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Dehydration – Physiopedia

Dehydration occurs when you lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. Young children, older adults, the ill and chronically ill are especially susceptible. Water is excreted from the body in many different forms: through urine and stool, sweating, and breathing (exhaling CO2). Dehydration symptoms generally become noticeable after 2% of one’s normal water volume has been lost.[1]

Adequate hydration plays a key role in maintaining:[2]

  • Circulation
  • Lubrication
  • Body temperature
  • Lymphatic system
  • Removal of waste products from the body and cells
  • Facilitating ingestion and digestion
  • Flushing out the urinary tract, eyes, and other organs

You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. [3] 

There are three main types of dehydration: hypotonic (primarily a loss of electrolytes), hypertonic (primarily loss of water), and isotonic (equal loss of water and electrolytes).  The most commonly seen in humans is isotonic. [4]

Body water is lost through the skin, lungs, kidneys, and GI tract. The loss of body water without sodium causes dehydration.

  • Water is lost from the skin, lungs, gastrointestinal tract, and kidneys.
  • Dehydration results when water losses from the body exceed water replacement.
  • It may be caused by failure to replace obligate water losses.

There are several forms of dehydration.

  1. Isotonic water loss occurs when water and sodium are lost together. Causes of isotonic water loss are vomiting, diarrhea, sweating, burns, intrinsic kidney disease, hyperglycemia, and hypoaldosteronism.
  2. Hypertonic dehydration occurs when water losses exceed sodium losses. Serum sodium and osmolality will always be elevated in hypertonic dehydration. Excess pure water loss occurs through the skin, lungs, and kidneys. Etiologies are fever, increased respiration, and diabetes insipidus.
  3. Hypotonic dehydration is mostly caused by diuretics, which cause more sodium loss than water loss. Hypotonic dehydration is characterized by low sodium and osmolality.

The source of water loss relates to the etiologies of dehydration:

  • Failure to replace water loss: altered mentation, immobility, impaired thirst mechanism, drug overdose leading to coma
  • Excess water loss from the skin: heat, exercise, burns, severe skin diseases
  • Excess water loss from the kidney: medications such as diuretics, acute and chronic renal disease, post-obstructive diuresis, salt-wasting tubular disease, Addison disease, hypoaldosteronism, hyperglycemia
  • Excess water loss from the GI tract: vomiting, diarrhea, laxatives, gastric suctioning, fistulas
  • Intraabdominal losses: pancreatitis, new ascites, peritonitis
  • Excess insensible loss: sepsis, medications, hyperthyroidism, asthma, chronic obstructive pulmonary disease (COPD), drugs[5]
  • Dehydration is most commonly found in the elderly, infants, people with fever, athletes, people living in high altitudes, and the chronically ill.   Children are most affected in the first two years of their life and 2.2 million will die in this year around the world.[1] 
  • The elderly have an altered sense of thirst perception, changes in body water composition, and a decline in renal function as they age. Dehydration was diagnosed in 6.7% of hospitalized geriatric patients in the year 2007.  In 50% of febrile cases, the patients were dehydrated and the mortality rate exceeds 50% in some studies.[6]
  • Athletes also have an increased risk for dehydration due to the environment and physical exertion. This CDC web page has information about heat illness including dehydration among high school athletes. 
  • A study done from 2009-2012 with participants ranging from ages 6-19 years old found that inadequate hydration occurred in 54.5% of participants. Of those participants, it was found that males were at increased risk for dehydration.[7]
  • In children, dehydration is at an increased risk compared to other populations due to increased metabolic rate, high incidence of infection leading to vomiting and diarrhoea (gastroenteritis), and increased body surface area compared to mass.  The elderly and children have the highest risk for dehydration.[8]

Characteristics/Clinical Presentation[edit | edit source]

Increased thirst, dry mouth, light-headedness, fatigue, impaired mental focus, low urine output, dry skin, inability to produce tears, sunken eyes are the signs of dehydration. [9]

Mild Dehydration
Moderate Dehydration
Severe Dehydration
  • flushed face
  • thirst
  • dry, warm skin
  • cannot pass urine or reduced amounts, dark, yellow coloring
  • light shade of yellow urine
  • weakness
  • cramping in arms and legs
  • unwell
  • headaches
  • dry mouth/lips, dry tongue; with thick saliva
  • lightheadedness, worse when standing
  • irritable or sleepy
  • crying with no or few tears (mainly in children)
  • low BP (postural hypotension[10])
  • headaches[10]
  • darker shade of yellow urine
  • fainting
  • severe muscle contractions in arms, legs, stomach, and back
  • convulsions
  • bloated stomach
  • heart failure
  • sunken fontanelle (soft spot on infant’s head)
  • sunken dry eyes
  • skin loses firmness and looks wrinkled
  • lack of elasticity of skin
  • rapid and deep breathing
  • fast, weak pulse
  • decline consciousness
  • increased heart rate (radial pulse may be undetectable)
  • decreased or low blood pressure
  • effects are more pronounced
  • peripheral cyanosis
  • confusion, lethargy, irritability[10]
  • cold hands and feet[10]
  • unable to urinate[10]
  • hypovolaemic shock
  • effects are more pronounced
  • death may occur, if rehydration is not started quickly

Increased tiredness, headaches, nausea, and paresthesias are experienced at about 5% to 6% water loss. With 10% to 15% fluid loss, may experience symptoms of muscle cramping, dry and wrinkly skin, beginning of delirium, painful and/or decreased urine output, and decline in eyesight. Losses of water greater than 15% are usually fatal[1].

When to seek medical attention[edit | edit source]

  • Constant or increased vomiting for greater than a 24 hour period
  • Diarrhoea greater than two days
  • Fever over 101o degrees
  • Decreased urine production
  • Weakness
  • Confusion[11]

A Primary Care Physician can often diagnose dehydration based off of a person’s physical signs and symptoms such as skin turgor, color of urine, low blood pressure, rapid heart rate, and sunken eyes.

To help confirm a diagnosis of dehydration and to what degree, a blood test and urinalysis may be performed.[3][12]

Blood test: can check levels of electrolytes like sodium and potassium, and how well one’s kidneys are working.

Urinalysis: can show whether a person is dehydrated and to what degree, using 3 evaluation methods: visual exam, dipstick test, and microscopic exam. The dipstick test looks at acidity or pH, concentration, protein, sugar, ketones, bilirubin, evidence of infection, and blood. The microscopic exam looks at white blood cells, red blood cells, epithelial cells, bacteria or yeasts, casts, or crystals.[13]

Acute Dehydration: Weight loss of >4% of body mass within 7 days[2]

  •  Calculate the body weight (wt) loss
  •  Fluid deficit (L) = pre-illness wt – illness wt
  •  % dehydration = (pre-illnesses wt-illness wt)/pre-illness wt x 100%

Capillary Refill: increased time for capillary bed to refill (>2-3 seconds)[2]

Dehydration can cause serious systemic involvement, especially severe dehydration. Some problems that may occur include heat injury, cerebral oedema, seizures, hypovolemic shock, kidney failure, coma and death[3].

  • Heat injury: Heat injury occurs most often in individuals who exercise vigorously and sweat excessively. The severity of heat injury ranges from mild heat cramps and heat exhaustion to more life-threatening heatstroke.
  • Cerebral edema: This condition, also called swelling of the brain, occurs when one is trying to rehydrate. Cerebral oedema occurs when one’s body tries to pull too much water back into its cells causing them to swell and rupture.
  • Seizures: Seizures occur when one’s electrolytes, specifically sodium and potassium, are out of balance and send mixed signals between cells. This can lead to involuntary muscle contractions and loss of consciousness.
  • Hypovolemic shock: This occurs when a low blood volume causes the person’s blood pressure and amount of oxygen in the body to drop. This is one of the more serious conditions that can come from dehydration. If not treated, it can become life-threatening.
  • Urinary and Kidney Dysfunction:  Prolonged or repeated bouts of dehydration may induce Urinary Tract Infections, kidney stones and eventually kidney failure.
  • Coma and death: If severe dehydration isn’t treated quickly, it can be fatal.
  • The principle differential of dehydration in adults is the loss of body water versus the loss of blood.
  • This is important because blood loss should be replaced with blood, while water loss should be replaced with fluid.
  • The next point to consider is the differential diagnosis of the cause of dehydration (see Etiology above)[5]

Treatment of dehydration is aimed at rapid fluid replacement as well as identification of the cause of fluid loss. Patients with fluid deficits should be given isotonic fluid boluses tailored to the individual circumstance. Patients with more severe dehydration get larger boluses of isotonic fluid. A more careful approach is needed in elderly patients and patients with heart failure and kidney failure. In these patients, small boluses should be given, followed by frequent reassessment and additional bolus as needed. [5]

  • The first goal of treatment of dehydration is to restore circulating volume. The second goal is to find the cause of the dehydration so that it will not recur.
  • In patients with normal heart and renal function, liberal fluid may be given to restore volume quickly. In patients with heart failure and renal disease, volume still needs to be replaced, but a more careful approach is indicated. This is best accomplished with small volumes given quickly, followed by immediate reassessment and redosing as needed.
  • In severe hyponatremia, rapid correction of volume deficits may cause a sharp rise in the serum sodium that can cause central pontine myelinolysis (CPM). The clinician must assess the risks and benefits of rapid volume repletion versus the risk of CPM. In all cases, the volume status and sodium levels must be monitored closely.[5]

Dehydrated children need extra fluid with the right mix of water and electrolytes. Plain water, milk, soda, juice, and sports drinks don’t have the right balance of water and electrolytes. What fluids to give:

  • Breast milk (breast milk contains electrolytes and is the best fluid for breastfeeding babies)
  • Oral rehydration solution (a combination of water and electrolytes), after the baby has gone 12 hours without vomiting, then you can give formula; give small sips of fluids every 10 minutes, then larger amounts more often if your child can keep it down.
  • If severe dehydration medical personal will give fluids through a vein (by IV)[14]

Physical Therapy Management & Prevention [edit | edit source]

There is no direct physical therapy intervention for dehydration in the severe category; however, prevention and fluid replacement orally is something physical therapists can influence through patient education.

Patients should be educated about the signs and symptoms of dehydration in order to know when they may need to seek help.  This is done by proper knowledge of hydration[15].

Environmental Factors[15][edit | edit source]

Heat [16]

  • Being outside on a hot or humid day can cause your body to need more fluids 
  • It is recommended by the American Heart Association to drink water before being outdoors in the heat. This way you do not have to play catch up with Hydration when strain has already been placed on the heart.  

