2016년 6월 30일 목요일

Dehydration (medical care)

Dehydration (medical care)

Dehydration
Cholera rehydration nurses.jpg
A classification and outside reference information
ICD-10 E86
ICD-9 276.51
DiseasesDB 3520
MedlinePlus 000982
eMedicine article/801012
MeSH D003681

The dehydration (だっすい, British :dehydration) means the state that quantity of the internal water was short in medicine.

Table of contents

Cause

It takes place by a fluid intake being short for quantity of water loss. Therefore, for a cause of the dehydration, two of the state that an intake of the water is short or the state that the loss of the water becomes superabundant are thought about. It is not really unusual to aggravate the loss at the same time as an intake of the water is short.

Fever
If general malaise becomes strong, an intake of the water decreases by fever. On the other hand, non-feeling transpiration (excretion of the water which is not conscious of by urination) aggravates it by sthenia of the sweat or increase of the ventilatory frequency and becomes the dehydration if degree becomes strong.
Diarrhea, vomiting
I am often seen as viral enteritis and food poisoning, a symptom of the acute digestive organ disease including cholera at the same time. An intake of the water decreases by vomiting, and the loss of the water increases by diarrhea. Because it is a symptom to lose all an electrolyte of diarrhea, vomiting (because an electrolyte is included in gastric juice), not only the water but also the electrolyte decreases.
High temperature environment, Shigesaku business, intense exercise
Because sweat aggravates it, it causes the dehydration without the intake of enough water and the electrolyte. The serious disease that these factors overlap and are caused has heat stroke, and the dehydration is main pathologic one of the heat stroke.

Classification

The dehydration is classified as follows by an electrolyte composition of the blood (cell external solution).

Hypotonicity dehydration
It is accompanied by a drop of plasma electrolyte concentration and the plasma osmotic pressure in the state that the loss of the electrolyte is remarkable than the loss of the water by diarrhea, vomiting.
I fall into it in what I continue supplementing only with water for the body fluid loss such as sweat or diarrhea vomiting easily.
Because it is hard to be accompanied by fever and mouth feeling thirsty, and there is little drying of skin, the mucous membrane, there are few subjective symptoms early, but general malaise and sleepiness are seen when it progresses, and, as for the hands and feet, the pulse becomes weak coolly. It becomes (++) and remains only for a water deficit, and a place of salt lack (+++) is easy to develop in the body to give priority to that I maintain quantity of body fluid over salinity of the body fluid. It is the symptom by the decrease in cell external solution (circulation blood volume) mainly.
It is less than serum sodium level 140mEq/l, and less than serum chlorine density 110mEq/l become the aim.
Isotonic dehydration
Dehydration by the loss of the isotonic sodium chloride solution. Because it is common to consume water for mouth feeling thirsty, it is easy to change for hypotonicity dehydration.
Nephrosis.
Hypertonicity dehydration
By sthenia of the sweat, the extreme drop of the water intake, water is in condition to have been short exclusively. Infants and the elderly person who cannot do the water intake by oneself have many it.
With fever and remarkable mouth feeling thirsty, the mucous membranes such as oral cavities dry. The consciousness is kept, but is in a condition of agitation, the excitement. The hands and feet do not become cold, and the pulse conflicts well, too.
More than serum sodium level 150mEq/l, more than serum chlorine density 110mEq/l become the aim.
Diabetes.

Treatment

In the medical institution, infusion and the oral supplementary water salt that the adjustment of the electrolyte was made are given. An ingredient, electrolysis mass, the supplement speed of the infusion varies among patients.

If it is mild, and ingestion is from head to foot in a possible state, I give you oral supplementary water salt orally. But there is the risk to bring about underwater poison from hyponatremia when I give it at the time of the dehydration of infants in particular because the sports drinks have low sodium level. There are soup, the specialist that a wash double the fruit and the 100% juice (apple juice) for supply is effective in potassium for salt supply [1].

When it is caused by heat stroke, the appropriate diagnosis and treatment with the medical institution are necessary.

Source

Footnote

Outside link

This article is taken from the Japanese Wikipedia Dehydration (medical care)

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