Dehydration of the body

Dehydration (dehydration) is the reduction of the total water content, when its losses exceed intake and formation or its sharp redistribution occurs.

Dehydration of the body accompanies many pathological conditions, complicating their course, since with it there is a thickening of blood due to a decrease in bcc, with a violation of microcirculation and: tissue metabolism. Dehydration of the body symptoms expressed already appear when the fluid is unbalanced in 1.5 liters of water (2.5% of body weight) - light degree; an average degree develops with the loss of 4-4.5 liters of water (3-6% of body weight); a severe degree is noted with the loss of 5-7 liters of water (7-14% of body weight). A large loss of water leads to death, since the cellular changes are irreversible.

Depending on the pathogenesis, dehydration of the body is divided into 3 types:

Dehydration of the organism isoosmolar type, when water and electrolytes are simultaneously lost through the gastrointestinal tract, skin, kidneys, respiratory tract, with multiple trauma, infections, bleeding. The hypovolemic syndrome and signs of general dehydration come to the forefront: dryness of mucous membranes, reduction of skin turgor, oliguria or anuria, acidosis and. Azotemia, brain disorders in the form of apathy, adynamia, up to coma. Depending on the severity of dehydration, there is a decrease in blood pressure and CVP, an increase in hematocrit, but the sodium content and osmolarity of the blood remain normal.

Dehydration of the body is hyperosmolar, when water is lost more than electrolytes. This dehydration of the body can be noted with insufficient intake of liquid (dryness), a significant loss of water through the gastrointestinal tract (copious diarrhea, intake of laxatives), kidneys (diuretic, diabetes insipidus), skin (profuse sweating), respiratory tract (intense breathing) , in cases of intensive therapy with the administration of hyperosmolar solutions or in the case of insufficient replenishment of the disturbed hydrobalance. Symptoms of cellular dehydration (expressed thirst, increased temperature, body, nervous system disorders) and extracellular dehydration (moderate hypotension, tachycardia, dry mucous membranes, decreased skin turgor, oliguria) are noted. Blood pressure and CVP decrease moderately, the signs of blood thickening appear to the forefront: an increase in hemoglobin, hematocrit, and blood protein. Signs of hyperosmolarity: increased osmolality of plasma and urine, increased sodium levels. A metabolic acidosis, quite pronounced, often decompensated, is accompanied by azotemia.

Dehydration of the body is hypo-osmolar, when electrolytes are lost more than water. This happens with the loss of electrolytes through the gastrointestinal tract, skin, kidneys, with adrenal insufficiency, certain types of injuries, fistulas, with intravenous administration of a large number of hypoosmolar solutions. The signs of cellular hyperhydration come to the forefront: vomiting, convulsions, edema of the brain, lungs, coma. Signs of extracellular dehydration are also expressed: hypotension, tachycardia, heart failure, oliguria, metabolic and respiratory acidosis, azotemia. Characteristic decrease in osmolarity of plasma and urine, a decrease in the level of sodium in the plasma.

In all cases of dehydration, the patient should be referred to or transferred to the intensive care unit.