Cold [17]

  • Fluid intake also needs to be increased in cooler environments. 
  • Cool temperatures may blunt thirst
  • Inhalation of cold, dry air increases warmth and moisture in the lungs which causes water vapor to be exhaled
  • Physical Activity in the cold can increase respiratory water losses by 15-45 mL per hour
  • Insulated clothing can also increase perspiration, increasing water loss

Hydration and Exercise

Before exercise: Drink 12-20oz of fluid 2 hours leading up to exercise

During Exercise:

  • <1-hour drink 16-30 oz of water
  •  1-3 hours drink 16-30 oz 6-8% CHO, sodium drink per hour of exercise   
  • >3 hours similar to guidelines for 1-3 hours but increase sodium intake

Avoid caffeine or alcohol in beverages due to their diuretic effects

Avoid hyponatremia which can occur by drinking too much fluid. therefore, diluting sodium

Monitor dehydration with changes in body weight and urine color. Each pound lost during exercise, drink 15-16oz of fluid [18]

  1. 1.01.11.2 Dehydration: Why is it so dangerous? Rehydrate website. 2012. Available at: rehydrate.org/dehydration/index.html (Accessed April 3, 2017)
  2. 2.02.12.2 Bunn D, Hooper L, Jimoh FO, Fairweather-Trait SJ. Water-Loss dehydration and aging. Mediterranean Diet and Inflammation in the Elderly. 2013; 10.1016/j.mad.2013.11.009 http://www.sciencedirect.com/science/article/pii/S0047637413001280 (assessed 3 April 2017).
  3. 3.03.13.2 MayoClinic. Dehydration. Mayoclinic website. 2014. Available at: http://www.mayoclinic.com/health/dehydration/DS00561. Accessed March 30, 2017.
  4. ↑ Dehydration-What is Dehydration?. News-medical website. Available at: http://www.news-medical.net/health/Dehydration-What-is-Dehydration. aspx. Accessed on March 30, 2017.
  5. 5.05.15.25.3 Taylor K, Jones EB. Adult Dehydration. InStatPearls [Internet] 2020 Mar 24. StatPearls Publishing.Available from:https://www.statpearls.com/articlelibrary/viewarticle/37754/ (last accessed 18.11.2020)
  6. ↑ Faes MC MD et al. Dehydration in Geriatrics. Medscape website. 2007 [cited 2013 March 19] Available at:http://www.medscape.com/viewarticle/567678
  7. ↑ Kenney EL, Long MW, Cradock AL, Gortmaker SL. Prevalence of Inadequate Hydration Among US Children and Disparities by Gender and Race/Ethnicity: National Health and Nutrition Examination Survey, 2009–2012. American Journal of Public Health. 2015;105(8):e113-e118. doi:10.2105/AJPH.2015.302572.
  8. ↑ Takayesu JK MD. Pediatric Dehydration. Emedicine website. 2011 [cited 2013 March 19]. Available at:http://emedicine.medscape.com/article/801012-overview
  9. ↑ http://survivalscoop.blogspot.com/2010/08/signs-of-dehydration-why-you-need-water. html
  10. 10.010.110.210.310.4 Goodman, C., & Snyder, T. (2013). Differential diagnosis for physical therapists: Screening for referral. (5th edition ed., pp. 171). St. Louis, MO: Saunders.
  11. ↑ Dehydration-Home Treatment. WebMD Website. Available at http://www.webmd.com/fitness-exercise/tc/dehydration-home-treatment#1 (2015)Accesed March 30,2017.
  12. ↑ Scales K. Use of Hypodermoclysis to Manage Dehydration. Nursing Older People. 2011 [cited 2013 March 15]; 5:16-22. Available from: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=4&sid=78597ea0-1b94-40b6-8230-44b518d28ad8%40sessionmgr111&hid=108
  13. ↑ Urinalysis. Mayo Clinic Web site. 2011. Available at: http://www.mayoclinic.com/health/urinalysis/MY00488/DSECTION=results. Accessed March 21, 2013.
  14. ↑ Dehydration Available from:https://www.msdmanuals.com/home/quick-facts-children-s-health-issues/miscellaneous-disorders-in-infants-and-young-children/dehydration-in-children
  15. 15. 015.1 Center for Disease Control. Dengue Clinical Case Management E-learning: Hydration Status. https://www.cdc.gov/dengue/training/cme/ccm/Hydration%20Status_F.pdf (assessed 3 April 2017)
  16. ↑ 20. American Heart Association. Staying Hydrated-Staying Healthy. (2014) Available at http://www.heart.org/HEARTORG/HealthyLiving/PhysicalActivity/FitnessBasics/Staying-Hydrated—Staying-Healthy_UCM_441180_Article.jsp#.WOWKD5h4ahA Accessed on March 30, 2017
  17. ↑ Quaglio L. The Dehydration Equation. American Fitness. Winter2017. Available from: SPORTDiscuss with Full Text. Accessed on March 30,2017.
  18. ↑ Pariser G. Nutrition for Exercise Performance. Powerpoint Presentation Given at Bellarmine University Spring 2016.

 

Kids Health Information : Dehydration

Dehydration occurs when there isn’t enough fluid in the body to keep it working properly. The body needs water to help maintain body temperature, make bodily fluids and for day-to-day functioning.

Young children and babies are at greater risk of becoming dehydrated than adults. Keeping your child hydrated is important at all times, but especially when they are unwell.

If your child is very thirsty, they are probably already dehydrated. The effects of severe dehydration can be serious.

Signs and symptoms of dehydration

If your child is mildly dehydrated, they may have:

  • dizziness or light-headedness 
  • nausea or headaches 
  • dark yellow or brown urine (wee) – urine should be pale yellow 
  • fewer wet nappies or nappies not as wet as usual; or older children will not go to the toilet as much 
  • dry lips, tongue, mouth or throat.

If your child has severe dehydration, they may be:

  • extremely thirsty
  • lethargic or less active than usual 
  • pale and have sunken eyes, tears may be absent when crying 
  • cold – especially their hands or feet 
  • breathing faster than usual and have a fast heart rate 
  • irritable, drowsy or confused.

If your child shows signs of severe dehydration, see your GP or go to your closest hospital emergency department.

Care at home for mild dehydration

The best treatment for mild dehydration is to give your child more fluid to drink, such as water or oral rehydration solutions. Gastrolyte, HYDRAlyte, Pedialyte and Repalyte are different types of oral rehydration solutions (fluids) that can be used to replace fluids and body salts. These are the best option if your child is
dehydrated, and can be purchased from your local pharmacy or supermarket. They are also available as icy poles, which children are often happy to have.

If your child refuses water or oral rehydration fluids, try diluted apple juice. You can also give your child their usual milk. Do not give drinks that are high in sugar (e.g. flat lemonade or sports drinks), because they can make dehydration worse.

Infants

If your baby is under six months old, they should always be seen by a doctor if they are dehydrated.  For babies over six months:

  • If you are breastfeeding your baby, continue to do this but feed more often. You can also give an oral rehydration solution or water for the first 12 hours.
  • If you are bottle feeding your baby, replace formula feeds with oral rehydration solution or water for the first 12 hours, then give normal formula in small, but more frequent amounts.

Older children

For older children (over 10 kg) who are dehydrated, give at least one cup (250 mL) of water (or oral rehydration solution) to drink, every hour for four hours. Give them more than this to drink if they are vomiting or have diarrhoea. Your child may want to drink it all at once or
drink smaller sips frequently.

Smaller children will need less to drink than older children.

When to see a doctor

Babies and young children are at greater risk of becoming dehydrated. If your child is under six months of age or has a chronic (long-term) illness, see your GP if you think your child is dehydrated.

If your child shows signs of severe dehydration or you are concerned for any reason, see your GP or go to your closest hospital emergency department.

If your child is unwell, they may need medical treatment to help replace lost fluids. This can involve using a feeding tube that goes into the stomach via the nose, or fluids given directly into a vein through a drip (intravenous or IV therapy).

What causes dehydration?

Children are more likely to become dehydrated:

  • after lots of physical activity or exercise
  • with severe vomiting or diarrhoea
  • if they have a fever
  • if they take certain medications, such as diuretics
  • if they don’t drink enough, especially during times of illness
  • if they are younger than six months of age
  • in hot weather.

Making sure your child drinks enough water each day can help prevent dehydration. Providing extra drinks of water in hot weather, during and after exercise and during illness is particularly important.

Key points to remember

  • Young children and babies are at most risk of becoming dehydrated.
  • If your child is very thirsty, they are probably already dehydrated.
  • Mild dehydration can be treated at home by giving oral rehydration fluids or water. Do not give drinks that are high in sugar.
  • If your child show signs of severe dehydration, see your GP or go to your closest hospital emergency department.

For more information

Common questions our doctors are asked

Should my child drink sports drinks when playing sports to
prevent dehydration?
    

Sports drinks are not recommended for hydration, as there is often a high sugar content. Drinks that are high in sugar can make dehydration worse. During sports, children can drink water or oral rehydration solutions.  

What illnesses are most likely to cause
dehydration? 
     

Gastroenteritis is the most common cause of dehydration, because the body loses fluids through the vomiting and diarrhoea, and oral intake is usually reduced. Illnesses where children have a sore throat or sore mouth (e.g. tonsillitis or hand, foot and mouth disease) can lead to
dehydration if the pain is making your child reluctant to eat or drink. Having a high fever is also linked with dehydration, because your child is losing fluids through sweating.

Developed by The Royal Children’s Hospital Community Information and Anaesthesia and Pain Management departments. We acknowledge the input of RCH consumers and carers. 

Reviewed August 2018. 

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au. 

Diagnosis and Management of Dehydration in Children

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3. Armon K,
Stephenson T,
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An evidence and consensus based guideline for acute diarrhoea management. Arch Dis Child.
2001;85(2):132–142.

4. Friedman JN,
Goldman RD,
Srivastava R,
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Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr.
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Is this child dehydrated? JAMA.
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Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics.
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7. Goldman RD,
Friedman JN,
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Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics.
2008;122(3):545–549.

8. Gorelick MH,
Shaw KN,
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1997;13(5):305–307.

9. Laron Z.
Skin turgor as a quantitative index of dehydration in children. Pediatrics.
1957;19(5):816–822.

10. Teach SJ,
Yates EW,
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Avner JR.
A prospective study of the usefulness of clinical and laboratory parameters for predicting percentage of dehydration in children. Pediatr Emerg Care.
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12. Reid SR,
Bonadio WA.
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1996;28(3):318–323.

13. Holliday MA,
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Wassner SJ.
Extracellular fluid restoration in dehydration: a critique of rapid versus slow. Pediatr Nephrol.
1999;13(4):292–297.

14. Practice parameter: the management of acute gastroenteritis in young children.
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15. Atherly-John YC,
Cunningham SJ,
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A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Arch Pediatr Adolesc Med.
2002;156(12):1240–1243.

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Lasche J,
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et al.
Oral rehydration solution for acute diarrhea prevents subsequent unscheduled follow-up visits. Pediatrics.
1999;104(3):e29.

