлик даражасини тиклаши, балки йўқотилган тузлар ўрнини тўлдириши, шунингдек организмнинг энергияга бўлган эҳтиёжини ҳам қоплаши зарур.\r\n\r\nШуни ёддан чиқармаслик зарурки, суюқлик ва электролитларнинг йўқотилиши қоннинг рН кўрсаткичи кислотали томонга ўтишига, натижада муҳим орган ва тизимлар ишининг бузилишига олиб келади.\r\n\r\nШунинг учун ҳам интоксикация вақтида “шунчаки сув ичиш” – бу  чора эмас. Сув ёрдам беради. Лекин ҳар қандай сув эмас.\r\n\r\nСувсизланишни бартараф этиш учун яхши тавсиялардан бири – бу ReO махсус суви бўлиб, у мувозанатлаштирилган сув-туз таркибига эга, таркибида консервантлар, бўёвчи моддалар ва углеводлар мавжуд эмас.\r\n\r\nТиббий мақсадлар учун ReO суви таркибида организм сувсизланиш вақтида жадал йўқотадиган микроэлементларнинг оптимал таркиби, биринчи навбатда  натрий ва калий мавжуд.  Шунингдек ReO да кальций, магний, гидрокарбонатлар ва хлоридларнинг организм учун зарур улуши бор. Шундай қилиб, сув кислота-ишқор мувозанатини тезда тиклашга ёрдам беради.\r\n<h2>Сифати ва таъм хусусиятлари</h2>\r\nЎрни келганда шуни айтиш керакки, кучсиз газланган ReO суви – бу тиббий мақсадлар учун биринчи сув бўлиб, сув ва электролитларнинг юқори даражада тез сўрилиши учун ишлаб чиқилган.\r\n\r\nСув заҳарли моддалар концентрациясини пасайтиради ва дегидратация белгиларини бартараф этади. Бу жараёнда унинг минераллашиш даражаси – 2500-3000 мг/дм<sup>3</sup> муҳим аҳамиятга эга бўлиб, у кам минераллашган сув ҳисобланади. Гап шундаки, кам минераллашган шифобахш сув юқори даражада минераллашган сувга нисбатан анча мураккаб таъсир кўрсатади.\r\n\r\nБу ерда шундай қоида ишлайди: эритма қанчалик мураккаб бўлса, шунчалик катта миқдордаги тузлар ионларга парчаланади, айнан улар организмга таъсир кўрсатади. Кам минераллашган сувлар ўртача ёки юқори даражада минераллашган сувларга нисбатан ошқозонда анча кўпроқ вақт туриб қолади, ингичка ичакда деярли тўлиқ сўрилади, чунки ионларни сўрилиш жараёни учун тайёр ҳолда олади ва минерал сувнинг ионларга парчаланиши учун қўшимча энергия ёки вақт сарфини талаб қилмайди.\r\n\r\nАйнан шунинг учун тиббий мақсадлар учун ReO суви сувсизланиш белгиларини тезда бартараф этади ва одамнинг ўзини ҳис қилишини тез яхшилашга ёрдам беради.\r\n\r\nСув организмнинг дегидратация ва интоксикация билан кечадиган ҳолатларида тавсия этилган бўлиб, улар орасида ҳомиладорлардаги токсикоз, жисмоний юкланишлар, болалардаги ичак инфекциялари, алкоголдан заҳарланиш, диарея, иситма каби ҳолатлар мавжуд.\r\n\r\nReO суви ёқимли нимшўр таъмга эга бўлиб, уни ҳатто кўнгил айниб турганида ҳам ичиш осон.\r\n\r\nСувнинг аъло таъм сифатлари уни нафақат катталар, балки болалар ҳам  жуда яхши қабул қилишини таъминлайди.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"302\"><strong>Жадвал. Тиббий мақсадлар учун ReO суви таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"151\"><strong>Концентрацияси</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"151\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"151\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"151\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"151\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"151\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"151\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Углекислота</td>\r\n<td width=\"151\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"302\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Тиббий мақсадлар учун ReO сувини кимга  тавсия қилиш мумкин?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\"><img class=\"aligncenter size-full wp-image-1202\" src=\"https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg\" alt=\"\" width=\"945\" height=\"1139\" /></a>\r\n\r\nReO — оддий сувдан яхшироқ!','Дорихона сувини танлаш','','inherit','closed','closed','','1656-revision-v1','','','2021-08-30 16:34:01','2021-08-30 13:34:01','',1656,'https://reo.ua/?p=1660',0,'revision','',0),(1661,1,'2021-07-14 17:31:52','2021-07-14 14:31:52','','schem-81-ua','','inherit','open','closed','','schem-81-ua','','','2021-07-14 17:31:52','2021-07-14 14:31:52','',1656,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg',0,'attachment','image/jpeg',0),(1662,1,'2021-07-14 17:43:54','2021-07-14 14:43:54','','schem-81-ru','','inherit','open','closed','','schem-81-ru','','','2021-07-14 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14:36:10','',1331,'https://reo.ua/wp-content/uploads/2021/08/reo-slider_3.webp',0,'attachment','image/webp',0),(1670,1,'2021-08-30 17:36:10','2021-08-30 14:36:10','','reo-slider_3','','inherit','open','closed','','reo-slider_3-2','','','2021-08-30 17:36:10','2021-08-30 14:36:10','',176,'https://reo.ua/wp-content/uploads/2021/08/reo-slider_3.webp',0,'attachment','image/webp',0),(1671,1,'2021-08-30 17:36:10','2021-08-30 14:36:10','','reo-slider_3','','inherit','open','closed','','reo-slider_3-2','','','2021-08-30 17:36:10','2021-08-30 14:36:10','',8,'https://reo.ua/wp-content/uploads/2021/08/reo-slider_3.webp',0,'attachment','image/webp',0),(1672,1,'2021-08-30 17:36:13','2021-08-30 14:36:13','','Бош саҳифа','','inherit','closed','closed','','1331-revision-v1','','','2021-08-30 17:36:13','2021-08-30 14:36:13','',1331,'https://reo.ua/?p=1672',0,'revision','',0),(1673,1,'2021-08-31 10:08:40','2021-08-31 07:08:40','<p style=\"text-align: center;\">Тиббий мақсадлар учун РеО сувини шаҳрингиз дорихоналаридан харид қилишингиз мумкин:</p>','қаердан сотиб олиш мумкин','','inherit','closed','closed','','1387-autosave-v1','','','2021-08-31 10:08:40','2021-08-31 07:08:40','',1387,'https://reo.ua/?p=1673',0,'revision','',0),(1674,1,'2021-08-31 10:08:47','2021-08-31 07:08:47','<p style=\"text-align: center;\">Тиббий мақсадлар учун РеО сувини шаҳрингиз дорихоналаридан харид қилишингиз мумкин:</p>','Қаердан харид қилиш мумкин','','inherit','closed','closed','','1387-revision-v1','','','2021-08-31 10:08:47','2021-08-31 07:08:47','',1387,'https://reo.ua/?p=1674',0,'revision','',0),(1675,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-1','','inherit','open','closed','','article-scheme-kz-1-1','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',1525,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg',0,'attachment','image/jpeg',0),(1676,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-1','','inherit','open','closed','','article-scheme-kz-1-1-2','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',377,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg',0,'attachment','image/jpeg',0),(1677,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-1','','inherit','open','closed','','article-scheme-kz-1-1-2','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',368,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg',0,'attachment','image/jpeg',0),(1678,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-2','','inherit','open','closed','','article-scheme-kz-1-2','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',1525,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg',0,'attachment','image/jpeg',0),(1679,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-2','','inherit','open','closed','','article-scheme-kz-1-2-2','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',377,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg',0,'attachment','image/jpeg',0),(1680,1,'2021-08-31 12:54:24','2021-08-31 09:54:24','','article-scheme-kz-1-2','','inherit','open','closed','','article-scheme-kz-1-2-2','','','2021-08-31 12:54:24','2021-08-31 09:54:24','',368,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg',0,'attachment','image/jpeg',0),(1681,1,'2021-08-31 12:55:35','2021-08-31 09:55:35','Ўткир ичак инфекциялари – юқумли касалликлар гуруҳи бўлиб, улар учун тўсатдан  бошланиш, диарея, баъзида эса – кўнгил айниши ва қайт қилиш, тана ҳароратининг ошиши, қорин ва мушаклардаги оғриқ, иштаҳанинг йўқолиши каби белгилар хосдир.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\"><img class=\"aligncenter size-full wp-image-1675\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\" alt=\"\" width=\"975\" height=\"226\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Гастроэнтерит белгилари</strong></p>\r\n&nbsp;\r\n\r\nЎткир ичак инфекциялари одатда бир неча кундан кейин ўзи ўтиб кетади, лекин 2 ҳафтагача ҳам давом этиши мумкин. Ичак инфекцияларига бактериялар, вируслар ёки паразитлар сабаб бўлиши мумкин. Аксарият ҳолларда антибиотиклар керак бўлмайди ва улар фақат беморнинг аҳволини ёмонлаштириши мумкин.\r\n<h2>Ичак инфекцияларида нима қилиш керак?</h2>\r\nЎткир ичак инфекцияларининг асосий асорати ва  хавфи – бу сувсизланиш. Сувсизланиш даражасини баҳолашда  суюқлик истеъмол қилиш ҳажми, сийиш ҳажми, диарея ва қайт қилишлар сонига эътибор бериш керак.\r\n\r\nУнча юқори бўлмаган ёки ўртача сувсизланишда орал регидратация  худди вена ичига юбориладиган регидратация каби самарали бўлади ва шифохонага ётқизишнинг (Listernick R. ва ҳаммуаллифлар, 1986; Cohen M. ва ҳаммуаллифлар, 1995) олдини олади. Орал регидратация олган 25 нафар болалардан фақат 1 бола  эритмаларни вена ичига юборишни талаб қилади (Hartling L. ва ҳаммуаллифлар, 2006).\r\n\r\nИштаҳа очилганида овқатланишни қайнатилган гуруч ва картошка, тост, банан каби маҳсулотлардан бошлаш зарур. Таркибида кофеин бўлган ичимликлар, алкоголь, ёғли ва ширин овқатлар, сут маҳсулотларини (кефир ва ширин бўлмаган йогуртдан ташқари) истеъмол қилмаслик керак.\r\n<h2>Врачга қачон мурожаат қилиш керак?</h2>\r\nБолаларда ўткир ичак инфекцияси юз берган ҳолларда қуйидаги белгилар пайдо бўлганда врачга мурожаат қилиш зарур:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>қусуқ массаларида қон ёки сафро пайдо бўлиши;</li>\r\n 	<li>юзнинг кўкариб кетиши;</li>\r\n 	<li>тинмай йиғлаш, кучли таъсирчанлик;</li>\r\n 	<li>нуқтасимон қизилча пайдо бўлиши;</li>\r\n 	<li>оёқ-қўлларнинг совиб кетиши;</li>\r\n 	<li>тез-тез нафас олиш;</li>\r\n 	<li>ҳарорат 40 °С дан кўтарилиши.</li>\r\n</ul>\r\nКатталарда қуйидаги белгилар хавфли ҳисобланади:\r\n<ul>\r\n 	<li>40 °С дан ошган ҳарорат;</li>\r\n 	<li>24 соат ва ундан ортиқ тўхтамай давом этадиган ич кетиши;</li>\r\n 	<li>48 соат ва ундан ортиқ давом этаётган қайт қилиш;</li>\r\n 	<li>қусуқ массаси ва нажасда қон пайдо бўлиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (кучли чанқоқ, сийишнинг кескин камайиши ёки умуман сиймай қўйиш, бирдан юз берадиган ҳолсизлик, бош айланиши)нинг пайдо бўлиши;</li>\r\n</ul>\r\nВрачга шунингдек ўткир ичак инфекцияси симптомлари болаларда 2 кундан кўп ёки катталарда 5 кундан кўп давом этаётган бўлса мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nБолалар учун суюқлик ҳажмини вазнига қараб жадвал ёки оддий формула ёрдамида ҳисоблаб чиқиш зарур: вазнни (кг) 75 га кўпайтириш орқали. Агар боланинг вазни аниқ бўлмаса,  ёш бўйича баҳолашдан фойдаланиш мумкин.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>В</strong><strong>азн</strong></th>\r\n<th width=\"33%\"><strong>Ёш</strong></th>\r\n<th width=\"33%\"><strong>Орал регидратация учун дастлабки                4 соатда берилиши зарур б</strong><strong>ўлган </strong><strong> эритманинг тахминий миқдори</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 ой</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 ой</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 ой</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 ёш</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 ёш</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 ёш</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nАгар одам кўпроқ суюқлик ичишни истаса, кўпроқ бериш мумкин.\r\n\r\nЧақалоқларга суюқлик шприц (игнасиз), кичкинтойлар ва катта болаларга – қошиқ ёки чашкада берилади. 2 ёшгача бўлган болаларга ҳар 1-2 дақиқада  чой қошиқда сув бериш, катта болаларни эса ўзлари мустақил чашкадан тез-тез ҳўплаб сув ичиб туришларини рағбатлантириш зарур. Қайт қилишда 5-10 дақиқа кутиб туриш ва регидратацияни давом эттириш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун минерал таркиби бўйича мувозанатлаштирилган, таркибида натрий, калий ва магний бўлган ичимликлар энг мақбул ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\"><img class=\"aligncenter wp-image-1678\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\" alt=\"\" width=\"748\" height=\"464\" /></a>\r\n<p style=\"text-align: center;\">\r\n<strong>2-расм. Сув-туз мувозанатини тиклаш</strong></p>\r\n&nbsp;\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви мувозанатлаштирилган таркибга эга ва сув-туз мувозанатини тиклаш учун энг муҳим электролитлар билан бойитилган. Ёқимли нимшўр таъми сабабли ReO сувини ҳатто ичак инфекцияларида кўп учраб турадиган кўнгил айнишларида ҳам оз-оздан ичиш имконини беради.\r\n<h2>Қандай қилиб ичак инфекцияларининг олдини олиш мумкин?</h2>\r\nИчак инфекцияларининг олдини олишнинг асосий чоралари  қўлларни тез-тез ювиб туриш ва умуман гигиенага яхши риоя қилиш ҳисобланади. Кичик ёшдаги болаларда эмизиш ичак инфекциялари учрашини ва шифохонага ётиш сонини пасайтиради. Сабзавот ва меваларни истеъмол қилишдан олдин яхшилаб ювиш; хом гўшт, балиқ ва денгиз маҳсулотларини истеъмол қилмаслик зарур. Бундан ташқари, сифатли ичимлик сувини ичиш ҳам муҳим аҳамиятга эга.\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Ичак инфекцияларида сувсизланиш','','inherit','closed','closed','','1525-revision-v1','','','2021-08-31 12:55:35','2021-08-31 09:55:35','',1525,'https://reo.ua/?p=1681',0,'revision','',0),(1682,1,'2021-08-31 12:57:33','2021-08-31 09:57:33','','article-scheme-kz-1-prev','','inherit','open','closed','','article-scheme-kz-1-prev','','','2021-08-31 12:57:33','2021-08-31 09:57:33','',1525,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-prev.jpg',0,'attachment','image/jpeg',0),(1683,1,'2021-08-31 12:57:33','2021-08-31 09:57:33','','article-scheme-kz-1-prev','','inherit','open','closed','','article-scheme-kz-1-prev-2','','','2021-08-31 12:57:33','2021-08-31 09:57:33','',377,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-prev.jpg',0,'attachment','image/jpeg',0),(1684,1,'2021-08-31 12:57:33','2021-08-31 09:57:33','','article-scheme-kz-1-prev','','inherit','open','closed','','article-scheme-kz-1-prev-2','','','2021-08-31 12:57:33','2021-08-31 09:57:33','',368,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-prev.jpg',0,'attachment','image/jpeg',0),(1685,1,'2021-08-31 12:57:35','2021-08-31 09:57:35','Ўткир ичак инфекциялари – юқумли касалликлар гуруҳи бўлиб, улар учун тўсатдан  бошланиш, диарея, баъзида эса – кўнгил айниши ва қайт қилиш, тана ҳароратининг ошиши, қорин ва мушаклардаги оғриқ, иштаҳанинг йўқолиши каби белгилар хосдир.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\"><img class=\"aligncenter size-full wp-image-1675\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-1.jpg\" alt=\"\" width=\"975\" height=\"226\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Гастроэнтерит белгилари</strong></p>\r\n&nbsp;\r\n\r\nЎткир ичак инфекциялари одатда бир неча кундан кейин ўзи ўтиб кетади, лекин 2 ҳафтагача ҳам давом этиши мумкин. Ичак инфекцияларига бактериялар, вируслар ёки паразитлар сабаб бўлиши мумкин. Аксарият ҳолларда антибиотиклар керак бўлмайди ва улар фақат беморнинг аҳволини ёмонлаштириши мумкин.\r\n<h2>Ичак инфекцияларида нима қилиш керак?</h2>\r\nЎткир ичак инфекцияларининг асосий асорати ва  хавфи – бу сувсизланиш. Сувсизланиш даражасини баҳолашда  суюқлик истеъмол қилиш ҳажми, сийиш ҳажми, диарея ва қайт қилишлар сонига эътибор бериш керак.\r\n\r\nУнча юқори бўлмаган ёки ўртача сувсизланишда орал регидратация  худди вена ичига юбориладиган регидратация каби самарали бўлади ва шифохонага ётқизишнинг (Listernick R. ва ҳаммуаллифлар, 1986; Cohen M. ва ҳаммуаллифлар, 1995) олдини олади. Орал регидратация олган 25 нафар болалардан фақат 1 бола  эритмаларни вена ичига юборишни талаб қилади (Hartling L. ва ҳаммуаллифлар, 2006).\r\n\r\nИштаҳа очилганида овқатланишни қайнатилган гуруч ва картошка, тост, банан каби маҳсулотлардан бошлаш зарур. Таркибида кофеин бўлган ичимликлар, алкоголь, ёғли ва ширин овқатлар, сут маҳсулотларини (кефир ва ширин бўлмаган йогуртдан ташқари) истеъмол қилмаслик керак.\r\n<h2>Врачга қачон мурожаат қилиш керак?</h2>\r\nБолаларда ўткир ичак инфекцияси юз берган ҳолларда қуйидаги белгилар пайдо бўлганда врачга мурожаат қилиш зарур:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>қусуқ массаларида қон ёки сафро пайдо бўлиши;</li>\r\n 	<li>юзнинг кўкариб кетиши;</li>\r\n 	<li>тинмай йиғлаш, кучли таъсирчанлик;</li>\r\n 	<li>нуқтасимон қизилча пайдо бўлиши;</li>\r\n 	<li>оёқ-қўлларнинг совиб кетиши;</li>\r\n 	<li>тез-тез нафас олиш;</li>\r\n 	<li>ҳарорат 40 °С дан кўтарилиши.</li>\r\n</ul>\r\nКатталарда қуйидаги белгилар хавфли ҳисобланади:\r\n<ul>\r\n 	<li>40 °С дан ошган ҳарорат;</li>\r\n 	<li>24 соат ва ундан ортиқ тўхтамай давом этадиган ич кетиши;</li>\r\n 	<li>48 соат ва ундан ортиқ давом этаётган қайт қилиш;</li>\r\n 	<li>қусуқ массаси ва нажасда қон пайдо бўлиши;</li>\r\n 	<li>кучли сувсизланиш белгилари (кучли чанқоқ, сийишнинг кескин камайиши ёки умуман сиймай қўйиш, бирдан юз берадиган ҳолсизлик, бош айланиши)нинг пайдо бўлиши;</li>\r\n</ul>\r\nВрачга шунингдек ўткир ичак инфекцияси симптомлари болаларда 2 кундан кўп ёки катталарда 5 кундан кўп давом этаётган бўлса мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nБолалар учун суюқлик ҳажмини вазнига қараб жадвал ёки оддий формула ёрдамида ҳисоблаб чиқиш зарур: вазнни (кг) 75 га кўпайтириш орқали. Агар боланинг вазни аниқ бўлмаса,  ёш бўйича баҳолашдан фойдаланиш мумкин.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th width=\"33%\"><strong>В</strong><strong>азн</strong></th>\r\n<th width=\"33%\"><strong>Ёш</strong></th>\r\n<th width=\"33%\"><strong>Орал регидратация учун дастлабки                4 соатда берилиши зарур б</strong><strong>ўлган </strong><strong> эритманинг тахминий миқдори</strong></th>\r\n</tr>\r\n</thead>\r\n<tbody>\r\n<tr>\r\n<td>&lt;5 кг</td>\r\n<td>&lt;4 ой</td>\r\n<td>200-400 мл</td>\r\n</tr>\r\n<tr>\r\n<td>5-7,9 кг</td>\r\n<td>4-11 ой</td>\r\n<td>400-600 мл</td>\r\n</tr>\r\n<tr>\r\n<td>8-10,9 кг</td>\r\n<td>12-23 ой</td>\r\n<td>600-800 мл</td>\r\n</tr>\r\n<tr>\r\n<td>11-15,9 кг</td>\r\n<td>2-4 ёш</td>\r\n<td>800-1200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>16-29,9 кг</td>\r\n<td>5-14 ёш</td>\r\n<td>1200-2200 мл</td>\r\n</tr>\r\n<tr>\r\n<td>≥30 кг</td>\r\n<td>≥15 ёш</td>\r\n<td>2200-4000 мл</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\nАгар одам кўпроқ суюқлик ичишни истаса, кўпроқ бериш мумкин.\r\n\r\nЧақалоқларга суюқлик шприц (игнасиз), кичкинтойлар ва катта болаларга – қошиқ ёки чашкада берилади. 2 ёшгача бўлган болаларга ҳар 1-2 дақиқада  чой қошиқда сув бериш, катта болаларни эса ўзлари мустақил чашкадан тез-тез ҳўплаб сув ичиб туришларини рағбатлантириш зарур. Қайт қилишда 5-10 дақиқа кутиб туриш ва регидратацияни давом эттириш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nДиарея ва қайт қилишда нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун минерал таркиби бўйича мувозанатлаштирилган, таркибида натрий, калий ва магний бўлган ичимликлар энг мақбул ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\"><img class=\"aligncenter wp-image-1678\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-1-2.jpg\" alt=\"\" width=\"748\" height=\"464\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Сув-туз мувозанатини тиклаш</strong></p>\r\n&nbsp;\r\n<h2>Тиббий мақсадлар учун ReO суви\r\n(«Юрия-Фарм»)</h2>\r\nТиббий мақсадлар учун ReO суви мувозанатлаштирилган таркибга эга ва сув-туз мувозанатини тиклаш учун энг муҳим электролитлар билан бойитилган. Ёқимли нимшўр таъми сабабли ReO сувини ҳатто ичак инфекцияларида кўп учраб турадиган кўнгил айнишларида ҳам оз-оздан ичиш имконини беради.