If dehydration (fluid deficiency) is based on a disease, its therapy is the primary concern (causal therapy). General measures In case of inpatient stay: Balancing fluid intake and output – daily water turnover is recorded. Fluid intake is composed of: Drinking Fluid contained in food, if necessary tubes, infusions. Oxidation water (water formed in metabolism) … Dehydration: Therapy
Medical history (history of illness) represents an important component in the diagnosis of dehydration (fluid deficiency). Family history Is there a history of frequent kidney disease or diabetes mellitus in your family? Social history Current medical history/systemic history (somatic and psychological complaints). What complaints have you noticed? How long have these changes existed? How often … Dehydration: Medical History
To prevent dehydration (fluid deficiency), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Inadequate fluid intake – To prevent dehydration, drink enough fluids evenly throughout the day: Daily drinking amount about 1.5-2 liters / day or 35 ml of water intake through drinks (= drinking amount) and solid food/kg bw … Dehydration: Prevention
The symptoms and complaints of dehydration (fluid deficiency) are based on whether the body has lost mostly water, sodium, or both (in equal amounts). The following symptoms and complaints may indicate dehydration: Isotonic dehydration Functional oliguria (< 500 ml urine/day). Hypovolemic symptoms (symptoms of a decrease in the amount of blood circulating, i.e., in the … Dehydration: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Isotonic dehydration Isotonic dehydration results from a lack of isotonic extracellular fluid (fluid outside the cells), which is lost, for example, through vomiting and/or diarrhea (diarrhea). In this case, the body loses water and sodium in equal amounts. Hypotonic dehydration In this form of dehydration, there is a decrease in extracellular … Dehydration: Causes
Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes insipidus – hormone-deficiency-related disorder of hydrogen metabolism resulting in extremely high urine output (polyuria; 5-25 l/day) due to impaired renal concentrating capacity. Diabetes mellitus Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99) Adrenocortical insufficiency (NNR insufficiency; adrenocortical insufficiency). Renal insufficiency (kidney weakness). “Salt-losing-nephritis” (salt-losing kidney) – ability … Dehydration: Or something else? Differential Diagnosis
The following are the major diseases or complications that may be contributed to by dehydration (lack of fluids): Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Constipation (constipation) Psyche – nervous system (F00-F99; G00-G99) Cerebral edema (swelling of the brain as a result of cerebral volume and pressure increase) – due to too rapid … Dehydration: Complications
Severity of dehydration Severity levels Fluid loss as % of body weight Mild dehydration 3-5 Moderate dehydration 6-8 Severe dehydration 9-12 Shock 12-15
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [dry skin and mucous membranes; dark circles; sunken eyes; standing skin folds; decreased skin perfusion (skin … Dehydration: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Serum sodium and serum sodium osmolality. Total serum protein (serum protein) Urine osmolality Interpretation Isotonic dehydration Hb (hemoglobin), hematocrit, serum protein [↑] NotesSerum sodium and serum osmolality is normal.Specific urine weight is increased with normal renal function. Hypotonic dehydration Hb (hemoglobin), hematocrit, … Dehydration: Test and Diagnosis
Therapy goals If the dehydration (lack of fluid) is based on a disease, its therapy is in the foreground (causal therapy). Rehydration (fluid balance). If necessary, correction of the sodium balance Therapy recommendations Rehydration (fluid replacement): in more severe cases of dehydration, in the form of parenteral rehydration (infusions) – based on an estimate of … Dehydration: Drug Therapy