17. Spandorfer PR,
Alessandrini EA,
Joffe MD,
Localio R,
Shaw KN.
Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics.
2005;115(2):295–301.

18. Nager AL,
Wang VJ.
Comparison of nasogastric and intravenous methods of rehydration in pediatric patients with acute dehydration. Pediatrics.
2002;109(4):566–572.

19. Islam MR,
Ahmed SM.
Oral rehydration solution without bicarbonate. Arch Dis Child.
1984;59(11):1072–1075.

20. Molla AM,
Rahman M,
Sarker SA,
Sack DA,
Molla A.
Stool electrolyte content and purging rates in diarrhea caused by rotavirus, enterotoxigenic E. coli, and V. cholerae in children. J Pediatr.
1981;98(5):835–838.

21. Rahman O,
Bennish ML,
Alam AN,
Salam MA.
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1988;113(4):654–660.

22. Meyers A,
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Safety and effectiveness of homemade and reconstituted packet cereal-based oral rehydration solutions: a randomized clinical trial. Pediatrics.
1997;100(5):E3.

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Segar WE.
The maintenance need for water in parenteral fluid therapy. Pediatrics.
1957;19(5):823–832.

24. Holliday MA,
Ray PE,
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Fluid therapy for children: facts, fashions and questions. Arch Dis Child.
2007;92(6):546–550.

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Bollen CW,
Bos AP,
Kok JH,
Offringa M.
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2006;32(7):995–1003.

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MacKenzie T,
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Dehydration in Children – Children’s Health Issues

  • Replacement of lost fluids

Dehydration is treated with fluids containing electrolytes, such as sodium and chloride. If dehydration is mild, fluids are generally given by mouth. Special oral rehydration solutions are available but are not always necessary for children who have had only mild diarrhea or vomiting. Treatment of dehydration in children of any age who are vomiting is more effective if the child is first given small, frequent sips of fluids about every 10 minutes. The amount of fluid can slowly be increased and given at less frequent intervals if the child can keep the fluid down without vomiting. If diarrhea is the only symptom, larger amounts of fluid can be given less often. If children have both vomiting and diarrhea, they are given small, frequent sips of fluids containing electrolytes. If this treatment increases the diarrhea, children may need to be hospitalized for fluids given by vein (intravenously).

Infants and children who are unable to take in any fluids, or who develop listlessness and other serious signs of dehydration, may require more intensive treatment with fluids and electrolytes given intravenously or electrolyte solutions given through a thin plastic tube (nasogastric tube) that is passed through the nose and down the throat until it reaches the stomach or small intestine.

In infants, dehydration is treated by encouraging an infant to drink fluids that contain electrolytes. Breast milk contains all the fluids and electrolytes an infant needs and is the best treatment when possible. If an infant is not breastfeeding, oral rehydration solutions (ORS) should be given. ORS contains specific amounts of sugars and electrolytes. ORS can be bought as powders that are mixed with water or as premixed liquids at drug or grocery stores without a prescription. The amount of ORS to give a child in a 24-hour period depends on the child’s weight, but generally should be about 1½ to 2½ ounces of ORS for each pound the child weighs (100 to 165 milliliters per kilogram). Thus, a 20-pound infant should drink 30 to 50 ounces total over 24 hours (a 10-kilogram infant should drink 1,000 to 1,650 milliliters total over 24 hours).

Children older than 1 year may try small sips of clear broths or soups, clear sodas, gelatin, or juice diluted to half-strength with water, or popsicles. Plain water, undiluted juice, or sports drinks are not ideal for treating dehydration at any age because the salt content of water is too low and because juice has a high sugar content and ingredients that irritate the digestive tract. ORS is an alternative, particularly for moderate dehydration. If children are able to tolerate fluids for 12 to 24 hours, they may resume their normal diet.

Adult Dehydration – StatPearls – NCBI Bookshelf

Continuing Education Activity

Dehydration is a common condition that affects patients of all ages. Dehydration may complicate other medical problems and may cause significant illness. Physical examination is used to diagnose dehydration. Laboratory testing identifies the complications of dehydration. Fluid replacement is used to treat dehydration. This activity outlines the evaluation and treatment of adult dehydration and highlights the importance of the interprofessional team.

Objectives:

  • Identify the etiology of adult dehydration medical conditions and emergencies.

  • Review the evaluation of adult dehydration.

  • Outline the management options available for adult dehydration.

  • Describe the interprofessional team strategies for improving care coordination and communication to advance adult dehydration and improve outcomes.

Earn continuing education credits (CME/CE) on this topic.

Introduction

According to the lay press, 75% of Americans are chronically dehydrated. While this is not supported by medical literature, dehydration is common in elderly patients. It has been reported to occur in 17% to 28% of older adults in the United States.[1] Dehydration is a frequent cause of hospital admission. It can cause morbidity and mortality on its own and complicates many medical conditions. Dehydration may also be over-diagnosed. This can lead to misdiagnosis of the real cause of the patient’s illness and lead to over-treatment with fluids. Dehydration is easily treatable and preventable. A thorough understanding of the causes and diagnosis of dehydration can improve patient care.

Etiology

Body water is lost through the skin, lungs, kidneys, and GI tract. The loss of body water without sodium causes dehydration. Water is lost from the skin, lungs, gastrointestinal tract, and kidneys. Dehydration results when water losses from the body exceed water replacement. It may be caused by failure to replace obligate water losses. There are several forms of dehydration.[1] Isotonic water loss occurs when water and sodium are lost together. Causes of isotonic water loss are vomiting, diarrhea, sweating, burns, intrinsic kidney disease, hyperglycemia, and hypoaldosteronism. Hypertonic dehydration occurs when water losses exceed sodium losses. Serum sodium and osmolality will always be elevated in hypertonic dehydration. Excess pure water loss occurs through the skin, lungs, and kidneys. Etiologies are fever, increased respiration, and diabetes insipidus. Hypotonic dehydration is mostly caused by diuretics, which cause more sodium loss than water loss. Hypotonic dehydration is characterized by low sodium and osmolality.

The source of water loss may also understand the etiologies of dehydration:

  • Failure to replace water loss: altered mentation, immobility, impaired thirst mechanism, drug overdose leading to coma

  • Excess water loss from the skin: heat, exercise, burns, severe skin diseases

  • Excess water loss from the kidney: medications such as diuretics, acute and chronic renal disease, post-obstructive diuresis, salt-wasting tubular disease, Addison disease, hypoaldosteronism, hyperglycemia

  • Excess water loss from the GI tract: vomiting, diarrhea, laxatives, gastric suctioning, fistulas

  • Intraabdominal losses: pancreatitis, new ascites, peritonitis

  • Excess insensible loss: sepsis, medications, hyperthyroidism, asthma, chronic obstructive pulmonary disease (COPD), drugs

Epidemiology

There is no recent data on rates of dehydration in the general population, but we do know much of the epidemiology of dehydration in adults. Healthy adults with access to water rarely become dehydrated. Any adult may develop dehydration as a complication of an illness such as hyperglycemia. Dehydration may cause illness or be caused by an illness, so searches of databases may not capture all cases of dehydration. The data that we do have shows that older adults are more likely to develop dehydration. The elderly population is also 20% to 30% more prone to developing dehydration due to immobility, impaired thirst mechanism, diabetes, renal disease, and falls.[2][3]

Pathophysiology

Water plays a key role in maintaining multiple physiological functions within the body. The human body is 55% to 65% of water. Two-thirds of that water is intracellular, and one-third is extracellular. One-fifth of extracellular water is intravascular. The body has a complex system designed to maintain euvolemia. Water is absorbed through the gastrointestinal tract. The primary control of water homeostasis is through osmoreceptors in the brain. As perceived by these osmoreceptors, dehydration stimulates the thirst center in the hypothalamus, which leads to water consumption. These osmoreceptors can also cause the conservation of water by the kidney. When the hypothalamus detects lower water concentration, it causes the posterior pituitary to release antidiuretic hormone (ADH), which stimulates the kidneys to reabsorb more water. Decreased blood pressure, which often accompanies dehydration, triggers renin secretion from the kidney. Renin converts angiotensin I to angiotensin II, which increases aldosterone release from the adrenals. Aldosterone increases the absorption of sodium and water from the kidney. Using these mechanisms, the body regulates body volume and sodium and water concentration.

History and Physical

Hypovolemic patients can present with a wide assortment of symptoms and physical exam findings. Some of the most common presenting symptoms of dehydration include but are not limited to fatigue, thirst, dry skin and lips, dark urine or decreased urine output, headaches, muscle cramps, lightheadedness, dizziness, syncope, orthostatic hypotension, and palpitations. The patient’s history may elicit factors that could cause dehydration, such as exercise, heat exposure, medications, illness, impaired access to water, fever, or fluid loss.

Vital signs may show hypotension, tachycardia, fever, and tachypnea. Hypotension will not appear until significant dehydration is present. Tachycardia may be absent due to medications such as beta-blockers. A patient may appear lethargic or obtunded upon observation in severe cases of dehydration. The physical examination could show dry mucosa, skin tenting, delayed capillary refill, or cracked lips. A 2015 Cochrane review evaluated predictors of dehydration in the elderly.[4] Historical and physical findings tested were dry axilla, mucous membranes, tongue, increased capillary refill time, poor skin turgor, sunken eyes, orthostatic blood pressure drop, dizziness, thirst, urine color, weakness, blue lips, altered mentation, tiredness, and appetite. Of all these factors, only fatigue and missed drinks between meals predicted the diagnosis of dehydration.

Evaluation

There is no gold standard test for dehydration. Serum and plasma osmolality tests are often used to diagnose but may be affected by fluid loss or fluid loss acuity. A reasonable definition of dehydration due to water loss is serum osmolality greater than or equal to 295 mOsm/kg. The 2015 Cochrane review used serum osmolality of greater than 294 mOsm/kg to define dehydration. Weight loss equal to or greater than 3% over 7 days may also indicate dehydration if this data is available. The 2015 Cochrane review of diagnostic tests for dehydration in elderly patients, bioelectrical impedance analysis, urine specific gravity, the osmolality of urine, saliva, or tears, tear volume, number of urine voids, and urine volume were not useful as stand-alone tests for dehydration in the elderly. 

Blood urea nitrogen to creatinine ratio should be higher than 10:1 in dehydration, but this may be mimicked by high urea production, low creatinine due to low muscle lass, and urea reabsorption due to upper gastrointestinal bleed. Urine tests may suggest volume depletion. Urine sodium concentration should be low, fractional excretion of sodium should be under 1%, and urine osmolality should be greater than 450 mOsm/kg. These tests of renal perception of low blood flow may also be abnormal in heart failure, cirrhosis, nephrotic syndrome, and other causes of kidney disease.