\r\n<h2>Қандай қилиб ичак инфекцияларининг олдини олиш мумкин?</h2>\r\nИчак инфекцияларининг олдини олишнинг асосий чоралари  қўлларни тез-тез ювиб туриш ва умуман гигиенага яхши риоя қилиш ҳисобланади. Кичик ёшдаги болаларда эмизиш ичак инфекциялари учрашини ва шифохонага ётиш сонини пасайтиради. Сабзавот ва меваларни истеъмол қилишдан олдин яхшилаб ювиш; хом гўшт, балиқ ва денгиз маҳсулотларини истеъмол қилмаслик зарур. Бундан ташқари, сифатли ичимлик сувини ичиш ҳам муҳим аҳамиятга эга.\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Hartman S., et al. Gastroenteritis in children. Am. Fam. Physician. 2019; 99 (3): 159-165.</li>\r\n 	<li>Available at: https://www.healthline.com/health/gastrointestinal-infection.</li>\r\n 	<li>Listernick R., Zieserl E., Davis A. Outpatient oral rehydration in the United States. AJDC. 1986; 140211-215.</li>\r\n 	<li>Cohen M.B., Mezoff A.G., Laney Jr. D.W., et al. Use of single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration. Pediatrics. 1995; 95639-645.</li>\r\n 	<li>Hartling L., Bellemare S., Wiebe N., Russell K., Klassen T., Craig W. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst. Rev. 2006; 2006 (3): CD004390.</li>\r\n</ol>','Ичак инфекцияларида сувсизланиш','','inherit','closed','closed','','1525-revision-v1','','','2021-08-31 12:57:35','2021-08-31 09:57:35','',1525,'https://reo.ua/?p=1685',0,'revision','',0),(1686,1,'2021-08-31 13:03:49','2021-08-31 10:03:49','','article-scheme-kz-2-1','','inherit','open','closed','','article-scheme-kz-2-1','','','2021-08-31 13:03:49','2021-08-31 10:03:49','',1493,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg',0,'attachment','image/jpeg',0),(1687,1,'2021-08-31 13:03:49','2021-08-31 10:03:49','','article-scheme-kz-2-1','','inherit','open','closed','','article-scheme-kz-2-1-2','','','2021-08-31 13:03:49','2021-08-31 10:03:49','',405,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg',0,'attachment','image/jpeg',0),(1688,1,'2021-08-31 13:03:49','2021-08-31 10:03:49','','article-scheme-kz-2-1','','inherit','open','closed','','article-scheme-kz-2-1-2','','','2021-08-31 13:03:49','2021-08-31 10:03:49','',396,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg',0,'attachment','image/jpeg',0),(1689,1,'2021-08-31 13:03:50','2021-08-31 10:03:50','','article-scheme-kz-2-2','','inherit','open','closed','','article-scheme-kz-2-2','','','2021-08-31 13:03:50','2021-08-31 10:03:50','',1493,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg',0,'attachment','image/jpeg',0),(1690,1,'2021-08-31 13:03:50','2021-08-31 10:03:50','','article-scheme-kz-2-2','','inherit','open','closed','','article-scheme-kz-2-2-2','','','2021-08-31 13:03:50','2021-08-31 10:03:50','',405,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg',0,'attachment','image/jpeg',0),(1691,1,'2021-08-31 13:03:50','2021-08-31 10:03:50','','article-scheme-kz-2-2','','inherit','open','closed','','article-scheme-kz-2-2-2','','','2021-08-31 13:03:50','2021-08-31 10:03:50','',396,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg',0,'attachment','image/jpeg',0),(1693,1,'2021-08-31 13:05:39','2021-08-31 10:05:39','Иситма  – бу иссиқликни бошқариш маркази ишидаги ўзгаришлар оқибатида тана ҳароратининг кўтарилишидир. Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\r\n\r\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\"><img class=\"aligncenter wp-image-1686\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\" alt=\"\" width=\"1024\" height=\"505\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n\r\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\r\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\"><img class=\"aligncenter wp-image-1689\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\r\n&nbsp;\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\r\n<h2>Нима ичиш керак?</h2>\r\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th><strong>Таркиби</strong></th>\r\n<th><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\r\n<ul>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','inherit','closed','closed','','1493-revision-v1','','','2021-08-31 13:05:39','2021-08-31 10:05:39','',1493,'https://reo.ua/?p=1693',0,'revision','',0),(1694,1,'2021-08-31 13:05:57','2021-08-31 10:05:57','Иситма  – бу иссиқликни бошқариш маркази ишидаги ўзгаришлар оқибатида тана ҳароратининг кўтарилишидир. Одатда иситма яллиғланиш ривожланишида ажралиб чиқадиган моддаларнинг таъсири остида пайдо бўлади  ва ҳимоя механизми ҳисобланади, чунки ҳарорат кўтарилиши организмнинг ўз иммун ҳимоясини кучайтиради ва зарарли бактериялар ўсишини тўхтатади.\r\n\r\nҲарорат кўтарилганида нафас олиш ва юрак уриши тезлашади, тер ажралиши кучаяди. Терлаш ва тез-тез нафас олиш оқибатида суюқлик йўқотилиши сувсизланишга олиб келиши мумкин. Катталарда чанқаш, оғиз қуриши, тери қуруқлиги, қабзият, чарчоқ, бош оғриғи, бош айланиши сувсизланишнинг симптомлари ҳисобланади.  Болаларда эса шунингдек инжиқлик, кўз ёшининг йўқлиги, сийишнинг камайиши ёки умуман сиймаслик; чақалоқларда -  3 соатдан ва ундан кўпроқ  тагликнинг қуруқлиги сувсизланиш белгилари ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\"><img class=\"aligncenter wp-image-1686\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-1.jpg\" alt=\"\" width=\"1024\" height=\"505\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Катталар ва болаларда сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n\r\nЮқори ҳароратда сувсизланиш хавфи кўп суюқлик ичиш заруриятини келтириб чиқаради. Кўп ҳолларда ҳароратнинг сабабчиси бўладиган вирусли касалликларда суюқлик ичиш шиллиқ қаватларнинг намланишига ёрдам беради, бу эса томоқдаги қичишиш ва оғриқни камайтиради, шунингдек йўтал вақтида балғам кўчишини осонлаштиради.\r\n<h2>Юқори ҳароратда нима қилиш керак?</h2>\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\"><img class=\"aligncenter wp-image-1689\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-2-2.jpg\" alt=\"\" width=\"1024\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Болаларда юқори ҳароратни даволашнинг хусусиятлари</strong></p>\r\n&nbsp;\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nҲарорат кўтарилганида суюқликнинг тер билан бирга чиқиб кетиши ортади. Бу йўқотишни, шунингдек тузлар йўқотилишини ўз вақтида тўлдириш зарур. Ҳарорат кўтарилганида  катталар бир кунда камида 10 стакан суюқлик ичиши зарур деб ҳисобланади.\r\n<h2>Нима ичиш керак?</h2>\r\nЮқори ҳарорат ва кучли тер ажралишида нафақат сув, балки тузлар  (электролитлар) ҳам йўқотилади, бу йўқотишларни  таркибида натрий, магний ва кальций билан бойитилган ичимликлар билан тўлдириш зарур.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. У тана ҳужайралари инсулин иштирокисиз ўзлаштирадиган энергиянинг қўшимча манбаи ҳисобланади. ReO таркибида консервантлар, бўёвчи моддалар йўқ ва у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th><strong>Таркиби</strong></th>\r\n<th><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>ReO суви тана ҳарорати кўтарилганида:</h2>\r\n<ul>\r\n 	<li>сувсизланиш белгиларини бартараф этади;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>диурезни меъёрлаштиради ва умумий интоксикацияни пасайтиради.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Understanding the pathophysiology of fever. Critical. Care. 2008; 38 (8): 56сс1-56сс2.</li>\r\n 	<li>Britannica, T. Editors of Encyclopaedia (2017, December 7). Dehydration. Encyclopedia Britannica. Available at: https://www.britannica.com/science/dehydration-physiology.</li>\r\n 	<li>Available at: https://www.jnjpediatrics.com/resource-suite/patient/pain-fever/fever-treatment-patient-education.</li>\r\n</ol>','Нима учун ҳарорат кўтарилганида кўп суюқлик ичиш зарур?','','inherit','closed','closed','','1493-revision-v1','','','2021-08-31 13:05:57','2021-08-31 10:05:57','',1493,'https://reo.ua/?p=1694',0,'revision','',0),(1695,1,'2021-08-31 13:10:30','2021-08-31 10:10:30','','article-scheme-kz-3-1','','inherit','open','closed','','article-scheme-kz-3-1','','','2021-08-31 13:10:30','2021-08-31 10:10:30','',1466,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg',0,'attachment','image/jpeg',0),(1696,1,'2021-08-31 13:10:30','2021-08-31 10:10:30','','article-scheme-kz-3-1','','inherit','open','closed','','article-scheme-kz-3-1-2','','','2021-08-31 13:10:30','2021-08-31 10:10:30','',432,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg',0,'attachment','image/jpeg',0),(1697,1,'2021-08-31 13:10:30','2021-08-31 10:10:30','','article-scheme-kz-3-1','','inherit','open','closed','','article-scheme-kz-3-1-2','','','2021-08-31 13:10:30','2021-08-31 10:10:30','',422,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg',0,'attachment','image/jpeg',0),(1698,1,'2021-08-31 13:10:31','2021-08-31 10:10:31','','article-scheme-kz-3-2','','inherit','open','closed','','article-scheme-kz-3-2','','','2021-08-31 13:10:31','2021-08-31 10:10:31','',1466,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg',0,'attachment','image/jpeg',0),(1699,1,'2021-08-31 13:10:31','2021-08-31 10:10:31','','article-scheme-kz-3-2','','inherit','open','closed','','article-scheme-kz-3-2-2','','','2021-08-31 13:10:31','2021-08-31 10:10:31','',432,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg',0,'attachment','image/jpeg',0),(1700,1,'2021-08-31 13:10:31','2021-08-31 10:10:31','','article-scheme-kz-3-2','','inherit','open','closed','','article-scheme-kz-3-2-2','','','2021-08-31 13:10:31','2021-08-31 10:10:31','',422,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg',0,'attachment','image/jpeg',0),(1701,1,'2021-08-31 13:10:32','2021-08-31 10:10:32','','article-scheme-kz-3-3','','inherit','open','closed','','article-scheme-kz-3-3','','','2021-08-31 13:10:32','2021-08-31 10:10:32','',1466,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg',0,'attachment','image/jpeg',0),(1702,1,'2021-08-31 13:10:32','2021-08-31 10:10:32','','article-scheme-kz-3-3','','inherit','open','closed','','article-scheme-kz-3-3-2','','','2021-08-31 13:10:32','2021-08-31 10:10:32','',432,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg',0,'attachment','image/jpeg',0),(1703,1,'2021-08-31 13:10:32','2021-08-31 10:10:32','','article-scheme-kz-3-3','','inherit','open','closed','','article-scheme-kz-3-3-2','','','2021-08-31 13:10:32','2021-08-31 10:10:32','',422,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg',0,'attachment','image/jpeg',0),(1704,1,'2021-08-31 13:10:34','2021-08-31 10:10:34','','article-scheme-kz-3-4','','inherit','open','closed','','article-scheme-kz-3-4','','','2021-08-31 13:10:34','2021-08-31 10:10:34','',1466,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg',0,'attachment','image/jpeg',0),(1705,1,'2021-08-31 13:10:34','2021-08-31 10:10:34','','article-scheme-kz-3-4','','inherit','open','closed','','article-scheme-kz-3-4-2','','','2021-08-31 13:10:34','2021-08-31 10:10:34','',432,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg',0,'attachment','image/jpeg',0),(1706,1,'2021-08-31 13:10:34','2021-08-31 10:10:34','','article-scheme-kz-3-4','','inherit','open','closed','','article-scheme-kz-3-4-2','','','2021-08-31 13:10:34','2021-08-31 10:10:34','',422,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg',0,'attachment','image/jpeg',0),(1708,1,'2021-08-31 13:14:35','2021-08-31 10:14:35','Одамда тана ҳарорати доимий даражада (ҳарорат мувозанати) сақланиб туради ва тана ҳароратининг ҳар қандай пасайиши ёки кўтарилиши касалликдан далолат бўлиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\"><img class=\"aligncenter wp-image-1695\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-1.jpg\" alt=\"\" width=\"924\" height=\"622\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Одамда ҳарорат мувозанатини сақлаб туриш</strong></p>\r\n&nbsp;\r\n\r\nҲароратнинг кўтарилиши (иситма)  бир қатор инфекцион ва ноинфекцион сабабларнинг оқибати бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2.jpg\"><img class=\"aligncenter wp-image-1698 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-2-1024x508.jpg\" alt=\"\" width=\"1024\" height=\"508\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Иситма сабаблари</strong></p>\r\n&nbsp;\r\n\r\nТана ҳароратининг 37 °С дан кўтарилиши ошган ҳарорат ҳисобланади, 39,5 °С дан ошиши хавфли ҳарорат саналади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\"><img class=\"aligncenter wp-image-1701\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-3.jpg\" alt=\"\" width=\"825\" height=\"478\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Тана ҳароратининг ошиш даражалари</strong></p>\r\n&nbsp;\r\n\r\nЮқори температура кўпинча мушак ва бўғимлардаги оғриқлар, кучли тер босиши, юрак тез уриши ва ҳоказолар билан бирга кечади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4.jpg\"><img class=\"aligncenter wp-image-1704\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-3-4-1024x887.jpg\" alt=\"\" width=\"670\" height=\"581\" /></a>\r\n<p style=\"text-align: center;\"><strong>4-расм. Ҳарорат кўтарилиши билан бирга кечувчи белгилар</strong></p>\r\n&nbsp;\r\n<h2>Ҳарорат кўтарилганида қандай ҳолларда врачга мурожаат қилиш зарур?</h2>\r\n<ul>\r\n 	<li>Кучайиб бораётган тошма</li>\r\n 	<li>Бош айланиши</li>\r\n 	<li>Қайт қилиш</li>\r\n 	<li>Нафас сиқиши</li>\r\n 	<li>Сийишдаги оғриқлар</li>\r\n 	<li>Қорин оғриғи</li>\r\n 	<li>Иякни кўкракка боса олмаслик</li>\r\n 	<li>Кучли бош оғриғи</li>\r\n 	<li>Талваса хуружлари</li>\r\n</ul>\r\n<h2>Сув ва юқори ҳарорат ўртасида қандай боғлиқлик бор?</h2>\r\nСув катта иссиқлик сиғими кўрсаткичига  эга, бу  атроф муҳит совуқ ёки иссиқлигида тана ҳароратини бир маромда сақлаб туришга ёрдам беради. Сувнинг тер билан бирга буғланиши тананинг анча миқдордаги иссиқликни йўқотишига имкон беради.\r\n\r\nТана ҳарорати кўтарилганида меъёридан ортиқ тер ажралиб чиқади, шунингдек нафас олиш тезлашади, оқибатда кўп миқдорда суюқлик йўқотилади. Шунинг учун сувсизланиш ривожлангунча бу йўқотишнинг ўрнини тўлдириш мақсадга мувофиқ бўлади.\r\n<h2>Тана ҳарорати кўтарилганда нима қилиш керак?</h2>\r\nҲарорат кўтарилиши организмнинг ҳимоя механизми ҳисобланади, у вируслар ва бактерияларнинг кўпайишини тўхтатади. Шунинг учун  38,5 °С дан юқори бўлмаган температурани пасайтирмаслик керак. Совуқ компресслардан фойдаланиш ҳароратни дориларсиз пасайтиришнинг мақбул усули ҳисобланади. Шунингдек тегишли гидратация ҳам зарур, чунки сувсизланган танада ҳароратнинг тез пасайиш эҳтимоли камроқ бўлади.\r\n\r\nАгар ҳароратнинг сезиларли кўтарилиш сабабига таъсир қилиб бўлмаса, нохуш симптомлар (бош ва мушаклар оғриғи) ни дорилар ёрдамида камайтириш зарур. Бу мақсадда, одатда, ибупрофен ва парацетамолдан фойдаланилади.\r\n<h2>Қанча суюқлик ичиш зарур?</h2>\r\nТана ҳарорати қанчалик юқори бўлса, суюқлик йўқотилиши ҳам шунчалик катта бўлади. Сувсизланиш ҳарорат кўтарилишининг ёқимсиз ва хавфли белгиларини (масалан, юрак уриш сонининг ошиши каби) кучайтириши мумкинлиги сабабли ҳам ўз вақтида йўқотилган суюқлик ўрнини тўлдириш  зарур. Бундан ташқари, кўп суюқлик ичиш диурезни ва буйрак орқали токсинлар ва ҳужайраларнинг парчаланиш маҳсулотлари чиқарилишини оширади. Шунинг учун  ҳарорат кўтарилганда бир кунда камида 10 стакан сув ичиш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nҲарорат кўтарилганида тер билан нафақат сув, балки тузлар ҳам йўқотилади. Шунинг учун ҳам  йўқотилган суюқликни таркибида электролитлар: натрий, калий, магний бўлган махсус ичимликлар билан тўлдириш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун RеО суви</h2>\r\nТиббий мақсадлар учун РеО суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади. РеО таркибида консервантлар, бўёқлар йўқ, шунингдек у ёқимли таъмга эга.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. ReO сувининг м</strong><strong>увозанат</strong><strong>лаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Таркиби</strong></th>\r\n<th width=\"50%\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Карбонат кислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Ҳарорат кўтарилганда РеО сувининг афзалликлари:</h2>\r\n<ul>\r\n 	<li>мувозанатлаштирилган таркибга эга;</li>\r\n 	<li>сув-туз мувозанатини тиклашга ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>таркибида консервантлар, бўёқлар ва углеводлар йўқ;</li>\r\n 	<li>ёқимли таъмга эга ва уни ҳатто кўнгил айниб турганда ҳам ичиш осон;</li>\r\n 	<li>сувсизланиш белгиларини бартараф этади.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Kenney W.L. Physiological responses to the thermal environment. Encyclopedia of Occupational Health and Safety.</li>\r\n 	<li>Jéquier E., Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur. J. Clin. Nutr. 2010; 64: 115-123.</li>\r\n 	<li>Available at: https://www.emedihealth.com/fever-causes.html.</li>\r\n</ol>','Тана ҳарорати кўтарилганида нима қилиш ва нима қилмаслик керак?','','inherit','closed','closed','','1466-revision-v1','','','2021-08-31 13:14:35','2021-08-31 10:14:35','',1466,'https://reo.ua/?p=1708',0,'revision','',0),(1709,1,'2021-08-31 13:18:01','2021-08-31 10:18:01','','article-scheme-kz-4-1','','inherit','open','closed','','article-scheme-kz-4-1','','','2021-08-31 13:18:01','2021-08-31 10:18:01','',1536,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg',0,'attachment','image/jpeg',0),(1710,1,'2021-08-31 13:18:01','2021-08-31 10:18:01','','article-scheme-kz-4-1','','inherit','open','closed','','article-scheme-kz-4-1-2','','','2021-08-31 13:18:01','2021-08-31 10:18:01','',565,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg',0,'attachment','image/jpeg',0),(1711,1,'2021-08-31 13:18:01','2021-08-31 10:18:01','','article-scheme-kz-4-1','','inherit','open','closed','','article-scheme-kz-4-1-2','','','2021-08-31 13:18:01','2021-08-31 10:18:01','',557,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg',0,'attachment','image/jpeg',0),(1712,1,'2021-08-31 13:18:03','2021-08-31 10:18:03','','article-scheme-kz-4-2','','inherit','open','closed','','article-scheme-kz-4-2','','','2021-08-31 13:18:03','2021-08-31 10:18:03','',1536,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg',0,'attachment','image/jpeg',0),(1713,1,'2021-08-31 13:18:03','2021-08-31 10:18:03','','article-scheme-kz-4-2','','inherit','open','closed','','article-scheme-kz-4-2-2','','','2021-08-31 13:18:03','2021-08-31 10:18:03','',565,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg',0,'attachment','image/jpeg',0),(1714,1,'2021-08-31 13:18:03','2021-08-31 10:18:03','','article-scheme-kz-4-2','','inherit','open','closed','','article-scheme-kz-4-2-2','','','2021-08-31 13:18:03','2021-08-31 10:18:03','',557,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg',0,'attachment','image/jpeg',0),(1715,1,'2021-08-31 13:18:04','2021-08-31 10:18:04','','article-scheme-kz-4-3','','inherit','open','closed','','article-scheme-kz-4-3','','','2021-08-31 13:18:04','2021-08-31 10:18:04','',1536,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg',0,'attachment','image/jpeg',0),(1716,1,'2021-08-31 13:18:04','2021-08-31 10:18:04','','article-scheme-kz-4-3','','inherit','open','closed','','article-scheme-kz-4-3-2','','','2021-08-31 13:18:04','2021-08-31 10:18:04','',565,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg',0,'attachment','image/jpeg',0),(1717,1,'2021-08-31 13:18:04','2021-08-31 10:18:04','','article-scheme-kz-4-3','','inherit','open','closed','','article-scheme-kz-4-3-2','','','2021-08-31 13:18:04','2021-08-31 10:18:04','',557,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg',0,'attachment','image/jpeg',0),(1718,1,'2021-08-31 13:19:03','2021-08-31 10:19:03','Инсон танасининг ички ҳарорати ҳар доим барқарор бўлади, шунинг учун атроф-муҳит ҳарорати ошиб кетганида организм салқинликни талаб қилади. Биринчи навбатда бу қон томирларининг кенгайиши ва тери юзасига қон оқиб келишининг ошиши ҳисобига амалга ошади.  