About dehydration

What is dehydration?

Dehydration facts

  • The body needs water to function.
  • Dehydration occurs when water intake is less than water loss.
  • Symptoms range from mild to life-threatening.
  • The young and the elderly are especially susceptible to dehydration.

What is dehydration?

Water is a critical element of the body, and keeping the body adequately hydrated is a must to allow the body to function. Up to 75% of the body's weight is made up of water. Most of the water is found within the cells of the body (intracellular space). The rest is found in the extracellular space, which consists of the blood vessels (intravascular space) and the spaces between cells (interstitial space).

Dehydration occurs when the amount of water leaving the body is greater than the amount being taken in. The body is very dynamic and always changing. This is especially true with water in the body. We lose water routinely when we:

  • breathe and humidified air leaves the body (this can be seen on a cold day when you can see your breath in the air, which is just water that has been exhaled);
  • sweat to cool the body; and
  • eliminate waste by urinating or having a bowel movement.

In a normal day, a person has to drink a significant amount of water to replace this routine loss.

The formula for daily fluid requirements depends upon an individual's weight. Normally, fluid and weight are calculated using the metric system; however, below is the approximation in imperial (American) units.

Body weight Daily fluid requirements (approximate) 10 pounds 15 ounces 20 pounds 30 ounces 30 pounds 40 ounces 40 pounds 45 ounces 50 pounds 50 ounces 75 pounds 55 ounces 100 pounds 50 ounces 150 pounds 65 ounces 200 pounds 70 ounces

If you would like to calculate your body weight and daily fluid requirements using the metric system, please use this formula.

  • For the first 10kg (kilogram) of body weight the daily fluid intake required is 100cc (or mL) per kg.
  • For the next 10kg of body weight, the fluid required is an additional 50 cc/kg.
  • For every additional kg of body weight, an additional 10cc/kg is required

This is the basic body requirement. More fluid would be needed to replace excess sweating from exercise or fever, fluid loss from vomiting, and diarrhea or increased urine production.

What are the symptoms for dehydration?

Low blood volume shock (hypovolemic shock) symptom was found in the dehydration condition

Thirst isn't always a reliable early indicator of the body's need for water. Many people, particularly older adults, don't feel thirsty until they're already dehydrated. That's why it's important to increase water intake during hot weather or when you're ill.

The signs and symptoms of Dehydration also may differ by age.

Infant or young child

  • Dry mouth and tongue
  • No tears when crying
  • No wet diapers for three hours
  • Sunken eyes, cheeks
  • Sunken soft spot on top of skull
  • Listlessness or Irritability

Adult

When to see a doctor

Call your family doctor if you or a loved one:

  • Has had Diarrhea for 24 hours or more
  • Is irritable or disoriented and much sleepier or less active than usual
  • Can't keep down fluids
  • Has bloody or stool

What are the causes for dehydration?

Sometimes dehydration occurs for simple reasons: You don't drink enough because you're sick or busy, or because you lack access to safe drinking water when you're traveling, hiking or camping.

Other dehydration causes include:

  • Diarrhea, vomiting. Severe, acute diarrhea — that is, diarrhea that comes on suddenly and violently — can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals.
  • Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting.
  • Excessive sweating. You lose water when you sweat. If you do vigorous activity and don't replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose.
  • Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more.

What are the treatments for dehydration?

Millions of children die worldwide each year because of dehydration, often because of diarrhea. As well, the temperature regulation and sweat mechanism of infants are not well developed, and this increases their risk of heat-related illness.

It is important to remember that infants and children are dependent upon others to provide them with water and nutrition. Infants cannot tell their parents or care providers when they are thirsty. Enough fluid needs to be provided so that the dehydration can be prevented. This is especially true if increased water loss occurs because of fever, vomiting or diarrhea.

In children, symptoms of dehydration increase as the level of dehydration increases.

Level of dehydration Estimated fluid loss Signs and Symptoms in Children Level of dehydration Estimated fluid loss Signs and symptoms Minimal <3% of body weight none Mild to moderate <10% of body weight Fussy, tired, irritable child. Dry mucous membranes (mouth, tongue), increased heart rate, increased breathing rate, decreased urine output, increased thirst Severe 10% of body weight or more Listless, lethargic, unconscious. Too weak to cry. Sunken eyes, sunken fontanelle (soft spot of skull). Increased heart rate, weak pulses, and rapid shallow breathing. Cool, mottled skin. No urine output (dry diapers). Too weak to suckle or drink fluids. Loss of muscle tone with the child appearing "floppy."

Infants and children respond well to fluid replacement, and often oral rehydration therapy (ORT) can treat dehydration. Small, frequent sips of fluid replacement solutions such as Pedialyte or Gatorade may be enough to prevent the need for intravenous fluids. In ORT, replacement begins with 5cc or one teaspoon of fluid every 5-10 minutes. If this is tolerated without vomiting, the amount of fluid is doubled, again providing small amounts every few minutes. However, if the child is too ill to drink or cannot tolerate even small sips of fluid, medical care should be accessed immediately.

Intravenous fluids can rehydrate the infant or child while the underlying illness is evaluated and treated. Occasionally, there is difficulty in placing an intravenous line and an intraosseous (inside the bone) needle can be placed, usually in the tibia (shin bone) that allows fluid resuscitation.

In children who are markedly dehydrated, blood tests may be used to monitor electrolytes, kidney function, and acid-base balance in the body.

It is important to find the reason for the illness because dehydration is the result of a disease process, not the cause of it.

What are the risk factors for dehydration?

Anyone can become dehydrated, but certain people are at greater risk:

  • Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can't tell you that they're thirsty, nor can they get a drink for themselves.
  • Older adults. As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves.
  • People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you're less likely to feel like eating or drinking when you're sick.
  • People who work or exercise outside. When it's hot and humid, your risk of dehydration and heat illness increases. That's because when the air is humid, sweat can't evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids.

Is there a cure/medications for dehydration?

Dehydration can occur due to many reasons. The prime reason is sweating. It can also be triggered by diarrhea or vomiting, which can quickly eliminate fluids from your body. All of these can trigger water and electrolyte loss in the body.

The most important way to treat dehydration is to replace the electrolytes and fluids the body has lost. Restoring the electrolyte balance will prevent an individual from dehydration.

Treatment for dehydration

  • Nutrition and hydration are the common interventions that possess the greatest impact on dehydration.
  • Medications such as opiates, loperamide, bismuth subsalicylate, anticholinergics and adsorbents are not recommended for dehydrations due to significant side effects.
  • The best approach is based on the age of the individual, the cause of dehydration, and the severity of dehydration.
  • For children and infants who have become dehydrated due to vomiting, fever or diarrhea, doctors use an over-the-counter oral rehydration solution (Pedialyte, Infalyte).
  • These contain salts and water in definite proportions to enhance electrolytes and fluids in the body.
  • For adults who work or exercise outdoors during humid weather, sports drinks containing electrolytes can be helpful.
  • Severe dehydration requires emergency treatment.
  • Intravenous fluid therapy is best recommended for such patients.


Conditions
Heat injury,Urinary and kidney problems,Seizures,Low blood volume shock (hypovolemic shock)
Drugs
Over-the-counter oral rehydration solution (Pedialyte, Infalyte)
Symptoms
Feeling thirsty,Tired,Dizzy,Dark yellow urine,Dry mouth

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