Ultrasound can be used to assess a patient’s fluid volume by measuring the collapsibility of the inferior vena cava (IVC) with respiration. A variation in the diameter of the IVC greater than 50% with respiration indicates a collapsible IVC. IVC collapse with inspiration may correlate with right atrial pressure and intravascular volume.[5] Ultrasound evaluation of the IVC may be influenced by cirrhosis, chronic heart conditions, and ventilation (spontaneous or mechanical). IVC ultrasound has limited ability to predict fluid responsiveness.[6] It may be used as part of the entire clinical picture.

Treatment / Management

Treatment of dehydration is aimed at rapid fluid replacement as well as identification of the cause of fluid loss. Patients with fluid deficits should be given isotonic fluid boluses tailored to the individual circumstance. Patients with more severe dehydration get larger boluses of isotonic fluid. A more careful approach is needed in elderly patients and patients with heart failure and kidney failure. In these patients, small boluses should be given, followed by frequent reassessment and additional bolus as needed.[7]

Blood pressure, heart rate, serum lactate, hematocrit (if bleeding, there is no blood loss), and urine output may be used to assess the volume deficit and to assess response to fluids.

Isotonic crystalloid fluid should be used in most cases of dehydration. Colloids such as albumin may be used in specific situations but do not improve outcomes.[8]

The choice of crystalloid should be customized to the patient. Normal saline lactated Ringer’s solution and a balanced crystalloid solution may all be used. Normal saline may cause hyperchloremic metabolic acidosis in large volumes. Buffered crystalloids may cause hyponatremia. Lactated Ringer’s solution also contains potassium, so it should not be used in renal failure or hyperkalemia. No fluid has proved superior in all patients.

In patients with dehydration and severe hyponatremia, rapid volume repletion may cause a rapid rise in sodium. This can cause central pontine myelinolysis (CPM). The clinician must weigh the risks of continued dehydration against the risks of CPM. The patient’s volume status and serum sodium must be followed closely.

As the patient is being resuscitated, clinical and laboratory examination must focus on the discovery and correction of the cause of dehydration.

Differential Diagnosis

The principle differential of dehydration in adults is the loss of body water versus the loss of blood. This is important because blood loss should be replaced with blood, while water loss should be replaced with fluid. The next point to consider is the differential diagnosis of the cause of dehydration, as discussed under etiology.

Prognosis

When the underlying cause of dehydration is treated, and the patient’s volume has been restored, the majority of patients recover fully. Failure to treat dehydration in older adults may lead to significant mortality.[9]

Complications

Complications of dehydration occur due to inadequate fluid replacement and over-aggressive fluid replacement. Complications of under-resuscitation are due to hypoperfusion of vital organs and complications due to renal efforts to retain fluid. Altered mental status, renal failure, shock liver, lactic acidosis, hypotension, and death are related to organ-hypoperfusion. Fluid and electrolyte abnormalities such as uremia, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, metabolic acidosis, and metabolic alkalosis may occur. Excess fluid administration to correct dehydration may cause peripheral edema and pulmonary edema. In patients with severe hyponatremia, volume correction may cause a rapid rise in sodium, which can cause central pontine myelinolysis.  

Consultations

Renal consultation will be needed at times, especially with severe hyponatremia, but in most cases, the treating clinician can evaluate and correct dehydration.

Deterrence and Patient Education

Although the CDC does not have defined water intake recommendations, adults are encouraged to maintain between 2-3 L per day. [10] Patients should be encouraged to replace their losses to keep up with activity. For example, marathon runners water should drink more than a nonmobile person. In elderly patients, excessive free water drinking can cause hyponatremia, so balanced hydration solutions are recommended.

Pearls and Other Issues

  • The diagnosis of volume depletion depends on the careful assessment of physical exam, history, and laboratory tests. There is no one test to diagnose dehydration.

  • In patients with normal heart and renal function, liberal fluid may be given to restore volume quickly. In patients with heart failure and renal disease, volume still needs to be replaced, but a more a=careful approach is indicated. This is best accomplished with small volumes given quickly, followed by immediate reassessment and redosing as needed.

  • In severe hyponatremia, rapid correction of volume deficits may cause a sharp rise in the serum sodium that can cause central pontine myelinolysis (CPM). The clinician must assess the risks and benefits of rapid volume repletion versus the risk of CPM. In all cases, the volume status and sodium levels must be monitored closely.

Enhancing Healthcare Team Outcomes

Often because water intake is not the most pressing topic for the average clinical visit, it is often overlooked regarding patient care. If we can encourage more healthy lifestyle choices and daily hydration, it can lead to decreased morbidity, mortality, and complications associated with dehydration. Healthcare providers should look toward implementing more incentives and initiatives toward increasing hydration amongst staff and patient populations.

Continuing Education / Review Questions

References

1.
Weinberg AD, Minaker KL. Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association. JAMA. 1995 Nov 15;274(19):1552-6. [PubMed: 7474224]
2.
Miller HJ. Dehydration in the Older Adult. J Gerontol Nurs. 2015 Sep 01;41(9):8-13. [PubMed: 26375144]
3.
Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc. 1999 Oct;47(10):1187-94. [PubMed: 10522951]
4.
Hooper L, Abdelhamid A, Attreed NJ, Campbell WW, Channell AM, Chassagne P, Culp KR, Fletcher SJ, Fortes MB, Fuller N, Gaspar PM, Gilbert DJ, Heathcote AC, Kafri MW, Kajii F, Lindner G, Mack GW, Mentes JC, Merlani P, Needham RA, Olde Rikkert MG, Perren A, Powers J, Ranson SC, Ritz P, Rowat AM, Sjöstrand F, Smith AC, Stookey JJ, Stotts NA, Thomas DR, Vivanti A, Wakefield BJ, Waldréus N, Walsh NP, Ward S, Potter JF, Hunter P. Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people. Cochrane Database Syst Rev. 2015 Apr 30;(4):CD009647. [PMC free article: PMC7097739] [PubMed: 25924806]
5.
Lamarche J, Rivera AP, Courville C, Taha M, Antar-Shultz M, Reyes A. Role of Point-of-Care Ultrasonography in the Evaluation and Management of Kidney Disease. Fed Pract. 2018 Dec;35(12):27-33. [PMC free article: PMC6366586] [PubMed: 30766335]
6.
Long E, Oakley E, Duke T, Babl FE., Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does Respiratory Variation in Inferior Vena Cava Diameter Predict Fluid Responsiveness: A Systematic Review and Meta-Analysis. Shock. 2017 May;47(5):550-559. [PubMed: 28410544]
7.
Castera MR, Borhade MB. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Mar 3, 2021. Fluid Management. [PubMed: 30335338]
8.
Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R. , SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004 May 27;350(22):2247-56. [PubMed: 15163774]
9.
Mahowald JM, Himmelstein DU. Hypernatremia in the elderly: relation to infection and mortality. J Am Geriatr Soc. 1981 Apr;29(4):177-80. [PubMed: 7204813]
10.
Gandy J. Water intake: validity of population assessment and recommendations. Eur J Nutr. 2015 Jun;54 Suppl 2:11-6. [PMC free article: PMC4473081] [PubMed: 26048039]

Dehydration: 9 symptoms to be aware of

With temperatures starting to warm up and summer in sight, it’s a good time to take stock of our hydration habits.

Drinking enough water is important regardless of the season, but we tend to sweat more in hot weather, making it especially important that we refill that water bottle.

Heat can sometimes be very subtle in how it affects the body. If you’re out in the sun, it can take just 30 minutes or up to a few hours for the heat to cause dehydration, nausea or trouble concentrating, said Dr. Corey Slovis, professor of emergency medicine and internal medicine at Vanderbilt Medical Center.

Dehydration is a serious health concern. A study published in the American Journal of Public Health found that more than half of all children and adolescents in the U.S. aren’t getting enough water.

“People don’t realize the amount of fluid they can lose in the heat, or while exercising,” explained Michael F. Bergeron, Ph.D., president and chief executive officer of Youth Sports of the Americas. “And it’s important to note that your hydration needs are very individual.”

This health issue is more serious than you might think and could land you in the hospital.

Heat stroke occurs when the body temperature gets above 105 degrees. “One of the earliest signs of a heat-related illness is just not feeling right,” said Slovis. “There’s no one specific symptom.”

How much liquid do we need each day? And how can you tell if you’re dehydrated? Here are a few signs and symptoms that you might be dehydrated and tips to stay healthy all summer long.

1. Increased thirst and a dry or sticky mouth

“If you feel thirsty, you’re already dehydrated,” explained Dr. Laura Goldberg, pediatric sports medicine specialist in the Division of Sports Medicine at Case Western Reserve University School of Medicine. The easiest remedy is to start drinking water (and beverages with electrolytes) as soon as you notice this, but try not to let yourself get to this point.

The best way to prevent this from happening is to meet your daily hydration needs, for women, the National Academy of Sciences recommends 2.7 liters of water a day (about 11.4 cups), and for men, 3.7 liters (15 cups). Try to drink more water if you’ve spent excessive time in the sun, or exercising.

2. Signs of fatigue, confusion or anger

Studies have found that mild levels of dehydration can affect your mood and cognitive functions. This is especially common in the young or elderly, who may seem less alert, or forgetful.

A study from the University of Connecticut’s Human Performance Laboratory found that even mild dehydration can alter a person’s mood, energy and ability to think clearly. The researchers defined mild dehydration as an approximately 1.5% loss in normal water volume in the body — and the adverse reaction is the same whether you’re exercising or sitting still.

Related

3. Dry eyes or blurred vision

“When you’ve been exercising for a long time, you’re sweating and your overall body fluid goes down — this can result in dry eyes or blurred vision,” said Goldberg, who also noted that any part of the body that is normally moist is going to feel dry or irritated.

“Monitor your hydration levels and make sure you’re drinking throughout any form of exercise,” she explained further.

4. Headaches or disorientation

Dehydration can result in a headache or migraine, light headedness or delirium. “I’ve seen marathon runners running in zigzags because they’re dehydrated. You can’t make decisions and feel delirious,” elaborated Goldberg.

“You may also experience weakness, dizziness or nausea, because the body doesn’t have enough fluid to send to other parts of the body. This could also result in heat exhaustion. You can collapse if you don’t stop exercising and cool down,” warned Bergeron, who also added that these specific symptoms can also be signs of over hydration, so be aware of how much you’re drinking.

Related

5. Muscle cramps

“If you’ve been exercising, it’s natural for your legs to feel tired, but if it’s more than that and you’re experiencing muscle cramping, that’s a serious sign of dehydration,” Goldberg explained. This is because of the loss of water and salt in the body — you also might experience tightness in your muscles, instead of cramping.

“Wandering and progressively widespread muscle cramping is a certain clue of a sodium deficit and dehydration in the fluid spaces surrounding certain muscles,” Bergeron elaborated. “But don’t confuse it with an overworked muscle which would just affect a small area.”