Тернинг буғланиши ҳам терини совитади, лекин ҳаддан ортиқ тер ажралиб чиқиши дегидратацияга олиб келиши мумкин.\r\n\r\nАгар сиз очиқ ҳавода ишласангиз ёки спорт билан шуғуллансангиз сувсизланиш хавфи кўпроқ бўлади. Агар ўз вақтида суюқлик захирасини тўлдирмасангиз, дегидратация ва атроф-муҳитнинг юқори ҳарорати ҳатто инсон ҳаётига хавф солиши мумкин бўладиган иссиқлик уришига олиб келиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg\"><img class=\"aligncenter wp-image-1709 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1-1024x730.jpg\" alt=\"\" width=\"1024\" height=\"730\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>1-расм. Иссиқ ва иссиқлик уришининг белгилари ва симптомлари</strong></p>\r\n&nbsp;\r\n<h2>Иссиқдан зарарланишда нима қилиш керак?</h2>\r\nАгар иссиқ жойда қолишда давом этсангиз иссиқдан зарарланиш ҳаёт ва саломатлик учун хавфли бўлган иссиқ уришига ўтиб кетиши мумкин, шунинг учун қуйидаги тарзда ҳаракат қилиш зарур:\r\n<ul>\r\n 	<li>салқин, соя жойга ўтинг;</li>\r\n 	<li>танангизни совуқ сув билан артинг ва елпиғич билан елпининг;</li>\r\n 	<li>қўлтиқ ости ва чов соҳаларига музли компресс қўйинг;</li>\r\n 	<li>салқин жойга ётинг ва оёқларингизни бир оз кўтаринг;</li>\r\n 	<li>сувсизланишни олдини олиш учун сув ичинг.</li>\r\n</ul>\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nАгар сиз иссиқлик уришининг ҳеч бўлмаганда битта белгисини (тананинг 40 °С дан юқори ҳарорати, терсиз қизил иссиқ қуруқ тери, томирнинг тез кучли уриши, бошнинг тўхтаб-тўхтаб оғриши, қусиш, онгнинг чалкашиши) сезсангиз, дарҳол врачга мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nСуюқлик ва тузлар-электролитларнинг меъёридаги мувозанати бузилганида уни тиклашдан кўра бу мувозанатни сақлаб туриш осонроқ. Шунинг учун чанқоқ ҳис қилишни кутиб ўтирмай, сув ичиб туриш керак. АҚШ Тиббиёт институтининг маълумотларига кўра аёллар бир кунда камида 9 стакан, эркаклар эса 13 стакан сув ичиб туришлари зарур.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\"><img class=\"aligncenter size-full wp-image-1712\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\" alt=\"\" width=\"945\" height=\"459\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Нима ичиш зарур?</h2>\r\nЖисмоний юкланишларда иссиқда соатига 1-2,5 литр тер йўқотилади, бир литр тер таркибидаги натрий эса 100-700 мг ни ташкил этади. Натрийнинг сезиларли танқислиги аҳволни анча ёмонлаштиради ва ҳатто талваса ва онгнинг бузилишига олиб келади. Оддий сув тер ва сийдик билан йўқотилган электролитларнинг ўрнини боса олмайди, шунинг учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган ичимликларни ичиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви сувсизланишнинг олдини олиш ва бартараф этишда ичиш учун тайёр эритма ҳисобланади. ReO суви – бу кам минераллашган сув бўлиб, таркибида барча зарур электролитлар (натрий, калий, магний, кальций) ва сорбитол – ҳужайралар осон ўзлаштирадиган энергиянинг қўшимча манбаи мавжуд. Ёқимли таъми туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам ичиш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"161\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Карбонат кислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минераллашиши (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Иссиқдан зарарланишда нима учун ReO сувини танлаш зарур?</h2>\r\n<ul>\r\n 	<li>ReO мувозанатлаштирилган сув-электролит таркибига эга;</li>\r\n 	<li>ReO сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>ReO таркибида консервантлар, углеводлар ва бўёвчи моддалар йўқ;</li>\r\n 	<li>ReO ёқимли таъмга эга, уни ҳатто кўнгил айниб турганда ҳам ичиш осон.</li>\r\n</ul>\r\n<h2>Иссиқда сувсизланишнинг олдини қандай олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Сувсизланиш ва чанқоқ ҳиссини кутманг. Олдиндан ҳаракат қилинг: ҳар қандай иш ёки бошқа бир жисмоний фаоллик олдидан, шунингдек очиқ жойда бўлишдан олдин сув ичинг.</li>\r\n 	<li>Энг иссиқ соатларда қуёшда бўлишдан сақланинг. Агар бу жуда зарур бўлса, енгил ёпиқ кийим кийинг, қуёшдан ҳимоя кўзойнакларини тақинг, бош кийим кийинг ва қуёшдан ҳимоялаш воситаларидан фойдаланинг.</li>\r\n 	<li>Сув ичиш учун доимий танаффусларни режалаштиринг ва ҳар доим ёнингизда бир бутилка сув олиб юринг.</li>\r\n 	<li>Нафақат сув захирасини, балки тузлар захирасини ҳам тўлдирадиган мувозанатлаштирилган ичимликларни афзал кўринг.</li>\r\n 	<li>Тамадди қилиб олиш учун сувга бой янги мевалар ва сабзавотларни (резавор мевалар, тарвуз, шафтоли, нектаринлар, грейпфрутлар, бодринглар, помидорлар ва ширин қалампир) танланг.</li>\r\n 	<li>Сийдикнинг рангига эътибор беринг. Сийдик ранги тўқ бўлганида ичиладиган суюқлик ҳажмини оширинг.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\"><img class=\"aligncenter size-full wp-image-1715\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\" alt=\"\" width=\"950\" height=\"240\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>3-расм. Қандай қилиб иссиқлик уришининг олдини олиш мумкин?</strong></p>\r\n&nbsp;\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Ёзги иссиқда қандай қилиб иссиқлик уриши ва сувсизланишнинг олдини олиш мумкин?','','inherit','closed','closed','','1536-revision-v1','','','2021-08-31 13:19:03','2021-08-31 10:19:03','',1536,'https://reo.ua/?p=1718',0,'revision','',0),(1719,1,'2021-08-31 13:19:49','2021-08-31 10:19:49','Инсон танасининг ички ҳарорати ҳар доим барқарор бўлади, шунинг учун атроф-муҳит ҳарорати ошиб кетганида организм салқинликни талаб қилади. Биринчи навбатда бу қон томирларининг кенгайиши ва тери юзасига қон оқиб келишининг ошиши ҳисобига амалга ошади.  Тернинг буғланиши ҳам терини совитади, лекин ҳаддан ортиқ тер ажралиб чиқиши дегидратацияга олиб келиши мумкин.\r\n\r\nАгар сиз очиқ ҳавода ишласангиз ёки спорт билан шуғуллансангиз сувсизланиш хавфи кўпроқ бўлади. Агар ўз вақтида суюқлик захирасини тўлдирмасангиз, дегидратация ва атроф-муҳитнинг юқори ҳарорати ҳатто инсон ҳаётига хавф солиши мумкин бўладиган иссиқлик уришига олиб келиши мумкин.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1.jpg\"><img class=\"aligncenter wp-image-1709 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-1-1024x730.jpg\" alt=\"\" width=\"1024\" height=\"730\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Иссиқ ва иссиқлик уришининг белгилари ва симптомлари</strong></p>\r\n&nbsp;\r\n<h2>Иссиқдан зарарланишда нима қилиш керак?</h2>\r\nАгар иссиқ жойда қолишда давом этсангиз иссиқдан зарарланиш ҳаёт ва саломатлик учун хавфли бўлган иссиқ уришига ўтиб кетиши мумкин, шунинг учун қуйидаги тарзда ҳаракат қилиш зарур:\r\n<ul>\r\n 	<li>салқин, соя жойга ўтинг;</li>\r\n 	<li>танангизни совуқ сув билан артинг ва елпиғич билан елпининг;</li>\r\n 	<li>қўлтиқ ости ва чов соҳаларига музли компресс қўйинг;</li>\r\n 	<li>салқин жойга ётинг ва оёқларингизни бир оз кўтаринг;</li>\r\n 	<li>сувсизланишни олдини олиш учун сув ичинг.</li>\r\n</ul>\r\n<h2>Қачон врачга мурожаат қилиш керак?</h2>\r\nАгар сиз иссиқлик уришининг ҳеч бўлмаганда битта белгисини (тананинг 40 °С дан юқори ҳарорати, терсиз қизил иссиқ қуруқ тери, томирнинг тез кучли уриши, бошнинг тўхтаб-тўхтаб оғриши, қусиш, онгнинг чалкашиши) сезсангиз, дарҳол врачга мурожаат қилиш зарур.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nСуюқлик ва тузлар-электролитларнинг меъёридаги мувозанати бузилганида уни тиклашдан кўра бу мувозанатни сақлаб туриш осонроқ. Шунинг учун чанқоқ ҳис қилишни кутиб ўтирмай, сув ичиб туриш керак. АҚШ Тиббиёт институтининг маълумотларига кўра аёллар бир кунда камида 9 стакан, эркаклар эса 13 стакан сув ичиб туришлари зарур.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\"><img class=\"aligncenter size-full wp-image-1712\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-2.jpg\" alt=\"\" width=\"945\" height=\"459\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 2. Сколько необходимо пить?</strong></p>\r\n&nbsp;\r\n<h2>Нима ичиш зарур?</h2>\r\nЖисмоний юкланишларда иссиқда соатига 1-2,5 литр тер йўқотилади, бир литр тер таркибидаги натрий эса 100-700 мг ни ташкил этади. Натрийнинг сезиларли танқислиги аҳволни анча ёмонлаштиради ва ҳатто талваса ва онгнинг бузилишига олиб келади. Оддий сув тер ва сийдик билан йўқотилган электролитларнинг ўрнини боса олмайди, шунинг учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган ичимликларни ичиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви сувсизланишнинг олдини олиш ва бартараф этишда ичиш учун тайёр эритма ҳисобланади. ReO суви – бу кам минераллашган сув бўлиб, таркибида барча зарур электролитлар (натрий, калий, магний, кальций) ва сорбитол – ҳужайралар осон ўзлаштирадиган энергиянинг қўшимча манбаи мавжуд. Ёқимли таъми туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам ичиш мумкин.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\" width=\"312\"><strong>Жадвал. ReO сувининг мувозанатлаштирилган таркиби</strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"151\"><strong>Таркиби</strong></th>\r\n<th width=\"161\"><strong>Миқдори</strong></th>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Na<sup>+</sup></td>\r\n<td width=\"161\">900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">K<sup>+</sup></td>\r\n<td width=\"161\">160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Mg<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Ca<sup>2+</sup></td>\r\n<td width=\"161\">50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Cl<sup>-</sup></td>\r\n<td width=\"161\">1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">HCO<sub>3</sub><sup>-</sup></td>\r\n<td width=\"161\">300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Сорбитол</td>\r\n<td width=\"161\">90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td width=\"151\">Карбонат кислота</td>\r\n<td width=\"161\">0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\" width=\"312\">Минераллашиши (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Иссиқдан зарарланишда нима учун ReO сувини танлаш зарур?</h2>\r\n<ul>\r\n 	<li>ReO мувозанатлаштирилган сув-электролит таркибига эга;</li>\r\n 	<li>ReO сув-туз мувозанатини тиклаш ва сақлаб туришга ёрдам беради;</li>\r\n 	<li>ReO таркибида консервантлар, углеводлар ва бўёвчи моддалар йўқ;</li>\r\n 	<li>ReO ёқимли таъмга эга, уни ҳатто кўнгил айниб турганда ҳам ичиш осон.</li>\r\n</ul>\r\n<h2>Иссиқда сувсизланишнинг олдини қандай олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Сувсизланиш ва чанқоқ ҳиссини кутманг. Олдиндан ҳаракат қилинг: ҳар қандай иш ёки бошқа бир жисмоний фаоллик олдидан, шунингдек очиқ жойда бўлишдан олдин сув ичинг.</li>\r\n 	<li>Энг иссиқ соатларда қуёшда бўлишдан сақланинг. Агар бу жуда зарур бўлса, енгил ёпиқ кийим кийинг, қуёшдан ҳимоя кўзойнакларини тақинг, бош кийим кийинг ва қуёшдан ҳимоялаш воситаларидан фойдаланинг.</li>\r\n 	<li>Сув ичиш учун доимий танаффусларни режалаштиринг ва ҳар доим ёнингизда бир бутилка сув олиб юринг.</li>\r\n 	<li>Нафақат сув захирасини, балки тузлар захирасини ҳам тўлдирадиган мувозанатлаштирилган ичимликларни афзал кўринг.</li>\r\n 	<li>Тамадди қилиб олиш учун сувга бой янги мевалар ва сабзавотларни (резавор мевалар, тарвуз, шафтоли, нектаринлар, грейпфрутлар, бодринглар, помидорлар ва ширин қалампир) танланг.</li>\r\n 	<li>Сийдикнинг рангига эътибор беринг. Сийдик ранги тўқ бўлганида ичиладиган суюқлик ҳажмини оширинг.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\"><img class=\"aligncenter size-full wp-image-1715\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-4-3.jpg\" alt=\"\" width=\"950\" height=\"240\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Қандай қилиб иссиқлик уришининг олдини олиш мумкин?</strong></p>\r\n&nbsp;\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>United States National Library of Medicine. Dehydration. Updated May 2019.</li>\r\n 	<li>Centers for Disease Control and Prevention. Heat stress: hydration. 2017.</li>\r\n 	<li>https://www.verywellfit.com/drink-more-water-during-hot-weather-2506918</li>\r\n 	<li>https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke</li>\r\n 	<li>https://www.khaleejtimes.com/nation/dubai/how-to-avoid-falling-sick-during-uaes-summer-months</li>\r\n 	<li>https://www.active.com/nutrition/articles/11-hydration-strategies-for-hot-weather?page=2</li>\r\n 	<li>https://www.frederickhealth.org/news/2019/june/10-tips-for-staying-hydrated-during-the-summer-h</li>\r\n 	<li>https://www.doctordoctor.com.au/enjoy-summer-tips-prevent-dehydration</li>\r\n</ol>','Ёзги иссиқда қандай қилиб иссиқлик уриши ва сувсизланишнинг олдини олиш мумкин?','','inherit','closed','closed','','1536-revision-v1','','','2021-08-31 13:19:49','2021-08-31 10:19:49','',1536,'https://reo.ua/?p=1719',0,'revision','',0),(1720,1,'2021-08-31 13:22:53','2021-08-31 10:22:53','','article-scheme-kz-5-1','','inherit','open','closed','','article-scheme-kz-5-1','','','2021-08-31 13:22:53','2021-08-31 10:22:53','',1515,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg',0,'attachment','image/jpeg',0),(1721,1,'2021-08-31 13:22:53','2021-08-31 10:22:53','','article-scheme-kz-5-1','','inherit','open','closed','','article-scheme-kz-5-1-2','','','2021-08-31 13:22:53','2021-08-31 10:22:53','',592,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg',0,'attachment','image/jpeg',0),(1722,1,'2021-08-31 13:22:53','2021-08-31 10:22:53','','article-scheme-kz-5-1','','inherit','open','closed','','article-scheme-kz-5-1-2','','','2021-08-31 13:22:53','2021-08-31 10:22:53','',586,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg',0,'attachment','image/jpeg',0),(1723,1,'2021-08-31 13:22:54','2021-08-31 10:22:54','','article-scheme-kz-5-2','','inherit','open','closed','','article-scheme-kz-5-2','','','2021-08-31 13:22:54','2021-08-31 10:22:54','',1515,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg',0,'attachment','image/jpeg',0),(1724,1,'2021-08-31 13:22:54','2021-08-31 10:22:54','','article-scheme-kz-5-2','','inherit','open','closed','','article-scheme-kz-5-2-2','','','2021-08-31 13:22:54','2021-08-31 10:22:54','',592,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg',0,'attachment','image/jpeg',0),(1725,1,'2021-08-31 13:22:54','2021-08-31 10:22:54','','article-scheme-kz-5-2','','inherit','open','closed','','article-scheme-kz-5-2-2','','','2021-08-31 13:22:54','2021-08-31 10:22:54','',586,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg',0,'attachment','image/jpeg',0),(1727,1,'2021-08-31 13:24:45','2021-08-31 10:24:45','Қайт қилиш кўплаб касалликлар ва ҳолатларнинг белгиси ҳисобланади. Сабаблари ҳам ички (ҳомиладорлик, бош мия шишлари, овқат ҳазм қилиш тизими касалликлари), ҳам ташқи омиллар (заҳарланиш) бўлиши мумкин.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1.jpg\"><img class=\"aligncenter wp-image-1720 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-1-1024x391.jpg\" alt=\"\" width=\"1024\" height=\"391\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Қайт қилишнинг кенг тарқалган сабаблари</strong></p>\r\n&nbsp;\r\n\r\nҚайт қилиш – организмнинг ҳимоя механизми бўлиб, заҳарли ёки зарарли моддаларни тезда ошқозондан чиқариб юбориш йўли билан уларнинг сўрилишига тўсқинлик қилади. Шунга қарамай, қайт қилишда кўп миқдорда суюқлик  ва тузлар йўқотилади, бу сувсизланишга ва нохуш белгилар: бош оғриғи ва бош айланиши, чарчоқ, кучли чанқоқ пайдо бўлишига олиб келади. Сийдик рангининг тўқ бўлиши ҳам дегидратация белгиси ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\"><img class=\"aligncenter wp-image-1723\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-5-2.jpg\" alt=\"\" width=\"724\" height=\"465\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Дегидратация белгилари</strong></p>\r\n&nbsp;\r\n<h2>Врачга мурожаат қилинг, агар:</h2>\r\n<ul>\r\n 	<li>кўнгил айниши ва қайт қилиш қаттиқ бош оғриғи, кўришнинг бузилиши, онгнинг бузилиши билан кечаётган бўлса;</li>\r\n 	<li>қайт қилиш катталар ва 2 ёшдан  катта болалар учун 2 кундан ортиқ, 2 ёшгача бўлган болалар учун  24 соат ва ундан ортиқ ва 1 ёшгача бўлган болалар учун 12 соат ва ундан ортиқ давом этаётган бўлса;</li>\r\n 	<li>вақти-вақти  билан бўлиб турадиган кўнгил айниши ва қайт қилиш ҳуружлари 1 ой мобайнида ёки ундан ортиқ безовта қилаётган бўлса;</li>\r\n 	<li>кўнгил айниши ва қайт қилиш тушунтириб бўлмайдиган озиш билан кечаётган бўлса;</li>\r\n 	<li>қусуқ массалари “кофе қуйқаси” каби бўлса, ичида қон бўлса ёки яшил рангли бўлса.</li>\r\n</ul>\r\n<h2>Қайт қилишда нима қилиш керак?</h2>\r\nКўпроқ, лекин оз-оздан суюқлик ичишга ҳаракат қилинг – бу қайт қилиш оқибатидаги сувсизланишнинг олдини олиш имконини беради.\r\n\r\nОрганизмга дам беринг. Ҳаддан ортиқ фаоллик кўнгил айнишини кучайтириши мумкин.\r\n\r\nКучли ҳидлар ва бошқа эҳтимолий қўзғатувчилар: тутун, ҳаддан ортиқ қизиб кетиш ва намлик, автотранспортда юриш, дим хоналарда бўлишдан сақланинг.\r\n\r\nОхирги қайт қилишдан кейин 6 соат мобайнида қаттиқ овқат истеъмол қилманг. Овқатланишни бошлаганингизда осон ҳазм бўладиган оддий овқатлар: тостлар, крекерлар, донли экинлар ёрмалари, гуруч, меваларни истеъмол қилинг.\r\n\r\nОвқатни кам-камдан истеъмол қилинг. Овқатдан сўнг ётиб олманг, бош оёқлардан юқори бўлган (ўтирган, ёнбошлаган) ҳолатда дам олинг.\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nОхирги қайт қилишдан кейинги 6-8 соат ичида ҳар 15 дақиқада бир неча қултумдан суюқлик ичинг ёки муз бўлагини шиминг. Ичилган суюқлик ҳажми нафақат  меъёрдаги кунлик эҳтиёжни (жадвалда келтирилган) таъминлаши, балки қусуқ массалари билан йўқотилган сув ўрнини ҳам қоплаши зарур.\r\n\r\n<strong>Жадвал. Болалар ва турли ёшдаги катталарнинг сувга бўлган эҳтиёжи</strong>\r\n<table width=\"569\">\r\n<tbody>\r\n<tr>\r\n<th><strong>Ёш</strong></th>\r\n<th><strong>Жинси</strong></th>\r\n<th><strong>Бир кунда ичиладиган сув миқдори, стакан </strong></th>\r\n</tr>\r\n<tr>\r\n<td>4-8 ёш</td>\r\n<td>Қизлар ва ўғил болалар</td>\r\n<td>7</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">9-13 ёшҚизлар</td>\r\n<td>Қизлар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">14-18 ёш</td>\r\n<td>Қизлар</td>\r\n<td>10</td>\r\n</tr>\r\n<tr>\r\n<td>Ўғил болалар</td>\r\n<td>14</td>\r\n</tr>\r\n<tr>\r\n<td rowspan=\"2\">&gt;19 ёш</td>\r\n<td>Аёллар</td>\r\n<td>9</td>\r\n</tr>\r\n<tr>\r\n<td>Эркаклар</td>\r\n<td>13</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<em>Изоҳ. Маълумотлар АҚШ Тиббиёт институти тавсияларига мувофиқ тақдим этилган.</em>\r\n<h2>Нима ичиш зарур?</h2>\r\nҚайт қилишда кўп миқдорда сув ва тузлар (электролитлар) йўқотилади, шунинг учун сув-туз мувозанатини тиклаш устувор вазифа ҳисобланади. Регидратация учун таркибида натрий, калий ва магний бўлган мувозанатлаштирилган эритмалардан фойдаланиш мақсадга мувофиқ.