Dehydration

About Dehydration

Dehydration occurs when the body loses more fluid than it takes in, disrupting normal physiological functions. It ranges from mild to life threatening. Causes include inadequate intake, excessive sweating, vomiting, diarrhea, fever, burns, diabetes with glycosuria, and diuretic medications. Symptoms progress based on severity. Mild dehydration 3 to 5 percent body weight loss causes thirst, dry mouth, decreased urine output, dark yellow urine, headache, and fatigue. Moderate dehydration 6 to 9 percent adds dizziness, rapid heart rate, rapid breathing, sunken eyes, decreased skin turgor skin tenting when pinched, and irritability. Severe dehydration over 10 percent is life threatening, with hypotension, weak rapid pulse, confusion, lack of urination, cold extremities, and shock. Infants and elderly are most vulnerable. In children, the most common cause is gastroenteritis with vomiting and diarrhea. The pinched skin sign is less reliable in elderly patients who normally have decreased skin elasticity. Diagnosis is clinical, supported by elevated serum sodium, elevated BUN and creatinine, and increased urine specific gravity or osmolality. Treatment involves oral rehydration for mild to moderate cases using WHO oral rehydration solution ORS containing sodium, glucose, potassium, and citrate. Severe dehydration requires intravenous fluids normal saline or lactated Ringer solution. Chronic dehydration in older people can be mistaken for dementia. Fluid needs vary with climate, activity, age, and health. Signs of severe dehydration, such as confusion, passing no urine, or a very drowsy or floppy infant, are a medical emergency; call your local emergency number.