To prevent this from occurring, it’s important to drink sports beverages that contain sodium, or snack on salted pretzels or low-fat cheeses. The sodium helps your body to re-hydrate and retain the water.

6. Lack of sweat

According to Goldberg, this is one of the more serious symptoms to look out for and a sign of severe dehydration. It means your body is in dire need of water. Though, on the other hand, Bergeron notes that more likely it may be a sign of overheating or heat stroke — though either can occur in the presence of continued sweating. Either way, it’s crucial to cool down rapidly if you’re not sweating anymore.

Related

7. Dark urine

“Straw-colored or light yellow urine means you’re properly hydrated. If your urine is dark, or if there’s blood in your pee, you need to stop exercising immediately,” warned Goldberg. Notably, perfectly clear urine may mean that you are over-hydrated.

8. Fever

“Dehydration can lead to hyperthermia and a fever-like symptoms (e.g. chills) because over-heating can alter your body’s normal temperature ‘set point,’” explained Goldberg. Excessive overheating is an urgent red flag. Stop exercising immediately, take an ice bath and hydrate.

9. Shriveled and dry skin

If your skin is hydrated, it will appear doughy. If you’re dehydrated, your skin will lack elasticity and won’t bounce back. “If you pinch your skin and it appears thin and doesn’t melt back onto your body quickly, you’re dehydrated,” said Goldberg.

Some key things to remember when exercising in the summer is that the longer you’re working out, the more water you need. Also, plain water is good for you, but a combination of water, electrolytes and sodium is really the best way to stay hydrated.

It’s also crucial to understand that hydrating properly isn’t 100% preventative, if you’re working too hard and too long in the summer heat, you can still overheat no matter how much water you’re drinking. So be aware of your body, and stop what you’re doing if you notice any of these symptoms.

Dehydration – AMBOSS

Last updated: December 7, 2020

Summary

Dehydration (exsiccosis) is a state of decreased total body water. This decrease in total body water occurs in excess of sodium (also called “free water loss”), resulting in a hypertonic and hypernatremic state. The terms “hypotonic” and “isotonic” are sometimes incorrectly used to describe dehydration, but these terms are only associated with _Definitions”#Z2c4b7b192fbfa8d2679ddc134ed0e9c5″ data-lxid=”Ig0Y92″>hypovolemia and hypovolemic shock. Dehydration most often affects children and the elderly. Treatment of dehydration involves correcting the free water deficit.

Etiology

References:[1][2][3][4][5]

Clinical features

References:[3][4][6][7][8]

Diagnostics

References:[3][4][7][9][10][11][12]

Treatment

Patients who are _Definitions”#Z2c4b7b192fbfa8d2679ddc134ed0e9c5″ data-lxid=”Ig0Y92″>hypovolemic as a result of severe dehydration require immediate fluid resuscitation with crystalloid solutions.

  1. Fluid resuscitation
  2. Correction of electrolyte abnormalities
    • Sodium imbalance should only be addressed once the patient is adequately resuscitated.

References:[3][13][14][15]

Complications

References:[16][17][18][19]

We list the most important complications. The selection is not exhaustive.

References

  1. Faes MC, Spigt MG, Olde Rikkert MGM. Dehydration in geriatrics. Geriatrics & Aging. 2007; 10
    (9): p.590-596.

  2. Wook Lee J. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010; 8
    (2): p.72-81.
    doi: 10.5049/EBP.2010.8.2.72 . | Open in Read by QxMD

  3. Huang LJ. Dehydration. In: Corden TE, Dehydration. New York, NY: WebMD. http://emedicine.medscape.com/article/906999. Updated: November 27, 2016. Accessed: April 12, 2017.
  4. Sterns RH. Etiology, Clinical Manifestations, and Diagnosis of Volume Depletion in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/etiology-clinical-manifestations-and-diagnosis-of-volume-depletion-in-adults.Last updated: February 29, 2016. Accessed: April 12, 2017.
  5. Fleisher GR, Ludwig S. Textbook of Pediatric Emergency Medicine .
    Lippincott Williams & Wilkins
    ; 2010

  6. Somers MJ. Clinical Assessment and Diagnosis of Hypovolemia (Dehydration) in Children. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/clinical-assessment-and-diagnosis-of-hypovolemia-dehydration-in-children.Last updated: November 30, 2016. Accessed: April 12, 2017.
  7. Sterns RH. General Principles of Disorders of Water Balance (Hyponatremia and Hypernatremia) and Sodium Balance (Hypovolemia and Edema). In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/general-principles-of-disorders-of-water-balance-hyponatremia-and-hypernatremia-and-sodium-balance-hypovolemia-and-edema.Last updated: February 1, 2017. Accessed: April 12, 2017.
  8. Davenport M, Syed SHS. Handbook of Pediatric Surgery .
    Springer Verlag London Limited
    ; 2010

  9. Dasgupta A, Wahed A. Clinical Chemistry, Immunology and Laboratory Quality Control.
    Academic Press
    ; 2013

  10. Horowitz GL. Creatinine. In: Staros EB, Creatinine. New York, NY: WebMD. http://emedicine.medscape.com/article/2054342. Updated: December 10, 2014. Accessed: April 12, 2017.
  11. Lukitsch I. Hypernatremia. In: Batuman V, Hypernatremia. New York, NY: WebMD. http://emedicine.medscape.com/article/241094. Updated: August 24, 2016. Accessed: April 14, 2017.
  12. Chiasson J, Aris-Jilwan N, Bélanger R et al. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. CMAJ. 2003; 168
    (7): p.859–866.

  13. Somers M. Treatment of Hypovolemia (Dehydration) in Children. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/treatment-of-hypovolemia-dehydration-in-children.Last updated: November 13, 2016. Accessed: January 19, 2018.
  14. Mandel J, Palevsky PM. Treatment of Severe Hypovolemia or Hypovolemic Shock in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/treatment-of-severe-hypovolemia-or-hypovolemic-shock-in-adults.Last updated: January 17, 2018. Accessed: January 19, 2018.
  15. Faubel, S and Topf, J. The Fluid, Electrolyte and Acid-Base Companion.
    Alert and Oriented Publishing Co
    ; 1999

  16. Sterns RH. Manifestations of Hyponatremia and Hypernatremia in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/manifestations-of-hyponatremia-and-hypernatremia-in-adults.Last updated: January 5, 2016. Accessed: February 14, 2017.
  17. Kolecki P. Hypovolemic Shock. In: Brenner BE, Hypovolemic Shock. New York, NY: WebMD. http://emedicine.medscape.com/article/760145. Updated: October 13, 2016. Accessed: April 14, 2017.
  18. Richards MJ, Stuart RL. Causes of Infection in Long-Term Care Facilities: An Overview. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/causes-of-infection-in-long-term-care-facilities-an-overview.Last updated: November 3, 2015. Accessed: April 14, 2017.
  19. Touhy TA, Jett KF. Ebersole and Hess’ Gerontological Nursing & Healthy Aging .
    Elsevier Health Sciences
    ; 2016

  20. UpToDate. Physical findings of volume depletion in infants and children. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/image?imageKey=PEDS%2F76198&topicKey=PEDS%2F6142&rank=1~150&source=see_link&search=dehydration%20children.Last updated: January 1, 2017. Accessed: April 12, 2017.

90,000 Signs of dehydration – SM-Clinic St. Petersburg

Do you drink enough water, monitoring your body will help. If he has little liquid, he reports it with the help of the following signs:

1. You sweat a little during sports

The body must actively sweat during heavy exertion, otherwise it will overheat. When exercising in hot weather, drink more liquid per glass per day.

2. The skin became oily and at the same time dry

If the skin lacks moisture, it dries up, while continuing to shine.

3. Bad breath

The cause of bad breath can lie in stomach diseases and problems with the gums. The problem that can be easily solved is the lack of saliva. If there is enough saliva, it protects well against bacteria in the mouth.

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4. Constant hunger

One part of the brain is responsible for the feeling of hunger and thirst, so it is easy to mistake the desire to drink water for the desire for something to eat.Instead of having a snack, try drinking plenty of water, and monitor your body: is it still hungry?

5. Weight gain

Nutrition and physical activity are normal, but you are only gaining weight? Probably, you have not thought enough about the mode of drinking water. Dehydration slows down your metabolism, so stay hydrated, especially in hot weather.

6. Weakness

The reasons for constant lethargy can be many, they are identified by the doctor.But enough water means a lot for strong immunity. First, try drinking more and see the result.

What Every Parent Should Know?

Dehydration (the medical term exicosis) is a pathological condition in which the body loses fluid, as well as salts and minerals dissolved in it.

What could be the cause of dehydration in children?

1. Difficulty entering fluid into the body.This situation is rare. This, or the lack of drinking water at hand. Or the child’s refusal to drink liquid. For example, due to pain when swallowing. Or severe pathological conditions in which the child cannot swallow on his own.

2. Increased excretion of water and minerals by the body. When the loss exceeds her income. This situation is observed in acute infections, food poisoning, parasitic infection, antibiotic-associated diarrhea, overheating, burns.

It is worth talking about these reasons in more detail.

1. Increased fluid loss can occur with acute respiratory infection. Sweating increases with high fever. This is a physiological process. This is how the body cools itself. In addition, fluid loss occurs with mucus flowing abundantly from the nose. And also when coughing, especially productive. Severe dehydration with ARVI usually does not occur. However, fluid loss should be replenished in full, especially in young children.That is why pediatricians recommend an abundant warm drink for colds. Warm water is absorbed faster in the intestines than cold water.

2. The most dangerous condition for dehydration is such a condition as an acute intestinal infection. Her symptoms:

  • increased temperature;
  • single or multiple vomiting;
  • 90,096 diarrhea, stool frequency can be from two (subject to liquid consistency) to 20 or more times per day;

    90,096 pain and rumbling in the abdomen;

  • loss of appetite, weakness, drowsiness;
  • 90,096 refusal of water and drink.

This infection is especially dangerous in infants. This is due to their physiological characteristics: they have a higher percentage of body fluids. For babies, losing even a small amount of fluid can be dangerous.

Intestinal infections are divided into two large groups – viral and bacterial. The mainstay of the treatment of viral infections is precisely the fight against dehydration. Some bacterial infections require an antibiotic. In order to distinguish between the two types of infections, you need to show the child to the pediatrician.It is not worth prescribing an antibiotic to the child yourself, because it is not necessary in all cases of intestinal infection.

3. Food poisoning – usually does not threaten the child’s life and goes away quickly enough, within 1-2 days, with rare exceptions.

4. It is very important to replenish fluid in case of burns, including sunburn. Since damaged skin loses a large amount of fluid.

What are the types of dehydration?

Doctors classify exicosis according to severity.Depending on how many percent of body weight the child lost in the form of water:

Grade 1 – 3% of body weight. Light degree of dehydration. Its main features:

  • thirst;
  • dry skin and mucous membranes;
  • tense urination.