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nТиббий мақсадлар учун ReO суви таркибида барча муҳим электролитлари бўлган орал регидратация учун тайёр эритма ҳисобланади.\r\n\r\nУ натрий, хлорид, калий, магний, кальций ва гидрокарбонат ионлари билан бойитилган. Нимшўр таъми  ReO сувини ҳатто кўнгил айниганида ҳам ичиш имконини беради.\r\n<h2>Қандай қилиб қайт қилишнинг олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>Ўтириб ёки ётиб олинг. Чуқур нафас олинг.</li>\r\n 	<li>Жисмоний юкланишлардан, алкоголь, таркибида кофеин бўлган ичимликлар, ёғли ва аччиқ овқатлар истеъмол қилишдан чекланинг.</li>\r\n 	<li>Муз бўлагини шиминг ёки совуқ сув ичинг.</li>\r\n</ul>\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.verywellhealth.com/causes-of-nausea-and-vomiting-1298245</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736#:~:text=Make%20an%20appointment%20with%20your,along%20with%20nausea%20and%20vomiting</li>\r\n 	<li>https://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736</li>\r\n 	<li>https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&amp;contentid=2939</li>\r\n 	<li>https://www.webmd.com/digestive-disorders/understanding-nausea-vomiting-prevention</li>\r\n 	<li>https://www.eatright.org/fitness/sports-and-performance/hydrate-right/water-go-with-the-flow</li>\r\n</ol>','Қайт қилиш сувсизланиш сабаби сифатида','','inherit','closed','closed','','1515-revision-v1','','','2021-08-31 13:24:45','2021-08-31 10:24:45','',1515,'https://reo.ua/?p=1727',0,'revision','',0),(1728,1,'2021-08-31 13:28:23','2021-08-31 10:28:23','','article-scheme-kz-6-2','','inherit','open','closed','','article-scheme-kz-6-2','','','2021-08-31 13:28:23','2021-08-31 10:28:23','',1505,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg',0,'attachment','image/jpeg',0),(1729,1,'2021-08-31 13:28:23','2021-08-31 10:28:23','','article-scheme-kz-6-2','','inherit','open','closed','','article-scheme-kz-6-2-2','','','2021-08-31 13:28:23','2021-08-31 10:28:23','',601,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg',0,'attachment','image/jpeg',0),(1730,1,'2021-08-31 13:28:23','2021-08-31 10:28:23','','article-scheme-kz-6-2','','inherit','open','closed','','article-scheme-kz-6-2-2','','','2021-08-31 13:28:23','2021-08-31 10:28:23','',595,'https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg',0,'attachment','image/jpeg',0),(1731,1,'2021-08-31 13:28:59','2021-08-31 10:28:59','Алкоголли ичимликлар сийдик ҳайдаш таъсирига эга, улар суиистеъмол қилинганида дегидратацияга олиб келади. Ҳаддан ортиқ алкоголь ичишдан кейинги қусиш ҳам суюқлик ва тузлар йўқотилишига олиб келиши мумкин. Айнан сувсизланиш ичкиликдан кейинги карахтлик симптомлари – бош оғриғи, бош айланиши ва чанқоқлик пайдо бўлишининг асосий сабабларидан бири ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Ичкиликдан кейинги карахтликда нима қилиш керак?</h2>\r\nАфсуски, алкоголдан кейинги карахтликни тез ва таъсирчан усул билан бартараф этишнинг имкони йўқ, чунки этил спиртининг заҳарли маҳсулотлари парчаланиши ва организмдан чиқарилиши вақт талаб қилади. Шунга қарамай, ўз организмингизга карахтлик синдромини енгишга ёрдам беришингиз мумкин. Қуйидаги чораларни қўллаб кўрса бўлади:\r\n<ul>\r\n 	<li>бутун кун мобайнида кўпроқ суюқлик ичинг, таркибида электролит (туз)лар бўлган суюқликларни ичиш мақсадга мувофиқ;</li>\r\n 	<li>тўйиб ухлаб олиш зарур;</li>\r\n 	<li>бош оғриғидан рецепсиз бериладиган препаратни қабул қилинг;</li>\r\n 	<li>таркибида кофеин бўлган ичимликларни суиистеъмол қилманг, чунки улар  сувсизланишни кучайтиради ва ошқозон шиллиқ қаватига таъсир қилади</li>\r\n 	<li>ҳаддан ортиқ қуёш нуридан қочинг;</li>\r\n 	<li>ошқозон шиллиқ қаватига таъсир қилмасдан қондаги қанд даражасини кўтариш учун оддий овқат (тост, крекерлар) ни истеъмол қилинг.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nИчкиликдан кейинги карахтликда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Умуман олганда бу ичилган алкоголь миқдори ва унинг ўткирлигига боғлиқ. Карахтлик белгилари мавжудлигида алкоголь суиистеъмол қилингандан кейинги бутун кун давомида бир неча дақиқа оралатиб 1-2 қултумдан сув ичиб туриш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nАлкоголли ичимликлар  организмда сув-туз мувозанатини бузади, бунинг оқибатида бош оғриғи, ҳолсизлик ва серзардалик юз беради. Бу мувозанатни тиклаш учун таркибида электролитлар – натрий, калий, магний, кальций бўлган ичимликларни истеъмол қилиш мақсадга мувофиқ. Бу юқорида санаб ўтилган белгиларни бартараф этишни тезлаштиради. Оддий сув ва газланган ширин ичимликлар таркибида электролитлар жуда паст концентрацияларда бўлади, шунинг учун сув-туз мувозанатини тўлиқ тиклай олмайди.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nReO суви «Юрия-Фарм» корпорацияси томонидан тиббий мақсадлар, хусусан организмнинг сув-туз мувозанатини тиклаш ва сақлаб туриш учун махсус ишлаб чиқилган. ReO сувининг мувозанатлаштирилган таркиби организм йўқотган электролитларни тўлдириш имконини беради, сорбитол эса ҳужайраларга энергия беради. Ёқимли нимшўр мазаси туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам кичик порцияларда ҳўплаб ичса бўлади.\r\n<h2>Карахтликда қачон врачга мурожаат қилиш керак ?</h2>\r\nИчкиликдан кейинги карахтлик – бу  бор-йўғи аксарият ҳолларда бир сутка ичида ўз-ўзидан ўтиб кетадиган  ёқимсиз белгилар мажмуидир. Алкоголдан заҳарланиш – бу бошқа гап, у ҳатто одамнинг ҳаётига хавф солиши мумкин. Агар сизда ва бошқа одамларда қуйидаги белгилар пайдо бўлса врачга мурожаат қилинг:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>талвасалар;</li>\r\n 	<li>тана ҳароратининг пасайиши;</li>\r\n 	<li>секинлашган ёки доимий бўлмаган нафас олиш.</li>\r\n</ul>\r\n<h2>Қандай қилиб ичкиликдан кейинги карахтликнинг олдини олиш мумкин?</h2>\r\nКарахтликни олдини олишнинг энг яхши усули – алкоголь ичишдан тийилиш. Лекин сиз  барибир ичкилик ичишга қарор қилган бўлсангиз, карахтлик синдроми ривожланишининг олдини олиш ёки уни енгиллаштиришнинг бир неча усуллари мавжуд.\r\n<ul>\r\n 	<li>Етарлича  сув ичинг. Алкоголнинг ҳар бир порцияси (25 мл ўткир ичимликлар, 100 мл вино, 259 мл пиво) дан кейин бир стакан  ва уйқу олдидан яна бир стакан қўшимча сув ичишни одат қилинг.</li>\r\n 	<li>Углеводларга бой овқатларни истеъмол қилинг. Жигарранг гуруч ёки макаронлар алкоголнинг ўзлаштирилишини секинлаштириши мумкин.</li>\r\n 	<li>Электролитлар етишмовчилигини тўлдиришга ҳаракат қилинг. Масалан, бананлар ва авокадо таркибида кўп калий, ёнғоқда – магний, тузланган маҳсулотларда – натрий кўп бўлади.</li>\r\n 	<li>Ранги оч ичимликларни танланг, чунки уларда карахтликни кучайтирадиган ферментация маҳсулотлари камроқ бўлади.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Газланган ичимликлардан қочинг, чунки улар алкоголнинг сўрилишини кучайтиради.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg\"><img class=\"aligncenter wp-image-1728 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2-1024x372.jpg\" alt=\"\" width=\"1024\" height=\"372\" /></a>\r\n\r\n&nbsp;\r\n<p style=\"text-align: center;\"><strong>2-расм. Карахтликнинг олдини олиш</strong></p>\r\n\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Алкоголь ичгандан кейинги асоратлар ва у билан бир вақтда кечадиган сувсизланишни қандай енгиш мумкин?','','inherit','closed','closed','','1505-revision-v1','','','2021-08-31 13:28:59','2021-08-31 10:28:59','',1505,'https://reo.ua/?p=1731',0,'revision','',0),(1732,1,'2021-08-31 13:29:33','2021-08-31 10:29:33','Алкоголли ичимликлар сийдик ҳайдаш таъсирига эга, улар суиистеъмол қилинганида дегидратацияга олиб келади. Ҳаддан ортиқ алкоголь ичишдан кейинги қусиш ҳам суюқлик ва тузлар йўқотилишига олиб келиши мумкин. Айнан сувсизланиш ичкиликдан кейинги карахтлик симптомлари – бош оғриғи, бош айланиши ва чанқоқлик пайдо бўлишининг асосий сабабларидан бири ҳисобланади.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2.png\"><img class=\"aligncenter wp-image-825\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t8-blyuvannya_2-1024x659.png\" alt=\"\" width=\"676\" height=\"435\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 1. Симптомы похмелья</strong></p>\r\n\r\n<h2>Ичкиликдан кейинги карахтликда нима қилиш керак?</h2>\r\nАфсуски, алкоголдан кейинги карахтликни тез ва таъсирчан усул билан бартараф этишнинг имкони йўқ, чунки этил спиртининг заҳарли маҳсулотлари парчаланиши ва организмдан чиқарилиши вақт талаб қилади. Шунга қарамай, ўз организмингизга карахтлик синдромини енгишга ёрдам беришингиз мумкин. Қуйидаги чораларни қўллаб кўрса бўлади:\r\n<ul>\r\n 	<li>бутун кун мобайнида кўпроқ суюқлик ичинг, таркибида электролит (туз)лар бўлган суюқликларни ичиш мақсадга мувофиқ;</li>\r\n 	<li>тўйиб ухлаб олиш зарур;</li>\r\n 	<li>бош оғриғидан рецепсиз бериладиган препаратни қабул қилинг;</li>\r\n 	<li>таркибида кофеин бўлган ичимликларни суиистеъмол қилманг, чунки улар  сувсизланишни кучайтиради ва ошқозон шиллиқ қаватига таъсир қилади</li>\r\n 	<li>ҳаддан ортиқ қуёш нуридан қочинг;</li>\r\n 	<li>ошқозон шиллиқ қаватига таъсир қилмасдан қондаги қанд даражасини кўтариш учун оддий овқат (тост, крекерлар) ни истеъмол қилинг.</li>\r\n</ul>\r\n<h2>Қанча суюқлик ичиш керак?</h2>\r\nИчкиликдан кейинги карахтликда ичилиши зарур бўлган суюқлик миқдори бўйича аниқ тавсиялар йўқ. Умуман олганда бу ичилган алкоголь миқдори ва унинг ўткирлигига боғлиқ. Карахтлик белгилари мавжудлигида алкоголь суиистеъмол қилингандан кейинги бутун кун давомида бир неча дақиқа оралатиб 1-2 қултумдан сув ичиб туриш керак.\r\n<h2>Нима ичиш зарур?</h2>\r\nАлкоголли ичимликлар  организмда сув-туз мувозанатини бузади, бунинг оқибатида бош оғриғи, ҳолсизлик ва серзардалик юз беради. Бу мувозанатни тиклаш учун таркибида электролитлар – натрий, калий, магний, кальций бўлган ичимликларни истеъмол қилиш мақсадга мувофиқ. Бу юқорида санаб ўтилган белгиларни бартараф этишни тезлаштиради. Оддий сув ва газланган ширин ичимликлар таркибида электролитлар жуда паст концентрацияларда бўлади, шунинг учун сув-туз мувозанатини тўлиқ тиклай олмайди.\r\n<h2>Тиббий мақсадлар учун ReO суви</h2>\r\nReO суви «Юрия-Фарм» корпорацияси томонидан тиббий мақсадлар, хусусан организмнинг сув-туз мувозанатини тиклаш ва сақлаб туриш учун махсус ишлаб чиқилган. ReO сувининг мувозанатлаштирилган таркиби организм йўқотган электролитларни тўлдириш имконини беради, сорбитол эса ҳужайраларга энергия беради. Ёқимли нимшўр мазаси туфайли ReO сувини ҳатто кўнгил айниб турганида ҳам кичик порцияларда ҳўплаб ичса бўлади.\r\n<h2>Карахтликда қачон врачга мурожаат қилиш керак ?</h2>\r\nИчкиликдан кейинги карахтлик – бу  бор-йўғи аксарият ҳолларда бир сутка ичида ўз-ўзидан ўтиб кетадиган  ёқимсиз белгилар мажмуидир. Алкоголдан заҳарланиш – бу бошқа гап, у ҳатто одамнинг ҳаётига хавф солиши мумкин. Агар сизда ва бошқа одамларда қуйидаги белгилар пайдо бўлса врачга мурожаат қилинг:\r\n<ul>\r\n 	<li>онгнинг бузилиши;</li>\r\n 	<li>талвасалар;</li>\r\n 	<li>тана ҳароратининг пасайиши;</li>\r\n 	<li>секинлашган ёки доимий бўлмаган нафас олиш.</li>\r\n</ul>\r\n<h2>Қандай қилиб ичкиликдан кейинги карахтликнинг олдини олиш мумкин?</h2>\r\nКарахтликни олдини олишнинг энг яхши усули – алкоголь ичишдан тийилиш. Лекин сиз  барибир ичкилик ичишга қарор қилган бўлсангиз, карахтлик синдроми ривожланишининг олдини олиш ёки уни енгиллаштиришнинг бир неча усуллари мавжуд.\r\n<ul>\r\n 	<li>Етарлича  сув ичинг. Алкоголнинг ҳар бир порцияси (25 мл ўткир ичимликлар, 100 мл вино, 259 мл пиво) дан кейин бир стакан  ва уйқу олдидан яна бир стакан қўшимча сув ичишни одат қилинг.</li>\r\n 	<li>Углеводларга бой овқатларни истеъмол қилинг. Жигарранг гуруч ёки макаронлар алкоголнинг ўзлаштирилишини секинлаштириши мумкин.</li>\r\n 	<li>Электролитлар етишмовчилигини тўлдиришга ҳаракат қилинг. Масалан, бананлар ва авокадо таркибида кўп калий, ёнғоқда – магний, тузланган маҳсулотларда – натрий кўп бўлади.</li>\r\n 	<li>Ранги оч ичимликларни танланг, чунки уларда карахтликни кучайтирадиган ферментация маҳсулотлари камроқ бўлади.</li>\r\n 	<li>Избегайте газированных напитков, поскольку они усиливают всасывание алкоголя.</li>\r\n 	<li>Газланган ичимликлардан қочинг, чунки улар алкоголнинг сўрилишини кучайтиради.</li>\r\n</ul>\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2.jpg\"><img class=\"aligncenter wp-image-1728 size-large\" src=\"https://reo.ua/wp-content/uploads/2021/06/article-scheme-kz-6-2-1024x372.jpg\" alt=\"\" width=\"1024\" height=\"372\" /></a>\r\n<p style=\"text-align: center;\"><strong>2-расм. Карахтликнинг олдини олиш</strong></p>\r\n\r\n<h2>Манбалар</h2>\r\n<ol>\r\n 	<li>https://www.healthline.com/health/what-causes-a-hangover#effects-and-associated-symptoms</li>\r\n 	<li>https://letstalkscience.ca/educational-resources/stem-in-context/why-do-people-get-hangovers</li>\r\n 	<li>https://www.healthline.com/health/how-to-sober-up#in-the-morning</li>\r\n 	<li>https://newsnetwork.mayoclinic.org/discussion/consumer-health-when-is-a-hangover-an-emergency</li>\r\n</ol>','Алкоголь ичгандан кейинги асоратлар ва у билан бир вақтда кечадиган сувсизланишни қандай енгиш мумкин?','','inherit','closed','closed','','1505-revision-v1','','','2021-08-31 13:29:33','2021-08-31 10:29:33','',1505,'https://reo.ua/?p=1732',0,'revision','',0),(1735,1,'2021-08-31 14:27:56','2021-08-31 11:27:56','','Бош саҳифа','','inherit','closed','closed','','1331-revision-v1','','','2021-08-31 14:27:56','2021-08-31 11:27:56','',1331,'https://reo.ua/?p=1735',0,'revision','',0),(1734,1,'2021-08-31 14:26:25','2021-08-31 11:26:25','','Бош саҳифа','','inherit','closed','closed','','1331-revision-v1','','','2021-08-31 14:26:25','2021-08-31 11:26:25','',1331,'https://reo.ua/?p=1734',0,'revision','',0),(1740,1,'2021-06-25 10:22:53','2021-06-25 07:22:53','Ҳар қандай жисмоний фаоллик ва спорт машғулотлари терлаш ва оғиз билан тез -тез нафас олиш сабабли танадан суюқликнинг сезиларли даражада йўқолиши билан кечади.\r\n\r\nБу суюқлик йўқотилиши спортчининг самарали натижа кўрсатишига салбий таъсир қилади ва офтоб уриши хавфини оширади. Сувсизланиш даражаси одамнинг ўз омилларига (генетик хусусиятлари, вазни, иқлимга мослашиши), шунингдек атроф -муҳит омилларига (ҳарорат ва намлик, кийимнинг хусусиятлари, жисмоний машқлар давомийлиги ва интенсивлиги) боғлиқ. Бундан ташқари, вазн йўқотиш учун махсус кийимлар кийганда, қаттиқ парҳезларга риоя қилишда, сийдик ҳайдовчи воситаларни қўллашда, кофеин таркибли ичимликлар (қаҳва, энергетик тониклар) ичиш пайтида сувсизланиш эҳтимоли янада ошади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Сувсизланиш хавфи билан боғлиқ омиллар </strong></p>\r\n&nbsp;\r\n<h2>Суюқликни йўқотиш нимаси билан хавфли?</h2>\r\nТана вазнининг атиги 1-2% ҳажмида суюқлик йўқотилиши (масалан, 70 кг оғирликдаги одам учун 700-1400 мл) тана нормал ишлашининг бузилишига ва юракка юкламанинг ошишига олиб келади. 3% йўқотиш ҳатто мушаклар тиришишига олиб келиши мумкин, вазннинг 4% ҳажмида суюқлик йўқотиш эса ўлим демакдир. Суюқликни тер билан йўқотилиши соатига 0,5-2 литр эканлигини ҳисобга олсак, сувсизланишнинг бундай даражасига 1 соатлик интенсив машғулотлардан сўнг, ва ҳатто спортчи сувсизланиш ҳолатида бўлиб туриб машғулотларни бошлаган бўлса, унданда тезроқ эришиш мумкин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Сувсизланишнинг салбий таъсири </strong></p>\r\n&nbsp;\r\n\r\nСуюқликни йўқотиш белгиларига бош айланиши, оғиз қуриши, мушакларнинг тиришиши, сийдикнинг тўқ рангга кириши ва етарлича ухлашга қарамай чарчоқ ҳисси киради.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n<h2>Қанча сув ичиш керак?</h2>\r\nФақатгина чанқоқ ҳисси пайдо бўлишига таянмаслик керак, чунки у дарҳол пайдо бўлмайди ва чанқоқ пайдо бўлиши сувсизланишнинг дастлабки босқичларидан дарак бериши мумкин.\r\n<ul>\r\n 	<li>ухлашдан олдин 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>уйғонишингиз билан 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>машғулотдан 20-30 дақиқа олдин 400-600 мл (1,5-2,5 стакан);</li>\r\n 	<li>ҳар 5-15 дақиқалик машғулотда 400-500 мл (1,5-2 стакан);</li>\r\n 	<li>ҳар 500 г вазн йўқотиш учун 800 мл (3 стакан).</li>\r\n</ul>\r\nУзоқ муддатли машғулотлар билан шуғулланганда, тузларнинг тўғри қабул қилинишини назорат қилиш керак: соатига калий, магний ва 300-600 мг натрий истеъмол қилиш зарур.\r\n<h2>Нима ичиш керак?</h2>\r\nБиринчидан, жисмоний фаоллик пайтида сув керак бўлади, лекин тузлар (электролитлар) ҳам катта аҳамиятга эга. Жисмоний машқлар пайтида кўп сув ичиш кераклигини биладиган спортчилар тез -тез оддий сув ичишади, бу эса суюлтириш натижасида қондаги натрий миқдорининг кескин пасайишига олиб келади. Бу умумий ҳолатни сезиларли даражада ёмонлаштириши мумкин ва ўта оғир ҳолатларда ҳатто ўлимга сабаб бўладиган оқибатлар, масалан, мия шишига олиб келиши мумкин.\r\n\r\nБу ҳолат баъзида сувдан заҳарланиш деб аталади. Бундан ташқари, оддий тузсиз (электролитларсиз) сувни ичиш қорин дам бўлишига олиб келади. Одам чанқоқни ҳис қилмайдиган бўлиб қолади, бу эса кейинчалик сув захираларини керакли миқдорда тўлдириш имкониятини камайтиради, шунингдек, сийдик чиқишини оширади, туз ва суюқлик йўқотилишини кўпайтиради.\r\n\r\nШунинг учун, спортчи учун энг мақбул ичимлик - бу сув-электролит эритмалари бўлиб, бу суюқлик ва тузлар танқислигини тўлдиришга имкон беради.\r\n<h2>Тиббий мақсадлар учун РеО суви</h2>\r\nТиббий мақсадлар учун РеО суви - бу \"энг муҳим электролитлар\" - натрий, калий, кальций, хлорни ўз ичига олган кам минераллаштирилган сув. Ушбу композиция туфайли РеО суви спорт машғулоти пайтида ва ундан кейин сув-туз мувозанатини тиклаш ва сақлашга имкон беради. РеО таркибида бўёқлар ёки консервантлар йўқ, шунингдек таъми ёқимли.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. РеО сувининг мувозанатлаштирилган таркиби </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Компонентлар  </strong></th>\r\n<th width=\"50%\"><strong>Таркиб</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Жисмоний фаоллик вақтида суюқлик йўқотилишини қандай олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>машғулотдан олдин ва кейин ўз вазнингизни кузатиб боринг ва ҳар 500 г вазн йўқотиш учун 800 мл суюқлик ичинг;</li>\r\n 	<li>сийдик рангини кузатинг: агар у одатдагидан кўра тўқроқ бўлса, бу сувсизланиш аломати бўлиши мумкин;</li>\r\n 	<li>сув танқислиги чанқаш, чарчоқ ва сийдик чиқаришнинг камайиши билан ҳам намоён бўлади;</li>\r\n 	<li>спорт кийимларини фаоллик ва ҳарорат даражасига, шунингдек ҳаво намлигига мослаштиринг;</li>\r\n 	<li>машғулотдан олдин, машғулот вақтида ва ундан кейин сув ичинг.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Жисмоний машқлар пайтида қанча сув ичиш керак?','','publish','open','open','','zhismonij-mash%d2%9blar-pajtida-%d2%9bancha-suv-ichish-kerak','','','2021-09-20 11:06:23','2021-09-20 08:06:23','',0,'https://reo.ua/uncategorized-uz/skolko-nuzhno-pit-vo-vremya-trenirovok/',38,'post','',0),(1741,1,'2021-06-25 10:20:03','2021-06-25 07:20:03','','infograph-8','','inherit','open','closed','','infograph-8-2-2','','','2021-06-25 10:20:03','2021-06-25 07:20:03','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-8.jpg',0,'attachment','image/jpeg',0),(1742,1,'2021-07-07 12:13:10','2021-07-07 09:13:10','','во время тренировок','','inherit','open','closed','','vo-vremya-trenirovok-2','','','2021-07-07 12:13:10','2021-07-07 09:13:10','',1740,'https://reo.ua/wp-content/uploads/2021/06/vo-vremya-trenirovok.jpg',0,'attachment','image/jpeg',0),(1743,1,'2021-09-20 10:13:14','2021-09-20 07:13:14','Ҳар қандай жисмоний фаоллик ва спорт машғулотлари терлаш ва оғиз билан тез -тез нафас олиш сабабли танадан суюқликнинг сезиларли даражада йўқолиши билан кечади.\n\nБу суюқлик йўқотилиши спортчининг самарали натижа кўрсатишига салбий таъсир қилади ва офтоб уриши хавфини оширади. Сувсизланиш даражаси одамнинг ўз омилларига (генетик хусусиятлари, вазни, иқлимга мослашиши), шунингдек атроф -муҳит омилларига (ҳарорат ва намлик, кийимнинг хусусиятлари, жисмоний машқлар давомийлиги ва интенсивлиги) боғлиқ. Бундан ташқари, вазн йўқотиш учун махсус кийимлар кийганда, қаттиқ парҳезларга риоя қилишда, сийдик ҳайдовчи воситаларни қўллашда, кофеин таркибли ичимликлар (қаҳва, энергетик тониклар) ичиш пайтида сувсизланиш эҳтимоли янада ошади.\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\n<p style=\"text-align: center;\"><strong>1-расм. Сувсизланиш хавфи билан боғлиқ омиллар </strong></p>\n&nbsp;\n<h2>Суюқликни йўқотиш нимаси билан хавфли?</h2>\nТана вазнининг атиги 1-2% ҳажмида суюқлик йўқотилиши (масалан, 70 кг оғирликдаги одам учун 700-1400 мл) тана нормал ишлашининг бузилишига ва юракка юкламанинг ошишига олиб келади. 3% йўқотиш ҳатто мушаклар тиришишига олиб келиши мумкин, вазннинг 4% ҳажмида суюқлик йўқотиш эса ўлим демакдир. Суюқликни тер билан йўқотилиши соатига 0,5-2 литр эканлигини ҳисобга олсак, сувсизланишнинг бундай даражасига 1 соатлик интенсив машғулотлардан сўнг, ва ҳатто спортчи сувсизланиш ҳолатида бўлиб туриб машғулотларни бошлаган бўлса, унданда тезроқ эришиш мумкин.\n\n&nbsp;\n\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\n<p style=\"text-align: center;\"><strong>2-расм. Сувсизланишнинг салбий таъсири </strong></p>\n&nbsp;\n\nСуюқликни йўқотиш белгиларига бош айланиши, оғиз қуриши, мушакларнинг тиришиши, сийдикнинг тўқ рангга кириши ва етарлича ухлашга қарамай чарчоқ ҳисси киради.\n\n&nbsp;\n\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\n&nbsp;\n<h2>Қанча сув ичиш керак?</h2>\nФақатгина чанқоқ ҳисси пайдо бўлишига таянмаслик керак, чунки у дарҳол пайдо бўлмайди ва чанқоқ пайдо бўлиши сувсизланишнинг дастлабки босқичларидан дарак бериши мумкин.\n<ul>\n 	<li>ухлашдан олдин 500 мл (тахминан 2,5 стакан);</li>\n 	<li>уйғонишингиз билан 500 мл (тахминан 2,5 стакан);</li>\n 	<li>машғулотдан 20-30 дақиқа олдин 400-600 мл (1,5-2,5 стакан);</li>\n 	<li>ҳар 5-15 дақиқалик машғулотда 400-500 мл (1,5-2 стакан);</li>\n 	<li>ҳар 500 г вазн йўқотиш учун 800 мл (3 стакан).</li>\n 	<li></li>\n</ul>\nПри длительных тренировках необходимо контролировать соответствующее поступление солей: необходимо употреблять калий, магний и 300-600 мг натрия в час.\n<h2>Что необходимо пить?</h2>\nПрежде всего при физических нагрузках нужна вода, однако не меньшую важность имеют и соли (электролиты). Спортсмены, которые знают, что во время тренировок необходимо много пить, часто пьют обычную воду, достигая резкого снижения содержания натрия в крови вследствие ее разведения. Это может существенно ухудшить самочувствие, а в крайних случаях привести даже к потенциально летальным последствиям, таким как отек мозга.\n\nТакое состояние иногда называют отравлением водой. Кроме того, питье обычной воды без солей приводит к вздутию живота, угнетает ощущение жажды, уменьшая возможность соответствующего пополнения запасов воды в дальнейшем, а также усиливает диурез, увеличивая потерю солей и жидкости.\n\nПоэтому оптимальным напитком для спортсмена являются водно-электролитные растворы, которые позволяют пополнить дефицит как жидкости, так и солей.\n<h2>Вода для медицинских целей РеО</h2>\nВода для медицинских целей РеО - это маломинерализированная вода, которая содержит «самые важные электролиты» – натрий, калий, кальций, хлор. Благодаря такому составу вода РеО позволяет восстанавливать и поддерживать водно-солевой баланс во время и после тренировок. РeО не содержит красителей и консервантов, а также приятна на вкус.\n<table>\n<tbody>\n<tr>\n<th colspan=\"2\"><strong>Табл. Сбалансированный состав воды РеО</strong></th>\n</tr>\n<tr>\n<th width=\"50%\"><strong>Составляющая</strong></th>\n<th width=\"50%\"><strong>Содержимое</strong></th>\n</tr>\n<tr>\n<td>Na<sup>+</sup></td>\n<td>900 мг/л</td>\n</tr>\n<tr>\n<td>K<sup>+</sup></td>\n<td>160 мг/л</td>\n</tr>\n<tr>\n<td>Mg<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Ca<sup>2+</sup></td>\n<td>50 мг/л</td>\n</tr>\n<tr>\n<td>Cl<sup>-</sup></td>\n<td>1600 мг/л</td>\n</tr>\n<tr>\n<td>HCO<sub>3</sub><sup>-</sup></td>\n<td>300 мг/л</td>\n</tr>\n<tr>\n<td>Сорбитол</td>\n<td>90 мг/л</td>\n</tr>\n<tr>\n<td>Углекислота</td>\n<td>0,05-0,3%</td>\n</tr>\n<tr>\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\n</tr>\n</tbody>\n</table>\n<h2>Как предотвратить потерю жидкости при спортивных нагрузках?</h2>\n<ul>\n 	<li>контролируйте вес до и после тренировки и пейте 800 мл жидкости на каждые 500 г уменьшения веса;</li>\n 	<li>следите за цветом мочи: если он темнее, чем обычно, это может свидетельствовать об обезвоживании;</li>\n 	<li>дефицит жидкости также проявляется жаждой, утомляемостью и уменьшением диуреза;</li>\n 	<li>приспособьте спортивную одежду к уровню нагрузки и температуры, а также влажности воздуха;</li>\n 	<li>пейте до, во время и после тренировки.</li>\n</ul>\n<h2>Список литературы</h2>\n<ol>\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\n</ol>','Жисмоний машқлар пайтида қанча сув ичиш керак?','','inherit','closed','closed','','1740-autosave-v1','','','2021-09-20 10:13:14','2021-09-20 07:13:14','',1740,'https://reo.ua/?p=1743',0,'revision','',0),(1744,1,'2021-09-20 10:14:46','2021-09-20 07:14:46','Ҳар қандай жисмоний фаоллик ва спорт машғулотлари терлаш ва оғиз билан тез -тез нафас олиш сабабли танадан суюқликнинг сезиларли даражада йўқолиши билан кечади.\r\n\r\nБу суюқлик йўқотилиши спортчининг самарали натижа кўрсатишига салбий таъсир қилади ва офтоб уриши хавфини оширади. Сувсизланиш даражаси одамнинг ўз омилларига (генетик хусусиятлари, вазни, иқлимга мослашиши), шунингдек атроф -муҳит омилларига (ҳарорат ва намлик, кийимнинг хусусиятлари, жисмоний машқлар давомийлиги ва интенсивлиги) боғлиқ. Бундан ташқари, вазн йўқотиш учун махсус кийимлар кийганда, қаттиқ парҳезларга риоя қилишда, сийдик ҳайдовчи воситаларни қўллашда, кофеин таркибли ичимликлар (қаҳва, энергетик тониклар) ичиш пайтида сувсизланиш эҳтимоли янада ошади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Сувсизланиш хавфи билан боғлиқ омиллар </strong></p>\r\n&nbsp;\r\n<h2>Суюқликни йўқотиш нимаси билан хавфли?</h2>\r\nТана вазнининг атиги 1-2% ҳажмида суюқлик йўқотилиши (масалан, 70 кг оғирликдаги одам учун 700-1400 мл) тана нормал ишлашининг бузилишига ва юракка юкламанинг ошишига олиб келади. 3% йўқотиш ҳатто мушаклар тиришишига олиб келиши мумкин, вазннинг 4% ҳажмида суюқлик йўқотиш эса ўлим демакдир. Суюқликни тер билан йўқотилиши соатига 0,5-2 литр эканлигини ҳисобга олсак, сувсизланишнинг бундай даражасига 1 соатлик интенсив машғулотлардан сўнг, ва ҳатто спортчи сувсизланиш ҳолатида бўлиб туриб машғулотларни бошлаган бўлса, унданда тезроқ эришиш мумкин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Сувсизланишнинг салбий таъсири </strong></p>\r\n&nbsp;\r\n\r\nСуюқликни йўқотиш белгиларига бош айланиши, оғиз қуриши, мушакларнинг тиришиши, сийдикнинг тўқ рангга кириши ва етарлича ухлашга қарамай чарчоқ ҳисси киради.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>Рис. 3. Признаки дегидратации</strong></p>\r\n&nbsp;\r\n<h2>Қанча сув ичиш керак?</h2>\r\nФақатгина чанқоқ ҳисси пайдо бўлишига таянмаслик керак, чунки у дарҳол пайдо бўлмайди ва чанқоқ пайдо бўлиши сувсизланишнинг дастлабки босқичларидан дарак бериши мумкин.\r\n<ul>\r\n 	<li>ухлашдан олдин 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>уйғонишингиз билан 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>машғулотдан 20-30 дақиқа олдин 400-600 мл (1,5-2,5 стакан);</li>\r\n 	<li>ҳар 5-15 дақиқалик машғулотда 400-500 мл (1,5-2 стакан);</li>\r\n 	<li>ҳар 500 г вазн йўқотиш учун 800 мл (3 стакан).</li>\r\n</ul>\r\nУзоқ муддатли машғулотлар билан шуғулланганда, тузларнинг тўғри қабул қилинишини назорат қилиш керак: соатига калий, магний ва 300-600 мг натрий истеъмол қилиш зарур.\r\n<h2>Нима ичиш керак?</h2>\r\nБиринчидан, жисмоний фаоллик пайтида сув керак бўлади, лекин тузлар (электролитлар) ҳам катта аҳамиятга эга. Жисмоний машқлар пайтида кўп сув ичиш кераклигини биладиган спортчилар тез -тез оддий сув ичишади, бу эса суюлтириш натижасида қондаги натрий миқдорининг кескин пасайишига олиб келади. Бу умумий ҳолатни сезиларли даражада ёмонлаштириши мумкин ва ўта оғир ҳолатларда ҳатто ўлимга сабаб бўладиган оқибатлар, масалан, мия шишига олиб келиши мумкин.\r\n\r\nБу ҳолат баъзида сувдан заҳарланиш деб аталади. Бундан ташқари, оддий тузсиз (электролитларсиз) сувни ичиш қорин дам бўлишига олиб келади. Одам чанқоқни ҳис қилмайдиган бўлиб қолади, бу эса кейинчалик сув захираларини керакли миқдорда тўлдириш имкониятини камайтиради, шунингдек, сийдик чиқишини оширади, туз ва суюқлик йўқотилишини кўпайтиради.\r\n\r\nШунинг учун, спортчи учун энг мақбул ичимлик - бу сув-электролит эритмалари бўлиб, бу суюқлик ва тузлар танқислигини тўлдиришга имкон беради.\r\n<h2>Тиббий мақсадлар учун РеО суви</h2>\r\nТиббий мақсадлар учун РеО суви - бу \"энг муҳим электролитлар\" - натрий, калий, кальций, хлорни ўз ичига олган кам минераллаштирилган сув. Ушбу композиция туфайли РеО суви спорт машғулоти пайтида ва ундан кейин сув-туз мувозанатини тиклаш ва сақлашга имкон беради. РеО таркибида бўёқлар ёки консервантлар йўқ, шунингдек таъми ёқимли.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. РеО сувининг мувозанатлаштирилган таркиби </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Компонентлар  </strong></th>\r\n<th width=\"50%\"><strong>Таркиб</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Жисмоний фаоллик вақтида суюқлик йўқотилишини қандай олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>машғулотдан олдин ва кейин ўз вазнингизни кузатиб боринг ва ҳар 500 г вазн йўқотиш учун 800 мл суюқлик ичинг;</li>\r\n 	<li>сийдик рангини кузатинг: агар у одатдагидан кўра тўқроқ бўлса, бу сувсизланиш аломати бўлиши мумкин;</li>\r\n 	<li>сув танқислиги чанқаш, чарчоқ ва сийдик чиқаришнинг камайиши билан ҳам намоён бўлади;</li>\r\n 	<li>спорт кийимларини фаоллик ва ҳарорат даражасига, шунингдек ҳаво намлигига мослаштиринг;</li>\r\n 	<li>машғулотдан олдин, машғулот вақтида ва ундан кейин сув ичинг.</li>\r\n 	<li></li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Жисмоний машқлар пайтида қанча сув ичиш керак?','','inherit','closed','closed','','1740-revision-v1','','','2021-09-20 10:14:46','2021-09-20 07:14:46','',1740,'https://reo.ua/?p=1744',0,'revision','',0),(1745,1,'2021-06-25 10:20:46','2021-06-25 07:20:46','','infograph-9','','inherit','open','closed','','infograph-9','','','2021-06-25 10:20:46','2021-06-25 07:20:46','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-9.jpg',0,'attachment','image/jpeg',0),(1746,1,'2021-06-25 10:21:19','2021-06-25 07:21:19','','infograph-10','','inherit','open','closed','','infograph-10','','','2021-06-25 10:21:19','2021-06-25 07:21:19','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-10.jpg',0,'attachment','image/jpeg',0),(1747,1,'2021-06-29 18:07:00','2021-06-29 15:07:00','','infograph-20-ru','','inherit','open','closed','','infograph-20-ru-2','','','2021-06-29 18:07:00','2021-06-29 15:07:00','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ru.jpg',0,'attachment','image/jpeg',0),(1748,1,'2021-06-29 18:07:02','2021-06-29 15:07:02','','infograph-20-ua','','inherit','open','closed','','infograph-20-ua-2','','','2021-06-29 18:07:02','2021-06-29 15:07:02','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-20-ua.jpg',0,'attachment','image/jpeg',0),(1749,1,'2021-06-29 18:07:04','2021-06-29 15:07:04','','infograph-21-ru','','inherit','open','closed','','infograph-21-ru-2','','','2021-06-29 18:07:04','2021-06-29 15:07:04','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg',0,'attachment','image/jpeg',0),(1750,1,'2021-06-29 18:07:05','2021-06-29 15:07:05','','infograph-21-ua','','inherit','open','closed','','infograph-21-ua-2','','','2021-06-29 18:07:05','2021-06-29 15:07:05','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-21-ua.jpg',0,'attachment','image/jpeg',0),(1751,1,'2021-06-29 18:07:06','2021-06-29 15:07:06','','infograph-22-ru','','inherit','open','closed','','infograph-22-ru-2','','','2021-06-29 18:07:06','2021-06-29 15:07:06','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ru.jpg',0,'attachment','image/jpeg',0),(1752,1,'2021-06-29 18:07:07','2021-06-29 15:07:07','','infograph-22-ua','','inherit','open','closed','','infograph-22-ua-2','','','2021-06-29 18:07:07','2021-06-29 15:07:07','',1740,'https://reo.ua/wp-content/uploads/2021/06/infograph-22-ua.jpg',0,'attachment','image/jpeg',0),(1753,1,'2021-07-07 14:19:20','2021-07-07 11:19:20','','Web_REO_T4 во время тренировок_2','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_2-2','','','2021-07-07 14:19:20','2021-07-07 11:19:20','',1740,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_2.png',0,'attachment','image/png',0),(1754,1,'2021-07-07 14:20:12','2021-07-07 11:20:12','','Web_REO_T4 во время тренировок_1 (1)','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_1-1-2','','','2021-07-07 14:20:12','2021-07-07 11:20:12','',1740,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png',0,'attachment','image/png',0),(1755,1,'2021-07-07 15:19:16','2021-07-07 12:19:16','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4','','','2021-07-07 15:19:16','2021-07-07 12:19:16','',1740,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4.png',0,'attachment','image/png',0),(1756,1,'2021-07-07 16:26:47','2021-07-07 13:26:47','','Web_REO_T4 во время тренировок_4','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_4-2','','','2021-07-07 16:26:47','2021-07-07 13:26:47','',1740,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_4-1.png',0,'attachment','image/png',0),(1757,1,'2021-07-07 16:28:35','2021-07-07 13:28:35','','Web_REO_T4 во время тренировок_3','','inherit','open','closed','','web_reo_t4-vo-vremya-trenirovok_3-2','','','2021-07-07 16:28:35','2021-07-07 13:28:35','',1740,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png',0,'attachment','image/png',0),(1759,1,'2021-09-20 11:06:23','2021-09-20 08:06:23','Ҳар қандай жисмоний фаоллик ва спорт машғулотлари терлаш ва оғиз билан тез -тез нафас олиш сабабли танадан суюқликнинг сезиларли даражада йўқолиши билан кечади.\r\n\r\nБу суюқлик йўқотилиши спортчининг самарали натижа кўрсатишига салбий таъсир қилади ва офтоб уриши хавфини оширади. Сувсизланиш даражаси одамнинг ўз омилларига (генетик хусусиятлари, вазни, иқлимга мослашиши), шунингдек атроф -муҳит омилларига (ҳарорат ва намлик, кийимнинг хусусиятлари, жисмоний машқлар давомийлиги ва интенсивлиги) боғлиқ. Бундан ташқари, вазн йўқотиш учун махсус кийимлар кийганда, қаттиқ парҳезларга риоя қилишда, сийдик ҳайдовчи воситаларни қўллашда, кофеин таркибли ичимликлар (қаҳва, энергетик тониклар) ичиш пайтида сувсизланиш эҳтимоли янада ошади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Сувсизланиш хавфи билан боғлиқ омиллар </strong></p>\r\n&nbsp;\r\n<h2>Суюқликни йўқотиш нимаси билан хавфли?</h2>\r\nТана вазнининг атиги 1-2% ҳажмида суюқлик йўқотилиши (масалан, 70 кг оғирликдаги одам учун 700-1400 мл) тана нормал ишлашининг бузилишига ва юракка юкламанинг ошишига олиб келади. 3% йўқотиш ҳатто мушаклар тиришишига олиб келиши мумкин, вазннинг 4% ҳажмида суюқлик йўқотиш эса ўлим демакдир. Суюқликни тер билан йўқотилиши соатига 0,5-2 литр эканлигини ҳисобга олсак, сувсизланишнинг бундай даражасига 1 соатлик интенсив машғулотлардан сўнг, ва ҳатто спортчи сувсизланиш ҳолатида бўлиб туриб машғулотларни бошлаган бўлса, унданда тезроқ эришиш мумкин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Сувсизланишнинг салбий таъсири </strong></p>\r\n&nbsp;\r\n\r\nСуюқликни йўқотиш белгиларига бош айланиши, оғиз қуриши, мушакларнинг тиришиши, сийдикнинг тўқ рангга кириши ва етарлича ухлашга қарамай чарчоқ ҳисси киради.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n<h2>Қанча сув ичиш керак?</h2>\r\nФақатгина чанқоқ ҳисси пайдо бўлишига таянмаслик керак, чунки у дарҳол пайдо бўлмайди ва чанқоқ пайдо бўлиши сувсизланишнинг дастлабки босқичларидан дарак бериши мумкин.\r\n<ul>\r\n 	<li>ухлашдан олдин 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>уйғонишингиз билан 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>машғулотдан 20-30 дақиқа олдин 400-600 мл (1,5-2,5 стакан);</li>\r\n 	<li>ҳар 5-15 дақиқалик машғулотда 400-500 мл (1,5-2 стакан);</li>\r\n 	<li>ҳар 500 г вазн йўқотиш учун 800 мл (3 стакан).</li>\r\n</ul>\r\nУзоқ муддатли машғулотлар билан шуғулланганда, тузларнинг тўғри қабул қилинишини назорат қилиш керак: соатига калий, магний ва 300-600 мг натрий истеъмол қилиш зарур.\r\n<h2>Нима ичиш керак?</h2>\r\nБиринчидан, жисмоний фаоллик пайтида сув керак бўлади, лекин тузлар (электролитлар) ҳам катта аҳамиятга эга. Жисмоний машқлар пайтида кўп сув ичиш кераклигини биладиган спортчилар тез -тез оддий сув ичишади, бу эса суюлтириш натижасида қондаги натрий миқдорининг кескин пасайишига олиб келади. Бу умумий ҳолатни сезиларли даражада ёмонлаштириши мумкин ва ўта оғир ҳолатларда ҳатто ўлимга сабаб бўладиган оқибатлар, масалан, мия шишига олиб келиши мумкин.\r\n\r\nБу ҳолат баъзида сувдан заҳарланиш деб аталади. Бундан ташқари, оддий тузсиз (электролитларсиз) сувни ичиш қорин дам бўлишига олиб келади. Одам чанқоқни ҳис қилмайдиган бўлиб қолади, бу эса кейинчалик сув захираларини керакли миқдорда тўлдириш имкониятини камайтиради, шунингдек, сийдик чиқишини оширади, туз ва суюқлик йўқотилишини кўпайтиради.\r\n\r\nШунинг учун, спортчи учун энг мақбул ичимлик - бу сув-электролит эритмалари бўлиб, бу суюқлик ва тузлар танқислигини тўлдиришга имкон беради.\r\n<h2>Тиббий мақсадлар учун РеО суви</h2>\r\nТиббий мақсадлар учун РеО суви - бу \"энг муҳим электролитлар\" - натрий, калий, кальций, хлорни ўз ичига олган кам минераллаштирилган сув. Ушбу композиция туфайли РеО суви спорт машғулоти пайтида ва ундан кейин сув-туз мувозанатини тиклаш ва сақлашга имкон беради. РеО таркибида бўёқлар ёки консервантлар йўқ, шунингдек таъми ёқимли.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. РеО сувининг мувозанатлаштирилган таркиби </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Компонентлар  </strong></th>\r\n<th width=\"50%\"><strong>Таркиб</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Жисмоний фаоллик вақтида суюқлик йўқотилишини қандай олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>машғулотдан олдин ва кейин ўз вазнингизни кузатиб боринг ва ҳар 500 г вазн йўқотиш учун 800 мл суюқлик ичинг;</li>\r\n 	<li>сийдик рангини кузатинг: агар у одатдагидан кўра тўқроқ бўлса, бу сувсизланиш аломати бўлиши мумкин;</li>\r\n 	<li>сув танқислиги чанқаш, чарчоқ ва сийдик чиқаришнинг камайиши билан ҳам намоён бўлади;</li>\r\n 	<li>спорт кийимларини фаоллик ва ҳарорат даражасига, шунингдек ҳаво намлигига мослаштиринг;</li>\r\n 	<li>машғулотдан олдин, машғулот вақтида ва ундан кейин сув ичинг.</li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. Nutrients. 2019; 11 (7): 1550.</li>\r\n 	<li>Available at: https://www.fastandup.in/blog/importance-of-hydration-for-athletes.