Grade 2 – from 3 to 6% of body weight. Moderate severity. The main symptoms are:

90 095 90 096 expressed thirst;

  • dry skin and mucous membranes;
  • tongue coated with white or grayish bloom;
  • weakness and drowsiness;
  • urinary retention up to 6 hours;
  • in infants, retraction of the fontanelle.
  • Grade 3 – 9% or more. Severe dehydration. This condition is dangerous and requires immediate medical attention. Its main features will be:

    90 095

  • crying of a child without tears;
  • severe weakness and drowsiness;
  • pronounced retraction of the fontanelle in infants;
  • 90 096 pronounced dry skin, chapped lips;

  • eye sinking;
  • The most severe symptoms of dehydration are:

    • thin saggy skin;
    • loss of consciousness;
    • 90,096 convulsions;

      90,096 drop in body temperature;

    What symptoms can a doctor find on examination?

    • shallow breathing;
    • rapid heart rate;
    • decrease in blood pressure;
    • increase, and in severe cases, a decrease in body temperature relative to the norm.

    In addition, you should definitely show your child to a doctor if:

    • blood was found in stool or vomit;
    • if the child categorically refuses to drink, and diarrhea continues for more than a day;
    • 90,096 the child drinks, but the diarrhea lasts more than a week.

    What to do when dehydrated?

    First of all, you need to try to get the child drunk.

    1 What should be given to drink?

    • Breast milk remains the topical drink for an infant.Babies with signs of dehydration should be applied to the breast as often as possible, do not skip night feedings, and do not shorten the feeding time. In addition to breast milk, children should be offered plain boiled water
    • For older children, there are special solutions for oral rehydration. With their help, you can replenish not only the loss of water, but also electrolytes (potassium, calcium, sodium, chlorine), as well as glucose. It is better to consult a doctor about the choice of a specific drug. not all oral rehydration solutions can be used at an early age.In the absence of a special medicine. Or, if the child refuses to drink it, you can give the child plain water or other liquids to drink.

    2 What shouldn’t be given to drink?

    • It is strictly forbidden to use coffee or tea to replace the loss of liquid. These drinks can worsen the symptoms of dehydration. have a diuretic effect.
    • Do not use sugary carbonated drinks for soldering. They can aggravate the manifestations of the underlying disease.
    • Small children should not be fed with rice water, because it may contain traces of arsenic.
    • Do not give fruit juices to children. Their daily consumption is limited in preschool children. Acidic juices can irritate the gastrointestinal tract and worsen diarrhea.
    • Do not give cows milk to children. It gives a high protein load on the baby’s digestive organs. May provoke vomiting. In addition, it should not be given even to healthy children under one year old.

    3. How to drink properly?

    You need to drink in small portions, starting with the volume of half or a whole teaspoon, gradually increasing the volume to 2-3 tablespoons. The one-time volume is individual and depends on the well-being of the child and the presence of vomiting. You need to offer liquid to the child every 5-15 minutes. Unsoldering lasts until the child stops losing fluid.

    5. How to determine the required volume of liquid?

    Clinical guidelines do not give strict recommendations in this regard.Approximate volume of 50-100 ml for each kilogram of the child’s weight for the first few hours. For an approximate calculation, you can rely on age. Up to 2 years old, a child needs to consume about a liter of liquid per day, after 2 years up to one and a half liters.

    6. What if the child does not drink?

    Only droppers can be an alternative to oral soldering. Therefore, you need to make every effort to ensure that the child drinks a certain amount of liquid.If the child categorically refuses to use special solutions, compote, highly diluted non-acidic juice, weak tea can become an alternative.

    In severe dehydration, fluid loss is replenished only by intravenous administration. This is possible only in an infectious hospital. With the development of a life-threatening condition, the child can be taken to the intensive care unit.

    How else can you help your child?

    Usually, children who are dehydrated refuse to eat.You should not feed your child if he flatly refuses. As soon as the baby becomes a little easier, he will ask for food himself. Cereals are considered optimal for nutrition. Porridge with milk diluted in half with water. You can also offer your baby steam cutlets, stewed vegetables, non-steep broths, dryers and crackers. They categorically exclude from the diet sugary carbonated drinks, fatty and fried, raw fruits and vegetables and whole milk.

    Food should be offered to the child in small portions, at short intervals.In my practice, it often happens that a baby who feels better asks for large amounts of food at once. Parents rejoice at the appetite that has appeared. As a result, the child is overfed. This provokes a new wave of malaise, vomiting and repeated dehydration.

    It is very important to provide an optimal environment. A sick child’s room should be cool. The hotter it is, the more water is lost. Dehydration increases.

    You cannot give your child antiemetic and antidiarrheal drugs on their own.These medicines can only be used as directed by a doctor and under his strict supervision.

    Online consultation of a Pediatrician

    Online consultation

    As part of the consultation, you will be able to voice your problem, the doctor will clarify the situation, decipher the analyzes, answer your questions and give the necessary recommendations.

    What are the adverse effects of dehydration in a child?

    If assistance was provided to the child on time and in full, dehydration does not have any negative consequences for the body.

    In advanced cases, the consequences may be disruption of the work of organs and systems:

    • Disruption of the cardiovascular system: decrease in blood pressure, oxygen starvation of the body, arrhythmia as a result of impaired ion exchange;
    • impaired renal function due to imbalance of blood electrolytes;
    • Disruption of the nervous system (convulsions).
    • violation of thermoregulation, drop in body temperature.

    Prevention of conditions contributing to dehydration

    First of all, you need to try to protect your baby from intestinal infections. Vaccination is a specific prophylaxis measure. A vaccine against rotavirus infection has now been developed. It is introduced to a child from 2 to 8 months of age three times. And it protects the baby’s body in 80-85% of cases from infection and in 100% of cases from a severe course.

    Non-specific prevention of intestinal infection is the observance of hygienic measures: frequent hand washing, reducing contact with sick children.

    If the infection could not be avoided, then the child should be shown to the pediatrician. And start soldering with water or a special solution on your own, even before the doctor arrives.

    Prevention of food poisoning is the rejection of the use of poor-quality products, proper heat treatment of food.

    In case of overheating and sunburn, it is necessary to replenish the lost fluid in a timely and sufficient amount.And also cool the body by rubbing with cold water or a cool bath.

    In the overwhelming majority of cases, parents manage to cope with the manifestations of dehydration in a baby on their own. However, you need to be wary of symptoms, especially in children under one year old, in order to provide them with medical assistance in a timely manner.

    Signs of dehydration in your dog | Beethoven – veterinary clinic, Krasnoyarsk

    Water is a part of cells, intercellular substance, tissue fluid and lymph.In adult mammals and birds, water makes up about 65%, or 2/3 of the live body weight, and serves in the body as a solvent for various substances.

    Animals deprived of water die in a very short time. A well-fed dog can survive fasting on condition of water supply for up to 100 days, but without water it dies after 10 days. The loss of only 10% of water causes severe pathological changes, and the loss of 15-20% of water leads to death.

    Water enters the body during drinking and with food and is absorbed in the intestine unchanged.The need for water varies depending on the composition of the feed, the physiological state of the animal, environmental conditions, etc. For example: when feeding with dry food, increased physical activity or in hot weather, the need for water is higher.

    The body’s need for water is regulated by the feeling of thirst . The water entering the body must fully compensate for its constant losses with urine, sweat, feces (feces), exhaled air, since the amount of water excreted from the body is always somewhat greater than that consumed with food and drink.

    If the body lacks water …

    With a decrease in the intake of water in the body or with severe losses (for example, with vomiting or in the presence of loose stools, with an increased volume of urination (polyuria)), dehydration of the body occurs. This condition is dangerous, since the blood thickens, the metabolism in the body is disrupted, since all chemical transformations occur only in aqueous solutions. Outwardly, this is characterized by general weakness, decreased skin elasticity, dryness of visible mucous membranes (mouth, nose, conjunctiva), retraction of the eyeballs.With the progression of dehydration, a state of shock (hypovolemic shock) develops and, if fluid loss is not replenished in time, death occurs.

    Dehydration should not be confused with blood loss – this is not the same thing, there is a fundamental difference between the two concepts. with dehydration, the animal’s body loses only water and electrolytes, and with blood loss, blood cells (erythrocytes) and blood plasma proteins are also lost, which are so necessary for the normal functioning of the animal’s body.

    There are several degrees of dehydration, but at home it is difficult for owners to determine the degree of dehydration on their own.

    The following symptoms should alert you:

    • Early signs of dehydration in dogs are lethargy, low mood, depression,
    • your pet has a decrease or complete lack of appetite and / or refusal to drink for one, maximum two days,
    • if you experience repeated vomiting or loose stools for several hours, a maximum of one day, as well as a high temperature and an increased volume of urination.

    Such symptoms are typical for many diseases, therefore, if your pet develops at least one of the above symptoms, you should consult a doctor as soon as possible.

    Before arriving at the clinic, you can try to forcibly drink water from a spoon, syringe or syringe and try to give food, but only if the animal does not have vomiting , if vomiting is present, then you do not need to give anything inside, because this provokes new bouts of vomiting and aggravates the situation.

    What the doctor will do

    When examining an animal, the doctor will pay attention to the condition of the mucous membranes, skin and the general condition of the animal and, if clinical signs of dehydration are detected, assess its degree.

    As additional studies, first of all, it is necessary to take blood tests (general clinical and biochemical), which will show the state of the internal systems of the body, the composition of the blood and the ratio of its elements and will help the doctor in diagnosing the underlying disease that caused dehydration of the dog’s body.However, these studies can not always provide all the necessary data for the diagnosis, in this case, a number of other diagnostic studies are carried out. For example: ultrasound, radiography, etc.

    In parallel, the doctor will begin to replenish fluid loss by intravenous or subcutaneous infusion of solutions (infusion therapy). The volume of injected solutions and the method of their administration depend on the degree of dehydration.

    Infusion therapy is carried out in the clinic in the infusion therapy room, where the animal is with the owner, or in a hospital where the animal is without the owner.The animal is admitted to the hospital if the degree of dehydration is very high and there is a threat to the life of the animal, or if the owner cannot come for the infusion, and the animal requires daily infusions.

    18 signs that we are drinking little water

    Water is the source of life on our planet, for all living things water is one of the main components in their organisms. As one of the most complex, the human body needs a daily replenishment of water reserves as it constantly loses it.We are so carried away by the modern pace of life that it is easy to forget about the last meal, not to mention the last glass of water. People have learned to overcome the feeling of hunger and thirst, but the latter is much more critical, since dehydration instantly affects the body. People who regularly expose their body to a lack of water, and there are a lot of them even in modern megacities with a high standard of living, may experience more serious consequences of dehydration.

    For you, we have collected 15 of the most common and easy-to-diagnose signs of a lack of water in the body, which will tell you that dehydration has come and you need to urgently replenish it by drinking a glass of water.