</li>\r\n 	<li>Available at: https://www.sportsperformancebulletin.com/nutrition-for-endurance-athletes/fuelling-and-hydration-for-exercise/dehydration-sport-vital-athlete-maintains-hydration-levels-exercise.</li>\r\n 	<li>Available at: https://www.usada.org/athletes/substances/nutrition/fluids-and-hydration.</li>\r\n</ol>','Жисмоний машқлар пайтида қанча сув ичиш керак?','','inherit','closed','closed','','1740-revision-v1','','','2021-09-20 11:06:23','2021-09-20 08:06:23','',1740,'https://reo.ua/?p=1759',0,'revision','',0),(1758,1,'2021-09-20 11:05:53','2021-09-20 08:05:53','Ҳар қандай жисмоний фаоллик ва спорт машғулотлари терлаш ва оғиз билан тез -тез нафас олиш сабабли танадан суюқликнинг сезиларли даражада йўқолиши билан кечади.\r\n\r\nБу суюқлик йўқотилиши спортчининг самарали натижа кўрсатишига салбий таъсир қилади ва офтоб уриши хавфини оширади. Сувсизланиш даражаси одамнинг ўз омилларига (генетик хусусиятлари, вазни, иқлимга мослашиши), шунингдек атроф -муҳит омилларига (ҳарорат ва намлик, кийимнинг хусусиятлари, жисмоний машқлар давомийлиги ва интенсивлиги) боғлиқ. Бундан ташқари, вазн йўқотиш учун махсус кийимлар кийганда, қаттиқ парҳезларга риоя қилишда, сийдик ҳайдовчи воситаларни қўллашда, кофеин таркибли ичимликлар (қаҳва, энергетик тониклар) ичиш пайтида сувсизланиш эҳтимоли янада ошади.\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3.png\"><img class=\"aligncenter wp-image-915\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_3-1024x869.png\" alt=\"\" width=\"760\" height=\"645\" /></a>\r\n<p style=\"text-align: center;\"><strong>1-расм. Сувсизланиш хавфи билан боғлиқ омиллар </strong></p>\r\n&nbsp;\r\n<h2>Суюқликни йўқотиш нимаси билан хавфли?</h2>\r\nТана вазнининг атиги 1-2% ҳажмида суюқлик йўқотилиши (масалан, 70 кг оғирликдаги одам учун 700-1400 мл) тана нормал ишлашининг бузилишига ва юракка юкламанинг ошишига олиб келади. 3% йўқотиш ҳатто мушаклар тиришишига олиб келиши мумкин, вазннинг 4% ҳажмида суюқлик йўқотиш эса ўлим демакдир. Суюқликни тер билан йўқотилиши соатига 0,5-2 литр эканлигини ҳисобга олсак, сувсизланишнинг бундай даражасига 1 соатлик интенсив машғулотлардан сўнг, ва ҳатто спортчи сувсизланиш ҳолатида бўлиб туриб машғулотларни бошлаган бўлса, унданда тезроқ эришиш мумкин.\r\n\r\n&nbsp;\r\n\r\n<img class=\"aligncenter wp-image-624\" src=\"https://reo.ua/wp-content/uploads/2021/06/infograph-21-ru.jpg\" alt=\"\" width=\"772\" height=\"321\" />\r\n<p style=\"text-align: center;\"><strong>2-расм. Сувсизланишнинг салбий таъсири </strong></p>\r\n&nbsp;\r\n\r\nСуюқликни йўқотиш белгиларига бош айланиши, оғиз қуриши, мушакларнинг тиришиши, сийдикнинг тўқ рангга кириши ва етарлича ухлашга қарамай чарчоқ ҳисси киради.\r\n\r\n&nbsp;\r\n\r\n<a href=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1.png\"><img class=\"aligncenter wp-image-895\" src=\"https://reo.ua/wp-content/uploads/2021/06/web_reo_t4-vo-vremya-trenirovok_1-1-1024x624.png\" alt=\"\" width=\"771\" height=\"470\" /></a>\r\n<p style=\"text-align: center;\"><strong>3-расм. Сувсизланиш белгилари</strong></p>\r\n&nbsp;\r\n<h2>Қанча сув ичиш керак?</h2>\r\nФақатгина чанқоқ ҳисси пайдо бўлишига таянмаслик керак, чунки у дарҳол пайдо бўлмайди ва чанқоқ пайдо бўлиши сувсизланишнинг дастлабки босқичларидан дарак бериши мумкин.\r\n<ul>\r\n 	<li>ухлашдан олдин 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>уйғонишингиз билан 500 мл (тахминан 2,5 стакан);</li>\r\n 	<li>машғулотдан 20-30 дақиқа олдин 400-600 мл (1,5-2,5 стакан);</li>\r\n 	<li>ҳар 5-15 дақиқалик машғулотда 400-500 мл (1,5-2 стакан);</li>\r\n 	<li>ҳар 500 г вазн йўқотиш учун 800 мл (3 стакан).</li>\r\n</ul>\r\nУзоқ муддатли машғулотлар билан шуғулланганда, тузларнинг тўғри қабул қилинишини назорат қилиш керак: соатига калий, магний ва 300-600 мг натрий истеъмол қилиш зарур.\r\n<h2>Нима ичиш керак?</h2>\r\nБиринчидан, жисмоний фаоллик пайтида сув керак бўлади, лекин тузлар (электролитлар) ҳам катта аҳамиятга эга. Жисмоний машқлар пайтида кўп сув ичиш кераклигини биладиган спортчилар тез -тез оддий сув ичишади, бу эса суюлтириш натижасида қондаги натрий миқдорининг кескин пасайишига олиб келади. Бу умумий ҳолатни сезиларли даражада ёмонлаштириши мумкин ва ўта оғир ҳолатларда ҳатто ўлимга сабаб бўладиган оқибатлар, масалан, мия шишига олиб келиши мумкин.\r\n\r\nБу ҳолат баъзида сувдан заҳарланиш деб аталади. Бундан ташқари, оддий тузсиз (электролитларсиз) сувни ичиш қорин дам бўлишига олиб келади. Одам чанқоқни ҳис қилмайдиган бўлиб қолади, бу эса кейинчалик сув захираларини керакли миқдорда тўлдириш имкониятини камайтиради, шунингдек, сийдик чиқишини оширади, туз ва суюқлик йўқотилишини кўпайтиради.\r\n\r\nШунинг учун, спортчи учун энг мақбул ичимлик - бу сув-электролит эритмалари бўлиб, бу суюқлик ва тузлар танқислигини тўлдиришга имкон беради.\r\n<h2>Тиббий мақсадлар учун РеО суви</h2>\r\nТиббий мақсадлар учун РеО суви - бу \"энг муҳим электролитлар\" - натрий, калий, кальций, хлорни ўз ичига олган кам минераллаштирилган сув. Ушбу композиция туфайли РеО суви спорт машғулоти пайтида ва ундан кейин сув-туз мувозанатини тиклаш ва сақлашга имкон беради. РеО таркибида бўёқлар ёки консервантлар йўқ, шунингдек таъми ёқимли.\r\n<table>\r\n<tbody>\r\n<tr>\r\n<th colspan=\"2\"><strong>Жадвал. РеО сувининг мувозанатлаштирилган таркиби </strong></th>\r\n</tr>\r\n<tr>\r\n<th width=\"50%\"><strong>Компонентлар  </strong></th>\r\n<th width=\"50%\"><strong>Таркиб</strong></th>\r\n</tr>\r\n<tr>\r\n<td>Na<sup>+</sup></td>\r\n<td>900 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>K<sup>+</sup></td>\r\n<td>160 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Mg<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Ca<sup>2+</sup></td>\r\n<td>50 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Cl<sup>-</sup></td>\r\n<td>1600 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>HCO<sub>3</sub><sup>-</sup></td>\r\n<td>300 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Сорбитол</td>\r\n<td>90 мг/л</td>\r\n</tr>\r\n<tr>\r\n<td>Углекислота</td>\r\n<td>0,05-0,3%</td>\r\n</tr>\r\n<tr>\r\n<td colspan=\"2\">Минерализация (мг/дм<sup>3</sup>): 2500-3000</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h2>Жисмоний фаоллик вақтида суюқлик йўқотилишини қандай олдини олиш мумкин?</h2>\r\n<ul>\r\n 	<li>машғулотдан олдин ва кейин ўз вазнингизни кузатиб боринг ва ҳар 500 г вазн йўқотиш учун 800 мл суюқлик ичинг;</li>\r\n 	<li>сийдик рангини кузатинг: агар у одатдагидан кўра тўқроқ бўлса, бу сувсизланиш аломати бўлиши мумкин;</li>\r\n 	<li>сув танқислиги чанқаш, чарчоқ ва сийдик чиқаришнинг камайиши билан ҳам намоён бўлади;</li>\r\n 	<li>спорт кийимларини фаоллик ва ҳарорат даражасига, шунингдек ҳаво намлигига мослаштиринг;</li>\r\n 	<li>машғулотдан олдин, машғулот вақтида ва ундан кейин сув ичинг.</li>\r\n 	<li></li>\r\n</ul>\r\n<h2>Адабиётлар рўйхати</h2>\r\n<ol>\r\n 	<li>Рекомендации Международного общества спортивного питания (2018). Kerksick C.M., Wilborn C.D., Roberts M.D., et al. ISSN exercise &amp; sports nutrition review update: research &amp; recommendations. J. Int. Soc. Sports Nutr. 2018; 15 (38).</li>\r\n 	<li>Belval L., Hosokawa Y., Casa D., et al. Practical hydration solutions for sports. 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150_ua','','inherit','open','closed','','winetime_logo_370-x-150_ua','','','2022-07-14 12:43:43','2022-07-14 09:43:43','',747,'https://reo.ua/wp-content/uploads/2022/07/winetime_logo_370-x-150_ua.jpg',0,'attachment','image/jpeg',0),(1848,1,'2022-07-14 12:43:43','2022-07-14 09:43:43','','winetime_logo_370 x 150_ua','','inherit','open','closed','','winetime_logo_370-x-150_ua-2','','','2022-07-14 12:43:43','2022-07-14 09:43:43','',776,'https://reo.ua/wp-content/uploads/2022/07/winetime_logo_370-x-150_ua.jpg',0,'attachment','image/jpeg',0),(1849,1,'2022-07-14 12:43:43','2022-07-14 09:43:43','','winetime_logo_370 x 150_ua','','inherit','open','closed','','winetime_logo_370-x-150_ua-2','','','2022-07-14 12:43:43','2022-07-14 09:43:43','',1387,'https://reo.ua/wp-content/uploads/2022/07/winetime_logo_370-x-150_ua.jpg',0,'attachment','image/jpeg',0),(1850,1,'2022-07-14 12:44:02','2022-07-14 09:44:02','<p style=\"text-align: center;\">Воду для медичних цілей РеО (ReO) можна придбати в аптеках та магазинах вашого міста:</p>','Де придбати','','inherit','closed','closed','','747-revision-v1','','','2022-07-14 12:44:02','2022-07-14 09:44:02','',747,'https://reo.ua/?p=1850',0,'revision','',0),(1851,1,'2022-07-14 12:44:44','2022-07-14 09:44:44','<p style=\"text-align: center;\">Воду для медицинских целей РеО (ReO) можно приобрести в аптеках и магазинах вашего города:</p>','Где купить','','inherit','closed','closed','','776-revision-v1','','','2022-07-14 12:44:44','2022-07-14 09:44:44','',776,'https://reo.ua/?p=1851',0,'revision','',0),(1858,1,'2022-09-15 18:15:15','2022-09-15 15:15:15','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – Политика) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Махфийлик сиёсати','','inherit','closed','closed','','1385-revision-v1','','','2022-09-15 18:15:15','2022-09-15 15:15:15','',1385,'https://reo.ua/?p=1858',0,'revision','',0),(1859,1,'2022-09-15 18:16:33','2022-09-15 15:16:33','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – <strong>Политика</strong>) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Махфийлик сиёсати','','inherit','closed','closed','','1385-revision-v1','','','2022-09-15 18:16:33','2022-09-15 15:16:33','',1385,'https://reo.ua/?p=1859',0,'revision','',0),(1860,1,'2022-09-15 18:16:55','2022-09-15 15:16:55','Нам очень важно защитить ваши персональные данные. Мы обязуемся защищать конфиденциальность лиц, которые посещают наш Веб-сайт и используют наши онлайн-инструменты. В настоящей Политике конфиденциальности (далее – <strong>Политика</strong>) мы хотим рассказать Вам о порядке сбора, обработки и использования персональных данных.\r\n\r\nПожалуйста, обратите внимание, что Вы принимаете эту Политику конфиденциальности в случае просмотра или использования Веб-сайта независимо от того, попросят ли Вас дать дополнительное разрешение при использовании Веб-сайта. Знакомство с этой политикой конфиденциальности является исключительно вашей ответственностью.\r\n<ol>\r\n 	<li><strong> Информация, которую мы собираем</strong></li>\r\n</ol>\r\n1.1. При использовании Веб-сайта Вы можете принять решение о предоставлении нам определенной информации о Вас, заполняя онлайн-формы, регистрируясь на нашем Веб-сайте, делая заказы, обращаясь к нам и т.д. Видами персональной информации, которую Вы можете нам предоставить, могут быть без ограничения контактная информация (адрес, электронная почта, номер телефона), имя пользователя и личные предпочтения, интересы и использование различных продуктов и услуг, содержание коммуникации с нами. Для доступа на Веб-сайт Вы не обязаны предоставлять вышеперечисленные персональные данные, однако в таком случае некоторые функции могут быть Вам недоступны.\r\n\r\n1.2. Сразу после того, как Вы зашли на сайт, мы можем автоматически получить некоторую информацию, которая может быть использована для Вашей идентификации, например номер домена, IP-адрес Вашего компьютера, вид используемого Вами браузера, операционной системы и платформы, техническая информация , информация о географическом местоположении во время посещения Веб-сайта (длительность пребывания, популярные продукты, время отклика страницы, пути навигации, а также информация о времени, частоте и способе использования услуги Вами и др.). Мы можем использовать такую ​​информацию отдельно или в совокупности для технического управления нашим Веб-сайтом, аналитической системы отслеживания, исследований и разработок. Цель такой обработки – мониторинг и улучшение нашего веб-сайта и услуг.\r\n<ol start=\"2\">\r\n 	<li><strong> Обработка персональных данных</strong></li>\r\n</ol>\r\nМы защищаем ваши данные, ограничивая доступ к вашим данным только лицами, которые должны иметь к ним доступ для осуществления или упрощения операций между вами и нами, или лицами, которые по другим причинам должны выполнять действия, описанные в данном разделе.\r\n\r\n2.1. Мы можем обрабатывать Вашу информацию, указанную в Вашем профиле на нашем Веб-сайте. Данные профиля могут содержать Ваше имя, адрес, номер телефона, адрес электронной почты, фото профиля, пол, дату рождения, семейный статус, интересы и хобби, данные об образовании и месте работы. Мы сознательно не собираем информацию о лицах младше 18 лет. Данные профиля могут быть обработаны для предоставления Вам возможности использования и мониторинга нашего Веб-сайта и услуг, создания Вашего личного профиля и управления им, работы с Веб-сайтом, предоставления наших услуг, обеспечения безопасности нашего Веб-сайта и услуг, резервного хранения данных в наших базах и общение с Вами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.2. Мы можем обрабатывать информацию, публикуемую на нашем Веб-сайте или через наши услуги. Данные публикации могут быть обработаны с целью разрешения публикаций или управления нашим Веб-сайтом и услугами. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.3. Мы можем обрабатывать информацию по Вашему запросу о товарах и/или услугах. Данные запроса могут быть обработаны с целью предложения, маркетинга и продажи соответствующих товаров и/или услуг и для обработки Ваших отдельных запросов. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.4. Мы можем обрабатывать информацию, связанную с взаимоотношениями с клиентами, включая контактную информацию клиента. Данные о взаимоотношениях клиента могут включать имя, место работы, название должности или роли, контактную информацию, информацию, полученную в коммуникации между нами. Данные о взаимоотношениях клиента могут обрабатываться с целью управления нашими взаимоотношениями с клиентами, коммуникации с клиентами, ведения записей о такой коммуникации, помощи при выборе товаров и предоставления Вам рекомендаций, рекламирования наших товаров и услуг клиентам. Целью такой обработки является надлежащее управление взаимоотношениями с клиентом.\r\n\r\n2.5. Мы можем обрабатывать предоставленную Вами информацию с целью подписания Вас на наши электронные рассылки и/или информационные письма. Данные о сообщениях могут обрабатываться с целью отправки Вам соответствующих сообщений и/или информационных писем, информации о нашей продукции, услугах и рекламных материалах. Цель такой обработки – надлежащее управление нашим Веб-сайтом и бизнесом.\r\n\r\n2.6. В дополнение к целям, для которых мы можем обрабатывать Ваши персональные данные, изложенные в этом разделе, мы также можем обрабатывать Ваши персональные данные, если такая обработка необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других лиц.\r\n<ol start=\"3\">\r\n 	<li><strong> Предоставление Ваших персональных данных другим лицам.</strong></li>\r\n</ol>\r\n3.1. Мы не передаем в аренду, не продаем или иным образом не разглашаем персональную информацию, которую мы собираем, за исключением описанных ниже случаев. Мы можем поделиться вашими персональными данными для осуществления действий, описанных в данном разделе.\r\n\r\n3.2. Мы можем огласить Ваши персональные данные любому участнику нашей группы компаний (т.е. дочерним предприятиям, конечной холдинговой компании и всем ее дочерним предприятиям), если это обоснованно необходимо для целей и правовых оснований, предусмотренных этой политикой.\r\n\r\n3.3. Мы можем огласить Ваши персональные данные нашим поставщикам услуг, предоставляющим услуги от нашего имени, по нашим распоряжениям, страховщикам или профессиональным консультантам, если это обоснованно необходимо для получения соответствующей страховки, управления рисками, получения профессиональной консультации и предоставления услуг.\r\n\r\nМы можем поделиться вашими персональными данными с нашими поставщиками услуг, участвующими в наших бизнес-процессах.\r\n\r\n<strong>Пример использования персональных данных нашими поставщиками услуг:</strong>\r\n<ul>\r\n 	<li>мы передаем Вашу персональную информацию поставщикам услуг, которые помогают нам в деятельности, связанной с маркетингом и анализом данных, чтобы сообщать Вам и предоставлять рекомендации о нашей продукции, в том числе о распродажах, специальных предложениях, новых характеристиках Веб-сайта, направлять Вам сообщения рекламного характера.</li>\r\n</ul>\r\nНашими поставщиками маркетинговых услуг и данных являются \"Google Analytics\", \"Google Ads\", \"Facebook Ads\", \"Contact Form 7\", \"AddThis\", \"Microsoft Dynamics 365 Marketing\", \"Sales Force\" и другие. Политика конфиденциальности наших поставщиков услуг доступна на их веб-сайтах. Мы не анализируем деятельность таких поставщиков услуг, страховщиков и профессиональных консультантов перед использованием или разглашением персональной информации, кроме случаев, когда это необходимо для предоставления услуг от нашего имени или выполнения требований закона, однако в любом случае мы не несем никакой ответственности за действия (деятельность)/бездействие таких поставщиков услуг.\r\n\r\n3.4. В дополнение к частным случаям разглашения, изложенным в этом разделе, мы также можем разглашать Ваши персональные данные, если такое разглашение информации необходимо для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов или жизненно важных интересов других физических лиц. Мы также можем разглашать ваши персональные данные, если такое разглашение необходимо для установления, реализации или защиты законных требований в судебном разбирательстве либо в административном порядке, либо в порядке досудебного разрешения спора.\r\n<ol start=\"4\">\r\n 	<li><strong> Передача Ваших персональных данных за границу</strong></li>\r\n</ol>\r\n4.1. В данном разделе мы предоставляем информацию о случаях, когда персональные данные могут передаваться за пределы Украины.\r\n\r\n4.2. Мы можем передавать Ваши персональные данные нашим контрагентам за пределами Украины (иностранным субъектам отношений, связанных с персональными данными) для предоставления услуг от нашего имени и/или выполнения требований законодательства. Передача иностранным субъектам отношений, связанных с персональными данными, будет защищена надлежащими средствами защиты и будет осуществляться при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.3. Хостинг нашего Веб-сайта находится в центрах данных г. Киев, Украина (хостинговый сервис: HOSTiQ). В случае передачи данных на хостинг иностранным субъектам отношений, связанных с персональными данными, такие данные будут защищены надлежащими средствами защиты и только при условии обеспечения соответствующим государством надлежащей защиты персональных данных в случаях, установленных законодательством Украины или международными договорами Украины.\r\n\r\n4.4. Если Вы заходите на данный Веб-сайт в стране, отличной от страны пребывания нашего сервера, коммуникация между нами может предусматривать передачу информации за пределы международных государственных границ. Посещая наш Веб-сайт или иным образом вступая с нами в электронную коммуникацию, Вы соглашаетесь с такой передачей. Даже если в Вашей юрисдикции отсутствуют такие же законодательные нормы о конфиденциальности, как в юрисдикции местонахождения сервера, мы будем считать Вашу информацию подлежащей защите этой политикой конфиденциальности.\r\n<ol start=\"5\">\r\n 	<li><strong> Сообщения и рассылки</strong></li>\r\n</ol>\r\nЗаполнив регистрационную форму на сайте и проставив при составлении регистрационной формы графического символа в поле, где предлагается дать согласие на рассылку информационных и маркетинговых сообщений, содержащих информацию о товарах и/или услугах, рекламные и коммерческие предложения по таким товарам и/или услугам, со ссылками на условия такого согласия (далее – Сообщение), вы дали согласие на использование ваших контактных данных (адрес электронной почты, номер телефона, другие сетевые идентификаторы абонента) для отправки Вам Сообщений (подписываетесь на рассылку) от нас, а также наших партнеров, в частности, ГУ «Институт патологии крови и трансфузионной медицины НАМН Украины», ЧП «Инфузия» (далее – Согласие).\r\n\r\nВ случае внесения дальнейших изменений в Политику, мы сообщим Вам о таких изменениях письмом на электронную почту, адрес которой указан Вами при регистрации.\r\n\r\nИнформационные и рекламные рассылки осуществляются на основании Вашего согласия (подписки на рассылки), оформленного Вами через Сайт, путем регистрации на онлайн-мероприятие, или при заказе товаров и/или услуг через Сайт, заполнение отдельной формы подписки на рассылки или формы обратной связи связи.\r\n\r\nМы можем направлять Вам информационные и рекламные рассылки, содержащие информацию о товарах и/или услугах, маркетинговые, рекламные и коммерческие предложения по таким товарам и/или услугам.\r\n\r\nМы осуществляем информационные, рекламные, маркетинговые рассылки в виде электронных писем, сообщений Viber, SMS-сообщений.\r\n\r\n<strong>Вы можете в любое время бесплатно, в простой и понятной форме отказаться от получения информационных и рекламных сообщений (отписаться от рассылок) и отозвать свое Соглашение на получение сообщений (рассылку).</strong>\r\n\r\nПорядок отписки от рассылки:\r\n<ul>\r\n 	<li><strong>Электронные письма. </strong>Для отказа от получения сообщений (отписки от рассылки), отсылаемых по адресу вашей электронной почты, перейдите по гиперссылке «отписаться от рассылки», которая находится в конце каждого электронного письма.</li>\r\n 	<li><strong>Viber</strong><strong>-рассылки. </strong>Для отказа от получения Сообщений (отписки от рассылки), которые посылаются через приложение Viber на Вашем смартфоне, Вам необходимо в самом приложении Viber выбрать контакт, из которого Вы получаете Сообщение от нас, нажать «Детально» и снять галочку «Получать сообщение».</li>\r\n 	<li><strong>SMS-рассылка. </strong>Чтобы отписаться от рассылки SMS-сообщений, напишите, пожалуйста, в произвольной форме обращение об отсылке от SMS-рассылки на почтовый ящик <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. В своем письме обязательно укажите Ваш контактный номер телефона, который Вы хотите отписать от рассылки.</li>\r\n</ul>\r\n<ol start=\"6\">\r\n 	<li><strong> Сохранение и удаление персональных данных</strong></li>\r\n</ol>\r\n6.1. В данном разделе описана политика и процедура хранения данных, обеспечивающая соблюдение нами юридических обязательств по хранению и удалению персональных данных.\r\n\r\n6.2. Мы можем хранить вашу персональную информацию только в течение срока, в течение которого у нас есть законный интерес для этого. После того, как необходимость в соответствующих данных отпала, мы удаляем информацию, которая может каким-либо образом идентифицировать Ваше лицо, однако можем хранить анонимизированные (обезличенные) данные, например, для аналитических или исследовательских целей, в частности, нами может осуществляться передача такой информации третьим лицам, однако только при удалении каких-либо персональных данных о Вас.\r\n\r\n6.3. Ваши персональные данные хранятся в течение минимального периода – 1 рабочий день после предоставления Вашего согласия с настоящей Политикой конфиденциальности, а также в течение максимального периода – 3 рабочих дня после уведомления об отмене подписки или запроса об удалении данных.\r\n\r\n6.4. Несмотря на вышеизложенные положения настоящего раздела 6, мы сохраняем Ваши персональные данные, если такая сохранность информации необходима для выполнения юридических обязательств, в соответствии с которыми мы обязаны это сделать для защиты Ваших жизненно важных интересов, или жизненно важных интересов других физических лиц\r\n<ol start=\"7\">\r\n 	<li><strong> Изменения и дополнения </strong></li>\r\n</ol>\r\n7.1. Мы можем периодически обновлять эту Политику, публикуя новую версию на нашем Веб-сайте.\r\n\r\n7.2. Мы можем в любой момент изменить или дополнить данную Политику по нашему усмотрению. Такие изменения вступают в силу сразу же после опубликования сообщения об изменении или добавлении на данном сайте. Мы также можем сообщать Вам об изменении Политики через электронную почту или другие средства электронной коммуникации.\r\n\r\nПродолжая использовать Веб-сайт, Вы подтверждаете согласие с условиями Политики с соответствующими изменениями и дополнениям.\r\n<ol start=\"8\">\r\n 	<li><strong> Ваши права и обязанности</strong></li>\r\n</ol>\r\n8.1. В данном разделе мы дадим краткую справку о Ваших правах по законодательству о защите данных. Некоторые права комплексны и не все подробности включены в нашу справку. Таким образом, Вам следует ознакомиться с соответствующими законами и наставлениями регуляторных органов, чтобы получить полное разъяснение таких прав.\r\n\r\n8.2. Вы имеете право на исправление любых неправильных персональных данных о Вас и с учетом целей обработки на дополнение неполных персональных данных о Вас.\r\n\r\n8.3. В некоторых случаях Вы имеете право удалить Ваши персональные данные без промедления. К таким случаям относятся:\r\n<ul>\r\n 	<li>персональные данные, которые уже не нужны для целей, для которых они собирались или обрабатывались иным образом;</li>\r\n 	<li>отмена Вами согласия на обработку данных, обработка которых требует Вашего согласия;</li>\r\n 	<li>если Вы против обработки данных в соответствии с нормами законодательства о защите данных;</li>\r\n 	<li>незаконная обработка персональных данных.</li>\r\n</ul>\r\nПри этом существуют исключения из права на удаление данных. Общее исключение подразумевает необходимость обработки для реализации свободы выражения и права на информацию; соблюдение предусмотренного законом обязательства; предъявление, реализацию или защиту законных претензий.\r\n\r\n8.4. В некоторых случаях вы имеете право ограничить обработку персональных данных. К таким случаям относятся:\r\n<ul>\r\n 	<li>обработка была произведена незаконным путем, однако Вы против удаления данных;</li>\r\n 	<li>нам уже не нужны персональные данные для целей, в которых они обрабатывались, но Вам понадобились персональные данные для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>Вы против обработки до проверки такого протеста.</li>\r\n</ul>\r\nЕсли обработка была ограничена на этом основании, мы можем продолжать хранить ваши персональные данные. При этом мы все равно будем производить ее обработку другим путем:\r\n<ul>\r\n 	<li>по Вашему согласию, для предъявления, реализации или защиты законных претензий;</li>\r\n 	<li>для защиты прав других физических или юридических лиц;</li>\r\n 	<li>по другим причинам, связанным с важными общественными интересами.</li>\r\n</ul>\r\n8.5. Чтобы помочь нам защитить вашу приватность:\r\n<ul>\r\n 	<li>завершите сеанс на сайте после завершения работы с ним;</li>\r\n 	<li>дайте нам правдивую, точную и полную информацию;</li>\r\n 	<li>не используйте Веб-сайт, если Вы моложе 18 лет;</li>\r\n 	<li>не предоставляйте нам информацию о любом другом лице, если у вас нет на это разрешения.</li>\r\n</ul>\r\n8.6. Если Вы хотите узнать больше о том, какую информацию о Вас мы храним, включая изменения или запросы на удаление, Вы имеете право подать Запрос субъекта персональных данных. Вы можете запросить по электронному адресу <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>. Просим обратить внимание на то, что мы должны будем исключить некоторую информацию как часть Вашего запроса, например, для защиты конфиденциальности других лиц, или если у нас есть законные или другие причины исключать такую ​​информацию.\r\n\r\n8.7. Пожалуйста, обратите внимание, что удаление вашей персональной информации ограничит нашу возможность связаться с вами для предоставления предложений, что, в свою очередь, ограничит вашу возможность воспользоваться такими предложениями.\r\n<ol start=\"9\">\r\n 	<li><strong> Файлы </strong><strong>Cookie</strong></li>\r\n</ol>\r\n9.1. Сookie – это файлы, содержащие идентификатор (набор букв и цифр), отправленный интернет-сервером интернет-браузера и хранящийся в браузере. Затем идентификатор следует обратно на сервер каждый раз, когда браузер запрашивает страницу на сервере.\r\n\r\n9.2. Cookie – файлы могут быть \"постоянными\" или \"сессионными\". Постоянные cookie хранятся в браузере и действуют до даты истечения срока действия, если не будут удалены до наступления такой даты; сессионные cookie прекращают действие после завершения сессии пользователем после закрытия браузера.\r\n<ol start=\"10\">\r\n 	<li><strong>Сookie</strong><strong>, которые мы используем.</strong></li>\r\n</ol>\r\n10.1. Мы используем cookie в следующих целях:\r\n<ul>\r\n 	<li>аутентификация – мы используем cookie для Вашей идентификации при посещении Вами Веб-сайта и навигации по нему;</li>\r\n 	<li>статус – мы используем cookie, чтобы помочь определить, вошли ли вы на наш Веб-сайт под своим логином;</li>\r\n 	<li>персонализация – мы используем cookie, чтобы хранить информацию о Ваших предпочтениях и персонализировать Веб-сайт под ваши потребности;</li>\r\n 	<li>безопасность – мы используем cookie как элемент защиты учетной записи пользователя, в том числе для предотвращения несанкционированного использования данных входа и защиты нашего Веб-сайта и услуг в целом;</li>\r\n 	<li>реклама – мы используем cookie, чтобы показывать рекламу, которая может быть интересна Вам;</li>\r\n 	<li>анализ – мы используем cookie, чтобы проанализировать эффективность нашего Веб-сайта и услуг;</li>\r\n 	<li>согласие – мы используем cookie, чтобы сохранять Ваши предпочтения по использованию cookie для более крупных целей.</li>\r\n</ul>\r\n<ol start=\"11\">\r\n 	<li><strong>Сookie</strong><strong>, используемые нашими поставщиками услуг.</strong></li>\r\n</ol>\r\n11.1. Наши поставщики услуг используют cookie и они могут храниться на вашем компьютере при посещении Веб-сайта.\r\n\r\n11.2. Для анализа использования нашего Веб-сайта мы используем Google Analytics. Google Analytics собирает информацию об использовании нашего Веб-сайта с помощью cookie. Собранная информация, касающаяся нашего Веб-сайта, используется для создания отчетов по использованию нашего Веб-сайта. Политика конфиденциальности Google доступна по <a href=\"https://policies.google.com/privacy?hl=uk\" target=\"_blank\" rel=\"noopener\"><strong>этой ссылке</strong></a>.\r\n\r\n11.3. Сookies от Analytics помогает нам понять, сколько посетителей заходит на наш Веб-сайт, сколько раз они его посетили и сколько раз просматривались определенные страницы на нашем сайте. Несмотря на то, что cookie аналитики позволяют нам собирать определенную информацию о Вашей веб истории или о том, сколько раз Вы заходили на сайт, мы не можем использовать это чтобы узнать Ваши данные, например, имя или адрес.\r\n<ol start=\"12\">\r\n 	<li><strong> Управление файлами </strong><strong>Cookie</strong></li>\r\n</ol>\r\n12.1. Если вы не хотите принимать cookies от нашего Веб-сайта, вы можете изменить настройки вашего браузера и cookie больше не будут приниматься. Если вы примете такое решение, пожалуйста, обратите внимание, что Веб-сайт не сможет функционировать как раньше.\r\n\r\n12.2. Все популярные браузеры (Google Chrome, Safari, Microsoft Edge, Firefox, Samsung Internet, Opera) позволяют изменять настройки cookie таким образом, чтобы не включать их ни на каких посещаемых Вами сайтах. Вы можете найти информацию об отключении cookie в основных браузерах в разделе \"Как управлять файлами cookie\", в частности на <a href=\"https://ico.org.uk/for-the-public/online/cookies\" target=\"_blank\" rel=\"noopener\"><strong>Веб-сайте Офиса Уполномоченно</strong><strong>го по информации Великобритании</strong></a>.\r\n<ol start=\"13\">\r\n 	<li><strong> Как с нами связаться</strong></li>\r\n</ol>\r\nПо вопросам обработки персональных данных, пожалуйста, обращайтесь:\r\nТел.: +38 (044) 246-83-83\r\nE-mail: <a href=\"mailto:uf@uf.ua\"><u>uf</u><u>@</u><u>uf</u><u>.</u><u>ua</u></a>\r\nБудем рады приветствовать Вас! Мы очень ценим ваше мнение, комментарии или предложения – они помогают нам улучшать качество нашей работы.\r\n<strong>Настоящая Политика в редакции на </strong><strong>12</strong><strong>.0</strong><strong>9</strong><strong>.2022.</strong>','Политика конфиденциальности','','inherit','closed','closed','','293-revision-v1','','','2022-09-15 18:16:55','2022-09-15 15:16:55','',293,'https://reo.ua/?p=1860',0,'revision','',0),(1862,1,'2022-09-28 11:52:14','2022-09-28 08:52:14','<p style=\"text-align: center;\">Воду для медицинских целей РеО (ReO) можно приобрести в аптеках и магазинах вашего города:</p>','Где купить','','inherit','closed','closed','','776-revision-v1','','','2022-09-28 11:52:14','2022-09-28 08:52:14','',776,'https://reo.ua/?p=1862',0,'revision','',0);
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14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(90,NULL,NULL,101,'post','acf-field',1,100,NULL,NULL,'Заголовок','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:34:07','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(91,NULL,NULL,102,'post','acf-field',1,100,NULL,NULL,'Формула','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:34:07','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(92,NULL,NULL,103,'post','acf-field',1,100,NULL,NULL,'Текст','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:34:07','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(93,NULL,NULL,106,'post','acf-field',1,40,NULL,NULL,'Преимущество 1','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:38:35','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(94,NULL,NULL,107,'post','acf-field',1,40,NULL,NULL,'Преимущество 2','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:38:35','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(95,NULL,NULL,108,'post','acf-field',1,40,NULL,NULL,'Преимущество 3','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:38:35','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(96,NULL,NULL,109,'post','acf-field',1,40,NULL,NULL,'Преимущество 4','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-08 14:38:35','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(98,NULL,NULL,112,'post','acf-field',1,111,NULL,NULL,'Про воду','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(99,NULL,NULL,113,'post','acf-field',1,111,NULL,NULL,'Про воду','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(100,NULL,NULL,114,'post','acf-field',1,111,NULL,NULL,'Компоненты','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(101,NULL,NULL,115,'post','acf-field',1,111,NULL,NULL,'Помощь','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(102,NULL,NULL,116,'post','acf-field',1,111,NULL,NULL,'Приемущества &#8212; список 1','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(103,NULL,NULL,117,'post','acf-field',1,116,NULL,NULL,'Строка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(104,NULL,NULL,118,'post','acf-field',1,111,NULL,NULL,'Приемущества &#8212; список 2','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(105,NULL,NULL,119,'post','acf-field',1,118,NULL,NULL,'Строка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(106,NULL,NULL,120,'post','acf-field',1,111,NULL,NULL,'Приемущества','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(107,NULL,NULL,121,'post','acf-field',1,111,NULL,NULL,'Заголовок','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(108,NULL,NULL,122,'post','acf-field',1,111,NULL,NULL,'Список','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(109,NULL,NULL,123,'post','acf-field',1,122,NULL,NULL,'Иконка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(110,NULL,NULL,124,'post','acf-field',1,122,NULL,NULL,'Текст','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(111,NULL,NULL,125,'post','acf-field',1,111,NULL,NULL,'Слоган','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:29:44','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(112,NULL,NULL,127,'post','attachment',1,11,NULL,NULL,'symptoms-icon-1','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-09 07:35:18','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(113,NULL,NULL,128,'post','attachment',1,11,NULL,NULL,'symptoms-icon-2','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-09 07:35:18','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(114,NULL,NULL,129,'post','attachment',1,11,NULL,NULL,'symptoms-icon-5','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-09 07:35:19','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(115,NULL,NULL,130,'post','attachment',1,11,NULL,NULL,'symptoms-icon-6','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-09 07:35:19','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(116,NULL,NULL,131,'post','attachment',1,11,NULL,NULL,'symptoms-icon-7','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-09 07:35:20','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(117,NULL,NULL,136,'post','acf-field',1,111,NULL,NULL,'Компоненты','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:58:30','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(118,NULL,NULL,137,'post','acf-field',1,136,NULL,NULL,'Заголовок','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:58:30','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(119,NULL,NULL,138,'post','acf-field',1,136,NULL,NULL,'Формула/заголовок','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:58:30','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(120,NULL,NULL,139,'post','acf-field',1,136,NULL,NULL,'Объем','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:58:30','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(121,NULL,NULL,140,'post','acf-field',1,136,NULL,NULL,'Текст','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 07:58:30','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(122,NULL,NULL,4,'term','category',NULL,NULL,NULL,NULL,'Без категории',NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 08:33:24','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(123,'https://reo.ua/ru/','18:fc83c7d21d66288575fe2ab18dc61e73',176,'post','page',1,0,NULL,NULL,'Главная','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 08:51:34','2021-11-16 09:46:39',1,NULL,NULL,NULL,NULL,0,NULL,2,'2021-09-30 17:24:30','2021-06-08 12:21:10'),(298,'https://reo.ua/ru/category/dlya-mediczinskih-speczialistov/reo-v-pediatrii-ru/','78:4fabef692e32116fd9a07bc19565d840',34,'term','category',NULL,NULL,NULL,NULL,'RеО в педиатрии',NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-25 08:07:47','2021-11-16 10:10:53',1,NULL,NULL,NULL,NULL,1,NULL,2,'2021-07-14 07:17:03','2021-06-25 10:03:00'),(124,'https://reo.ua/ru/about/','24:92000a06a15c69c2104e3dc66727c70c',177,'post','page',1,0,NULL,NULL,'Про воду ReO','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 08:51:39','2021-12-21 08:28:06',1,NULL,NULL,NULL,NULL,0,NULL,2,'2021-12-21 10:28:06','2021-06-08 12:22:03'),(125,'https://reo.ua/ru/maker/','24:cae17b4fd033dada2a499599717822ef',178,'post','page',1,0,NULL,NULL,'Производитель','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 08:51:43','2021-11-16 