    1. Feeling of dry mouth

    The simplest and surest sign that you have a lack of water in your body is dry mouth. Usually the sensation appears even before the feeling of thirst. It seems that everyone encounters him regularly, and in the hot summer months almost every day. Sometimes this sensation even wakes up at night so that you can make up for the lack of water. Sometimes dry mouth appears after long conversations and conversations, when the mucous surfaces of the mouth are exposed to abundant contact with air, it is not for nothing that speakers at presentations and reports take a bottle of water with them.In athletes engaged in prolonged physical activity, for example, jogging, the mucous membrane of the mouth dries out constantly at regular intervals, so many athletes do not drink water during the competition, but simply moisten their mouth with water and spit it out.

    2. Sensation of dryness in the eyes

    Surely you felt dryness in your eyes, it feels like something got into your eyes, but in fact there is nothing there. Unpleasant sensations in which the eyes turn red, blood vessels appear on the surface and you have to blink more often.People who wear contact lenses feel this much more critical, because the lenses dry out and begin to fall out, move out of place and further irritate the mucous membrane of the eye. All these are true signs of a lack of water in the body, the mucous membranes are always the first to react to its lack. When dryness appears in the eyes, you do not need to immediately get eye drops, it is enough to replenish the lack of water in the body, as all the unpleasant sensations of dryness in the eyes will go away in a matter of minutes.

    3. Feeling of intense thirst

    Feeling not just thirst, but intense thirst, when you urgently want to drink any liquid, no matter cold or hot, mineral water or sweet soda. Thirst itself is already a sign of a lack of water in the body. A good example of a hangover, although this is a one-time case when you really want to drink, but after a while the thirst comes back again. Chronic high thirst means that you regularly drink less water than your body needs.

    4. Dry skin

    The skin is the largest organ of the human body and has many functions, of which the most important is protective. Dermatologists often call the skin a mirror of the state of the body, because all diseases and the lack of any substances and microelements are very quickly projected onto it. A huge amount of moisture evaporates from the surface of the skin, with a lack of water in the body, dry skin is one of the serious signs of dehydration. Feeling dry is a very worrying sign, as your body wants to tell you to replenish your water supplies immediately.In addition, dry skin is more prone to microtrauma, sunburn and calluses.

    5. Feeling of unquenchable hunger

    Mild dehydration can easily be confused with a feeling of mild hunger. When it occurs during the day, a person intuitively tries to eat something small that will be at hand, in the evening and at night there is a desire to go to the refrigerator and see what is there for a quick snack. The feeling of thirst can be transformed into a feeling of hunger, from which even a full meal will not help, not to mention small snacks, which will muffle this feeling only for a short time.If you are confident that the amount of food you are eating is sufficient, then try to determine the amount of water consumed during the day. Perhaps you can forget about various cookies and night trips to the refrigerator if you drink enough water.

    6. Muscle mass decreases

    Muscles, like the entire human body, are mainly composed of water, therefore, a decrease in the amount of water in the body directly affects muscle mass. The body, realizing that at the moment it does not need muscles so much than other vital organs, will immediately take away their water.Due to the lack of water, the muscles become smaller, lose their elasticity and are capable of only part of the loads that they could take on with a sufficient amount of water in the body. Athletes are advised to drink water during and after training, including so that the muscles are in good shape and the training is as effective as possible.

    7. Weakened immunity and long-term illnesses

    Probably everyone remembers that from childhood we are advised to drink more water during colds and flu, and this is quite reasonable advice.Water not only delivers micro-substances to the body, but also removes toxins from it. If there is not enough water in the body, then the excretion processes will begin to slow down, the organs will take water from the blood, which will slow down the metabolism, and therefore the process of the body’s natural fight against the disease will also be delayed in time.

    8. Drowsiness and chronic fatigue

    Drowsiness is a natural protective function of the body when there is a lack of energy, overwork and dehydration.The body tries to go into a resource-saving mode and go to sleep, in which some of the energy will be restored by prolonged rest. But, as a rule, sleepiness, which does not come late in the evening and not after prolonged physical exertion, may indicate a lack of water in the body. The body itself cannot replenish its deficiency, but it is enough to save the remaining water for a longer period during dehydration with the help of sleep, which it is trying to do. Chronic fatigue and lethargy also indicate that the body does not receive the water it needs so much, low energy levels in most cases are caused precisely by dehydration.

    9. Rapid fatigue

    If, after a short physical exertion, the body feels tired, then most likely it is not a lack of habit to exercise, but low muscle tone caused by a lack of water. If in the mode of low activity of a person, slight dehydration does not make itself felt, then with the appearance of physical activity, albeit very small, dehydration immediately becomes obvious, because the water consumption increases significantly.

    10. Unexplained digestive problems

    It would seem that the whole diet was normal, but for some reason there were problems with digestion, indigestion, sometimes even heartburn can be the result.Like all mucous membranes, the stomach wall also needs a sufficient amount of moisture. Gastric juice and its structure are also strongly tied to the amount of water in the body and can thicken when there is a lack of it.

    11. Constipation and unpleasant sensations during bowel movements

    Perhaps another simple way to understand that there is a lack of water in the body. As a rule, even doctors advise in such situations not to try to immediately solve the problem with the help of drugs and other external influences, but just drink a couple of glasses of water and wait, because dehydration is one of the most common causes of constipation.In addition, with a lack of water, problems in the work of the intestines may arise, its surface may lose its properties and it will be much more difficult for it to cope with its functions, hence, unpleasant sensations during bowel movements are possible. With such regular conditions of the intestine, more serious consequences are possible than just unpleasant sensations.

    12. The appearance of signs of premature aging

    With age, our body gradually loses its various abilities, including the decrease in the volume of water that it can hold as a reserve.If signs of premature aging began to appear on the body, then similar processes occur inside the body, which are much more destructive for the body and its productivity than those that are visible externally. Regular dehydration only aggravates and accelerates the aging process, which can only be slowed down. Therefore, it is very important to maintain the water balance at a normal level and do not deny yourself a few sips when you feel like it.

    13. Insufficient urination

    Observe how many times you go to the toilet per day.If you urinate less than 4 times a day, then this is a reason to think about whether you are drinking enough water, pay attention to the color of urine and review your diet for an increase in moisture-containing foods. Infrequent urination leads to bladder problems and urinary tract infections.

    14. Weight gain

    With a lack of water in the body, he tries to retain it by all available means, including accumulating it. Therefore, with a constant stay of the body in a state of dehydration, weight gain can be observed just due to that stored water.There is nothing good in such an effect, because it is worth limiting oneself even on diets in anything, but not in the amount of water consumed.

    15. Squeak and joint pain

    The main part of each joint is cartilage, which is 80% water, thanks to which they are sufficiently strong and elastic. The joint capsule also contains synovial fluid, which acts as a lubricant, filling all cavities between cartilages and softening friction inside the joint. When the body is dehydrated, the joints feel a lack of water on themselves, sometimes there is a creak in the knees and elbows, painful sensations.Cartilage loses its elasticity, and the synovial fluid becomes thicker and worse at its functions of preventing excessive friction and cushioning. First of all, the knees and spine suffer from dehydration, since even with a quiet lifestyle, they have the greatest constant load.

    16. Discoloration of urine

    Urine should be as clear as possible, this indicates that the body is healthy and has a sufficient level of water. As soon as the color of the urine changes and becomes pronounced, it means that the body is dehydrated, or, much less likely, some kind of disease has appeared.Usually, this phenomenon can be observed in the morning after sleep at the first urination, since the urine is stagnant in the body, and it is dehydrated, because sleep usually lasts about 8 hours. If the urine has a rich color during wakefulness, this means that there is a lack of water in the body and it needs to be replenished.

    17. Dizziness and headaches

    Headache is one of the alarming signs of dehydration, which turns on if the rest of the body’s signals about a lack of water have not worked.Dehydration headaches are similar to those experienced during a hangover, as the nature of their occurrence is very similar.

    18. Food poisoning, diarrhea and vomiting

    In these states, the body loses water at a monstrous rate and its volumes need to be replenished as soon as possible, only you should not drink any drinks, but just plain clean water as soon as it is available absorbed faster and will not harm the body in its current not very healthy state.With prolonged vomiting and diarrhea, it is recommended to add some salt to the water and drink such a solution gradually in small sips, because salt helps to retain water in the body and reduce the likelihood of dehydration.

    Such a huge number of problems with dehydration can be solved with just a few sips of water, but it is important to remember that the appearance of most of the signs mentioned above means a constant lack of water in the body, so you need to take these few additional sips constantly, several times every day.The clean drinking water that is now available can help prevent such a huge number of serious negative consequences of its shortage. All you need to do is follow the signals of your body, which is very sensitive to the balance of water and in every possible way signals about its lack. To always have clean drinking water at your home and office, order water from us with free delivery on the day of order. Remember that you should never limit yourself to drinking water, because it is the foundation of your body.

    7 signs of dehydration

    Lack of water in the body leads to serious consequences, ranging from constant headaches, depression and death. Any dehydration is stress for the body, therefore, all doctors and traditional healers recommend drinking clean water. It is important to drink just plain water, and not replace it with drinks – tea, coffee, soda.

    The lack of water in the body does not go unnoticed.In this article, we’ll look at the main signs of dehydration and how to train yourself to drink more water.

    How much water should you drink per day?

    Man consists of 70-75% water. This environment is actively involved in all vital processes – metabolism, cell nutrition, removal of toxins and toxins, body thermoregulation, etc. In addition, water ensures stable joint and muscle function.

    We lose fluids every day in the form of sweat and urine, so it needs to be replenished regularly as well.It is best to use regular non-carbonated water for drinking throughout the day. Tea, coffee and other drinks are not good for this, and they are also powerful diuretics.

    The amount of water consumed per day depends on many factors: climatic conditions, lifestyle, age, physical activity, etc. However, the required volume for an adult varies from 1.5-2 liters of ordinary water per day.

    Dehydration symptoms

    Lack of water in the body causes the following ailments and discomfort:

    • Dry mouth.If the body has little water reserves, then saliva production stops partially or completely. The person feels unpleasant dryness in the nasopharynx. The best way to fix the problem is to drink a glass of water.
    • Dry skin. One of the signs of a serious fluid imbalance in the body.
    • Highlights are dark yellow. A dark shade of urine indicates severe dehydration.
    • Drying of the mucous membranes of the eyes. There is an itching sensation around the eyes, as if sand had got into them.
    • Painful symptoms in the joints when walking. Water is an important element in the bone and muscle structure of the body, so when there is a lack of fluid, they are the first to start to hurt.
    • Sleepiness, tiredness. Water is a universal transporter of oxygen to the blood and body cells. If you feel a constant lack of strength, you want to sleep and move less, then in 90% of cases it is a sign of dehydration.
    • Problems with bowel movements. Water helps to stabilize the gastrointestinal tract, soften stool and promote normal gastric emptying.

    The habit of drinking enough water

    If you drank little water before, then it is not easy to immediately switch to 1.5-2 liters a day. It is important to gradually accustom the body to water. Drink 3 glasses a day first: in the morning, at lunchtime and before bedtime. Then after a month, increase the rate to 6 glasses and so bring it to 8-9 servings of 250 ml per day.

    It is also important to drink water in small sips, so as not to overload the kidneys. To train yourself to drink clean liquid every 2-3 hours, put a reminder with an alert on your cell phone.

    It is also important to learn to distinguish between the feeling of thirst and the desire to eat. Often, the body of modern people confuses these urges, which leads to gaining excess body weight. The simplest solution: before you want to eat, drink a glass of water. If after 20 minutes the feeling of hunger has not passed, then it’s time to eat.

    If clear water is not to your taste

    Sometimes raw water is not very tasty, especially for people who are not used to drinking it.

    In this case, try the following fluid additives:

    • Citrus fruits.Add a slice of lemon, lime or orange to a glass of water and refrigerate overnight. In the morning it will be pleasant and useful to drink such water.
    • Pineapple water is not only pleasant to drink, but also activates metabolic processes in the body – it helps to lose weight. In addition, it removes toxins and antioxidants from the body, treats arthritis, atherosclerosis and other joint diseases. The recipe for pineapple water is simple: cut 200 grams of the product without the peel, add a little mint, pour all 2 liters of water and leave in the refrigerator overnight.
    • Apple water will help you to cheer up in the morning. The simplest recipe is to chop a sour apple, add half a teaspoon of grated ginger and a quarter spoon of cinnamon, then pour 1.5 liters of boiling water over everything and leave to cool in the refrigerator.
    • Berries. In the summer season, you can take 200 grams of any berries, knead them, squeeze lime juice and add a sage leaf. Pour 2 liters of water and leave in the refrigerator overnight.

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    90,000 How to understand that the body lacks water

    A person, depending on his weight, needs to drink from 1.2 to 3 liters of clean water per day.Thanks to a sufficient amount of fluid, the internal organs function, the metabolism is improved, the optimal body temperature is maintained. If the body lacks it, it begins to signal this. Signs of dehydration include dry skin, high blood pressure, and dizziness.

    What signals does the body give when dehydrated

    The following signs may indicate that the body is lacking water. They appear simultaneously or separately.

    Heartburn

    If heartburn rarely torments you, do not worry. When discomfort occurs regularly, it could be due to dehydration. Heartburn appears with increased acidity of the stomach, in order to bring the indicator back to normal, you need to drink more. Drinking clean water half an hour before meals and two hours after will help.

    Dry mouth

    Prolonged absence of saliva can damage the oral cavity.This is an indicator of severe dehydration, which is eliminated by regular intake of daily fluid intake. In this case, sweet or alcoholic drinks, coffee are not suitable. Only clean drinking water.

    Dizziness

    If you periodically suffer from slight dizziness, this may be due to a lack of fluid in the body. You can get rid of them if you drink enough water every day.

    Overpressure

    The lack of fluid also affects the state of the blood: it thickens, begins to move worse through the vessels, and this causes an increase in pressure.A glass of clean drinking water will help bring it back to normal.

    Dry skin

    A common symptom by which you can determine dehydration. If the skin is dry, peeling, there is a feeling of tightness, maintaining the water balance will help to bring it back to normal.

    The daily rate is determined by a person’s body weight. With a weight of 40 kg per day, it is enough to drink 1.2 liters, with a weight of 60 kg – 1.8 liters, 80 kg – 2.4 liters, 100 kg – 3 liters. For convenience, you can create a “water calendar” and mark the amount of fluid you drink every day.

    It is best to start the day with a glass of water – it helps to wake up and normalizes metabolic processes. In order not to forget to drink, you can distribute the receptions throughout the day. For example, drink 250 ml every 2 hours. After a couple of weeks, the body will get used to it and itself will remind you of the need to replenish the water balance.

    90,000 7 Signs And Symptoms Of Dehydration In Young Children

    Medical examination by the doctor Afonina Daria Alexandrovna (doctor of medicine, pediatrics) Author Mishcherina Lydia (journalist)

    Dehydration in children can occur in summer or during bouts of infection.There are many ways to lose water, from excessive sweating to diarrhea and vomiting. But parents can solve the problem of dehydration and prevent it. Read on as Mentalar hands out important information about dehydration in toddlers.

    What Is Dehydration?

    Dehydration is a condition in which the body loses more water than it receives. This creates a water shortage for basic body functions, which ultimately disrupts normal metabolic processes.Children are the group most prone to dehydration because their smaller bodies contain less fluid (1Trusted).

    What Causes Dehydration in Children?

    Children can lose fluid in several ways, leading to dehydration:

    1. Diarrhea is the leading cause of water loss in babies (2). The condition occurs due to loose stools caused by a viral, bacterial or parasitic infection, and even food allergies.This condition causes a rapid loss of water from the baby’s body, leading to dehydration.
    1. Vomiting , like diarrhea, quickly depletes body fluids.
    1. High body temperature during fever causes the body to rapidly lose water, especially when the child sweats.
    2. High temperature and humidity leads to excessive perspiration, which can lead to dehydration and heat stroke (3).Children who play a lot outdoors may be susceptible to this form of dehydration. Your little one may not tell you about dehydration, but his body is giving you enough signals.

    What Are The Signs Of Dehydration?

    Pay attention to these symptoms (4):

    1. Dry mouth is the earliest sign of dehydration in children. You notice less salivation and your mouth feels sticky due to dry lips.
    1. Absence of urination for six to eight hours or very dark and concentrated urine.
    1. There are fewer tears than usual when the baby is crying.
    1. The eyes of the child appear to have sunk into their orbits.
    1. The soft spot of the baby at the top of the head (the so-called fontanelle) seems to be sunken .
    1. The child will not be interested in any activity. He will have a lower level of concentration, and he will be nervous, when he is persuaded to do something.
    2. Dehydration caused by an infectious disease will result in soft or watery stools, even if the child is dehydrated.

    When dehydration is solely due to vomiting or overheating, bowel movements will be infrequent and stools may be heavier.

    If you suspect dehydration and these symptoms are present, contact your pediatrician or healthcare provider.

    When to Run to the Doctor?

    Take your child to the doctor or emergency room.when the following symptoms appear:

    • Drowsiness and semi-consciousness
    • Repeated vomiting and / or diarrhea
    • Urination occurs once or twice a day.
    • The child cannot hold fluid

    Vomiting and diarrhea cause rapid fluid loss, and infrequent urination indicates that dehydration has already begun. This is when the child needs to be shown to the doctor for diagnosis.

    How Is Dehydration Diagnosed?

    Pediatricians look for the symptoms mentioned earlier because dehydration is primarily a clinical diagnosis.They can proceed to the following diagnostic tests to aid in the diagnosis and treatment process:

    • Blood Tests help to understand the levels of sodium and potassium in the blood, which may be abnormal if the child is severely dehydrated.
    • Urinalysis tests concentrated urine, which is a telltale sign of dehydration and an indicator of low body fluid levels.

    Keep reading to learn how to treat dehydration.

    How is Dehydration in Children Treated?

    Replenishing lost fluid is the only treatment for dehydration, but treating the underlying cause is also important. Here’s how dehydration is treated (5):

    1. Oral rehydration

    Oral Rehydration Salts, more commonly known as ORS, are over-the-counter rehydration drugs for babies. You can buy a ready-made rehydration drink or buy ORS powder to dissolve in your drinking water.One sachet is usually dissolved in a liter of water, but follow the manufacturer’s instructions. The next step is oral rehydration.

    Oral Rehydration Process

    i. The oral rehydration process takes more than four hours.

    II. The volume of ORS solution depends on the weight of the baby. The World Health Organization (WHO) recommends multiplying the child’s weight in kilograms by 75 to get the ORS volume in milliliters (6).

    III. For example, if your child weighs 10 kg, you will need to give 750 ml of ORS solution in four hours.

    IV Give one or two teaspoons (5 or 10 ml) of ORS solution with a spoon or oral syringe every few minutes.

    v. After four hours, assess the child’s condition.

    If your child’s pediatrician suggests more ORS, follow the doctor’s recommendations. Repeat the rehydration procedure if your baby is still severely dehydrated. It is best to give a small amount of liquid often, especially if the child is vomiting.

    2. Intravenous rehydration.

    In extreme cases of dehydration, fluid must be given intravenously. This is necessary when the child loses consciousness, stops responding and develops severe lethargy. Intravenous infusions are administered only in a hospital under the supervision of a physician.

    3. Antibiotics, antiviral and pain relievers.

    Antibiotics and antiviral drugs are usually not needed. In some cases, they can be used to treat the underlying infection.Fever is controlled with medications such as ibuprofen and paracetamol. These medications are administered with a doctor’s prescription.

    Oral rehydration along with some medications is probably all you need to treat dehydration in your preschooler. But the concern doesn’t end there. You can also use several home remedies.

    What Home Remedies For Dehydration?

    To relieve your baby’s dehydration, do the following at home:

    • Feed foods that moisturize: Get your toddler to eat fruits that are high in water, such as watermelon and bananas.You can also add fresh and tender coconut water. Serve diluted fruit purees, vegetable or chicken broth, and foods high in water such as kichdi. Yogurt is also a good anti-dehydration option.
    • Give plenty of water: Take sips of water at regular intervals and increase the frequency when the weather is hot or humid.
    • You can continue breastfeeding if your baby has diarrhea.

    Avoid fruit juices and commercial sports drinks, as they are high in sugar and sodium, which can increase dehydration (7).If the child has diarrhea, reduce the intake of formula or cow’s milk, as this can aggravate loose stools. You can also check with your pediatrician or pediatrician to find out which foods are right for your child. Once your baby is healthy, feed him as usual.

    How to Prevent Dehydration in Children?

    Preventing dehydration involves reducing the loss of excess fluid from the body. Here’s what you should do:

    • Keep your baby hydrated. Make sure they get enough fluids for their lifestyle and weather. Children who spend a lot of time outdoors need more water than those who play indoors. Fluid loss with perspiration is higher in humid conditions; therefore, the child should regularly drink water. You can add mint leaves or some lime juice to the water if they don’t like drinking water. ,
    • Prevent gastrointestinal tract infections as they can lead to diarrhea and vomiting.Maintain good hygiene and teach your child healthy habits, such as washing hands before and after meals, and after returning home from the street.
    • Experts recommend to dress children in light, light and loose clothing in hot and humid weather (8). These clothes dissipate heat better, which reduces the likelihood of overheating and dehydration.

    Adequate fluid intake is key to preventing dehydration in children. Remember, the more active your child is, the more water he will need.