18:01:09',1,NULL,NULL,NULL,NULL,0,NULL,2,'2021-06-15 08:11:59','2021-06-08 12:32:00'),(126,'https://reo.ua/ru/bez-kategorii/182/','46:0e378d15727bd0b8c4e65645536001a0',182,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:44','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(127,'https://reo.ua/ru/bez-kategorii/yak-piti-vodu-reo-2/','62:b11be9fa18b5b334d4b075af694ca4ff',183,'post','nav_menu_item',1,0,NULL,NULL,'Как пить воду РеО','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(128,NULL,NULL,184,'post','nav_menu_item',1,0,NULL,NULL,'Где купить','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(129,'https://reo.ua/ru/bez-kategorii/185/','46:6b3593a3ae9616d7c5af18ccf3083ebb',185,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(130,'https://reo.ua/ru/bez-kategorii/chasti-pitannya-2/','60:8a2367f4855f5b85477b47a7cf7564ef',186,'post','nav_menu_item',1,0,NULL,NULL,'Частые вопросы','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(131,NULL,NULL,187,'post','nav_menu_item',1,0,NULL,NULL,'Контакты','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(132,NULL,NULL,188,'post','nav_menu_item',1,0,NULL,NULL,'Для потребителя','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(133,NULL,NULL,189,'post','nav_menu_item',1,0,NULL,NULL,'RеО при повышенной температуре','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(134,NULL,NULL,190,'post','nav_menu_item',1,0,NULL,NULL,'RеО при пищевых отравлениях','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(135,NULL,NULL,191,'post','nav_menu_item',1,0,NULL,NULL,'RеО при кишечных инфекциях','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(136,NULL,NULL,192,'post','nav_menu_item',1,0,NULL,NULL,'RеО во время беременности','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(137,NULL,NULL,193,'post','nav_menu_item',1,0,NULL,NULL,'RеО во время занятий спортом','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(138,NULL,NULL,194,'post','nav_menu_item',1,0,NULL,NULL,'RеО при похмельном синдроме','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(139,NULL,NULL,195,'post','nav_menu_item',1,0,NULL,NULL,'Для медицинских специалистов','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(140,NULL,NULL,196,'post','nav_menu_item',1,0,NULL,NULL,'RеО в терапевтической практике','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(141,NULL,NULL,197,'post','nav_menu_item',1,0,NULL,NULL,'RеО в акушерстве и гинекологии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(142,NULL,NULL,198,'post','nav_menu_item',1,0,NULL,NULL,'RеО в педиатрии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(143,NULL,NULL,199,'post','nav_menu_item',1,0,NULL,NULL,'RеО в хирургии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(144,NULL,NULL,200,'post','nav_menu_item',1,0,NULL,NULL,'ReO в гастроэнтерологии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(145,NULL,NULL,201,'post','nav_menu_item',1,0,NULL,NULL,'ReO в аллергологии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(146,NULL,NULL,202,'post','nav_menu_item',1,0,NULL,NULL,'ReO в дерматологии и косметологии','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 14:03:58',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(147,NULL,NULL,203,'post','nav_menu_item',1,0,NULL,NULL,'Для провизора','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-09 09:02:45','2021-06-09 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09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(543,'https://reo.ua/wp-content/uploads/2021/07/socar.webp','52:2c8799978f225dbcc677275cae842131',1281,'post','attachment',1,776,NULL,NULL,'socar','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-27 07:24:50','2021-07-27 04:24:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(154,NULL,NULL,217,'post','acf-field',1,212,NULL,NULL,'Про юрия фарм','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:18:44','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(155,NULL,NULL,221,'post','acf-field',1,212,NULL,NULL,'Заголовок','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:25:18','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(156,NULL,NULL,222,'post','acf-field',1,212,NULL,NULL,'Кружок 1','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:25:18','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(157,NULL,NULL,223,'post','acf-field',1,212,NULL,NULL,'Кружок 2','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:25:18','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(296,'https://reo.ua/ru/category/dlya-mediczinskih-speczialistov/reo-v-dermatologii-i-kosmetologii/','93:6633529f8225952c35db0c14af380d04',32,'term','category',NULL,NULL,NULL,NULL,'ReO в дерматологии и косметологии',NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-25 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12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(163,NULL,NULL,230,'post','acf-field',1,229,NULL,NULL,'Иконка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:44:48','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(220,NULL,NULL,346,'post','attachment',1,176,NULL,NULL,'reo-slider_RU_8','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/reo-slider_ru_8.jpg',NULL,'346','attachment-image',NULL,NULL,NULL,'346','attachment-image',NULL,NULL,NULL,NULL,'2021-06-16 12:52:07','2021-06-24 10:23:47',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(164,NULL,NULL,231,'post','acf-field',1,229,NULL,NULL,'Текст','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-06-15 07:44:48','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(165,NULL,NULL,232,'post','attachment',1,178,NULL,NULL,'facts-icon-1','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-15 07:45:30','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(166,NULL,NULL,234,'post','attachment',1,178,NULL,NULL,'facts-icon-2','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-15 07:45:31','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(167,NULL,NULL,236,'post','attachment',1,178,NULL,NULL,'facts-icon-3','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-15 07:45:32','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(219,NULL,NULL,344,'post','attachment',1,176,NULL,NULL,'reo-slider_RU_7','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/reo-slider_ru_7.jpg',NULL,'344','attachment-image',NULL,NULL,NULL,'344','attachment-image',NULL,NULL,NULL,NULL,'2021-06-16 12:52:05','2021-06-24 10:23:47',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(168,NULL,NULL,238,'post','attachment',1,178,NULL,NULL,'facts-icon-4','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-15 07:45:32','2021-06-15 12:18:24',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(169,NULL,NULL,240,'post','attachment',1,178,NULL,NULL,'facts-icon-5','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-06-15 07:45:33','2021-06-15 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(2)','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t9-regidradacziya-u-doroslih_1-2.png',NULL,'1054','attachment-image',NULL,NULL,NULL,'1054','attachment-image',NULL,NULL,2,NULL,'2021-07-09 11:30:45','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(474,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png','75:8ee5a04935d375b3e7ffaba128612d6b',1059,'post','attachment',1,473,NULL,NULL,'Web_REO_T6 при беременности_2','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t6-pri-beremennosti_2.png',NULL,'1059','attachment-image',NULL,NULL,NULL,'1059','attachment-image',NULL,NULL,4,NULL,'2021-07-09 11:58:06','2021-08-28 12:46:55',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(476,NULL,'102:315710ff33e4058366d56b88e13e3001',1090,'post','attachment',1,422,NULL,NULL,'Web_REO_T5 при повышении температуры тела_1 (1)','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_1-1.png',NULL,'1090','attachment-image',NULL,NULL,NULL,'1090','attachment-image',NULL,NULL,2,NULL,'2021-07-13 10:19:04','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(477,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png','92:4170200260b05e8e8a38429a7d3296a9',1098,'post','attachment',1,432,NULL,NULL,'Web_REO_T5 при повышении температуры тела_2 (1)','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t5-pri-povyshenii-temperatury-tela_2-1.png',NULL,'1098','attachment-image',NULL,NULL,NULL,'1098','attachment-image',NULL,NULL,2,NULL,'2021-07-13 13:19:18','2021-08-31 10:13:34',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(478,NULL,'96:d784d08aae5bde785fa9d5d07f8c07cb',1111,'post','attachment',1,405,NULL,NULL,'Web_REO_T3 при повышенной температуре_3','inherit',NULL,0,0,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3.png',NULL,'1111','attachment-image',NULL,NULL,NULL,'1111','attachment-image',NULL,NULL,NULL,NULL,'2021-07-13 14:41:12','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(479,NULL,'98:fbc15a542907e9dbb777c1ddb4406e05',1113,'post','attachment',1,405,NULL,NULL,'Web_REO_T3 при повышенной температуре_3','inherit',NULL,0,0,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_3-1.png',NULL,'1113','attachment-image',NULL,NULL,NULL,'1113','attachment-image',NULL,NULL,2,NULL,'2021-07-13 14:41:27','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(525,'https://reo.ua/wp-content/uploads/2021/07/yak-vporatisya-z-nepriєmnimi-simptomami-toksikozu.pdf','96:43b7cce50b933a2f9c51295e64eda19f',1222,'post','attachment',1,1219,NULL,NULL,'Як впоратися з неприємними симптомами токсикозу','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-16 14:11:43','2021-07-16 14:11:50',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(480,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png','86:16dc8ff70672255909979160dc773d96',1115,'post','attachment',1,405,NULL,NULL,'Web_REO_T3 при повышенной температуре_4','inherit',NULL,0,0,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4.png',NULL,'1115','attachment-image',NULL,NULL,NULL,'1115','attachment-image',NULL,NULL,2,NULL,'2021-07-13 14:41:48','2021-08-31 10:04:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(481,NULL,'98:5e798bb99c20c20c871649afad4bbf53',1118,'post','attachment',1,396,NULL,NULL,'Web_REO_T3 при повышенной температуре_4','inherit',NULL,0,0,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/06/web_reo_t3-pri-povyshennoj-temperature_4-1.png',NULL,'1118','attachment-image',NULL,NULL,NULL,'1118','attachment-image',NULL,NULL,NULL,NULL,'2021-07-13 14:42:46','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(482,NULL,'90:fc51232225537623633033c4531455d9',1130,'post','attachment',1,571,NULL,NULL,'Оральная регидратация у взрослых','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-14 07:16:44','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(483,NULL,'87:748931f0413f530eeaa503aae1e325ff',1132,'post','attachment',1,571,NULL,NULL,'Оральная регидратация у детей','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-14 07:16:50','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(484,NULL,'105:f40a4c3c7b4409de58e63e82786a440f',1134,'post','attachment',1,571,NULL,NULL,'Оральная регидратация у лиц пожилого возраста','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-14 07:16:56','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(485,'https://reo.ua/?post_type=acf-field&p=1139','52:702681bd04e9992ee907cfbb10748ac1',1139,'post','acf-field',1,46,NULL,NULL,'Ссылка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 07:23:33','2021-07-14 04:37:13',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(486,'https://reo.ua/?post_type=acf-field&p=1140','52:fd98c02ef207aeb49e86efb5b10a5020',1140,'post','acf-field',1,88,NULL,NULL,'Ссылка','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 07:25:54','2021-07-14 04:37:32',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(492,'https://reo.ua/ru/bez-kategorii/video-2/','50:3367b6457f08799f91c86660f9c91f74',1159,'post','nav_menu_item',1,0,NULL,NULL,'Видео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:35:33','2021-07-14 07:35:48',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(507,'https://reo.ua/ru/bez-kategorii/1178/','47:73720d6ced39d49d6da2c8aad6626e28',1178,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 11:00:25','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(506,'https://reo.ua/ru/bez-kategorii/1177/','47:84402c894ba9abb6966469613158d1e7',1177,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 11:00:25','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(505,'https://reo.ua/ru/bez-kategorii/1176/','47:d7d1340ccdb31fbd09312c130cd08703',1176,'post','nav_menu_item',1,0,NULL,NULL,'Видео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 11:00:25','2021-07-14 08:01:40',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(498,'https://reo.ua/dlya-spozhivacha/','32:6dfe1f829aa7c81ff661e3a9d27676bf',1165,'post','page',1,0,NULL,NULL,'Для споживача','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,30,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:57:12','2021-11-24 01:56:39',1,NULL,NULL,NULL,NULL,0,0,2,'2021-07-15 08:04:44','2021-07-14 10:57:23'),(496,'https://reo.ua/bez-kategori%d1%97/dlya-spozhivacha-4/','63:4f8ac6d2fe0c459aa289244fde5fb81b',1163,'post','nav_menu_item',1,0,NULL,NULL,'Для споживача','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:42:33','2021-07-14 07:42:33',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(497,'https://reo.ua/bez-kategori%d1%97/dlya-medichnih-speczialistiv-3/','75:1f0d2519f8db00bac9d5902b07d73aa4',1164,'post','nav_menu_item',1,0,NULL,NULL,'Для медичних спеціалістів','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:42:33','2021-07-14 07:42:33',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(499,'https://reo.ua/dlya-medichnih-speczialistiv/','44:d13fd6675bd86f7402e896965a277ea5',1167,'post','page',1,0,NULL,NULL,'Для медичних спеціалістів','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,60,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:57:49','2021-11-18 00:34:12',1,NULL,NULL,NULL,NULL,0,1,2,'2021-07-15 08:04:53','2021-07-14 10:57:49'),(500,'https://reo.ua/ru/dlya-mediczinskih-speczialistov/','50:88a0c2b1c3f4f05c6fbac435d1dd3cd8',1169,'post','page',1,0,NULL,NULL,'Для медицинских специалистов','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,30,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:58:01','2021-11-25 10:07:48',1,NULL,NULL,NULL,NULL,0,1,2,'2021-07-15 08:04:21','2021-07-14 10:57:49'),(501,'https://reo.ua/ru/dlya-spozhivacha/','35:36a3772d3bc56ec063ef4584038f4c73',1171,'post','page',1,0,NULL,NULL,'Для потребителя','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,30,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:59:07','2021-11-17 15:56:53',1,NULL,NULL,NULL,NULL,0,0,2,'2021-07-15 08:04:31','2021-07-14 10:57:23'),(502,'https://reo.ua/bez-kategori%d1%97/1173/','49:5ea947bc4277a26af6f61b806f5c5606',1173,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:59:48','2021-07-14 08:00:12',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(503,'https://reo.ua/bez-kategori%d1%97/1174/','49:7d8a24646f4f472727908a8a090b73cd',1174,'post','nav_menu_item',1,0,NULL,NULL,'','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:59:48','2021-07-14 08:00:12',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(504,'https://reo.ua/bez-kategori%d1%97/video-3/','52:ef0cd5873cf0a87855173ac3d2ec2465',1175,'post','nav_menu_item',1,0,NULL,NULL,'Вiдео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-14 10:59:50','2021-07-14 08:00:12',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(508,'https://reo.ua/dlya-provizora/aptechna-pitna-voda-shho-poraditi/','64:29bc618fe8d47be8f71766e9bcf10327',1188,'post','post',1,0,NULL,NULL,'Аптечна питна вода: що порадити?','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,60,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/prev.png',NULL,'1199','featured-image',NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/prev.png','1199','featured-image','{\"width\":713,\"height\":412,\"url\":\"https://reo.ua/wp-content/uploads/2021/07/prev.png\",\"path\":\"/home/hx430980/reo.ua/www/wp-content/uploads/2021/07/prev.png\",\"size\":\"full\",\"id\":1199,\"alt\":\"\",\"pixels\":293756,\"type\":\"image/png\"}',1,NULL,NULL,'2021-07-14 14:28:12','2021-11-20 07:35:58',1,NULL,NULL,NULL,NULL,0,4,2,'2021-07-14 14:37:52','2021-07-14 14:31:29'),(509,NULL,'128:eca5bf16828b05a89b374fec84474f06',1189,'post','attachment',1,1188,NULL,NULL,'3. Вибір аптечної води. Що порадити відвідувачу аптеки_укр_ИСХОДНИК','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2021-07-14 14:29:08','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(510,NULL,'67:a14079acbdbdf8cb2953cbfed6df5864',1192,'post','attachment',1,1188,NULL,NULL,'schem-81-ua','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ua.jpg',NULL,'1192','attachment-image',NULL,NULL,NULL,'1192','attachment-image',NULL,NULL,2,NULL,'2021-07-14 14:31:52','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(511,'https://reo.ua/ru/dlya-provizora/aptechna-pitna-voda-shho-poraditi/','67:275b2468b9baa93d0bd445374c6485ca',1197,'post','post',1,0,NULL,NULL,'Выбор аптечной воды','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,30,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/prev.png',NULL,'1200','featured-image',NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/prev.png','1200','featured-image','{\"width\":713,\"height\":412,\"url\":\"https://reo.ua/wp-content/uploads/2021/07/prev.png\",\"path\":\"/home/hx430980/reo.ua/www/wp-content/uploads/2021/07/prev.png\",\"size\":\"full\",\"id\":1200,\"alt\":\"\",\"pixels\":293756,\"type\":\"image/png\"}',1,NULL,NULL,'2021-07-14 14:33:53','2021-11-17 21:46:04',1,NULL,NULL,NULL,NULL,0,4,2,'2021-07-14 14:49:00','2021-07-14 14:31:29'),(512,NULL,'60:34829939a11a20b512d961c794a7f7cb',1199,'post','attachment',1,1188,NULL,NULL,'prev','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/prev.png',NULL,'1199','attachment-image',NULL,NULL,NULL,'1199','attachment-image',NULL,NULL,NULL,NULL,'2021-07-14 14:37:49','2021-07-15 09:18:50',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(513,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg','57:2939fd458e991ff5eb5ee1b5cc727e84',1202,'post','attachment',1,1197,NULL,NULL,'schem-81-ru','inherit',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,'https://reo.ua/wp-content/uploads/2021/07/schem-81-ru.jpg',NULL,'1202','attachment-image',NULL,NULL,NULL,'1202','attachment-image',NULL,NULL,4,NULL,'2021-07-14 14:43:54','2021-08-30 13:34:01',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(514,'https://reo.ua/?post_type=acf-field&p=1207','52:71da0a6e19c94bb84ac70ca3310c1161',1207,'post','acf-field',1,1206,NULL,NULL,'Видео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-15 07:49:37','2021-07-15 04:49:37',1,NULL,NULL,NULL,NULL,1,NULL,1,NULL,NULL),(515,'https://reo.ua/?post_type=acf-field-group&p=1206','58:3b9736bf80039e377bb8728e47820c13',1206,'post','acf-field-group',1,0,NULL,NULL,'Видео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-15 07:49:37','2021-07-15 05:04:10',1,NULL,NULL,NULL,NULL,0,NULL,1,NULL,NULL),(516,'https://reo.ua/?post_type=acf-field&p=1208','52:aaad24e90f03d910309cedf7817022db',1208,'post','acf-field',1,1206,NULL,NULL,'Тип видео','publish',NULL,0,NULL,NULL,NULL,NULL,NULL,0,0,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'2021-07-15 07:49:37','2021-07-15 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