Isotonic dehydration: Diagnosis, Treatment
How to diagnose Isotonic dehydration?
Isotonic dehydration is diagnosed base on medical history and clinical manifestations. Should be asked in detail about the loss of body fluids, the daily number of liquid missing? How much time continuous? Characters such as fluid loss. Determination of extracellular fluid volume and serum sodium, in order to understand the situation of water scarcity and loss of sodium. Serum Na + and Cl-general had no significant decrease in plasma osmolality in the normal range. Higher specific gravity. Red blood cell count, hemoglobin and hematocrit has increased significantly, said hemoconcentration. If necessary, can be used for determination of blood gas analysis to determine whether there is an imbalance of acid-base balance.
How to treat Isotonic dehydration?
First of all, as far as possible, isotonic treatment of water loss caused reasons, in order to reduce the loss of water and sodium. Extracellular fluid volume for the reduction in general can be isotonic saline or balanced salt solution to add volume as soon as possible. Fine in accordance with the pulse rate and blood pressure to estimate the decline in symptoms such as loss of body fluid volume, has reached 5% of body weight, and can quickly enter the above-mentioned liquid about 3.0L. In order to restore blood volume, or hematocrit to calculate the amount of liquid required to fill. Fill the volume of isotonic saline (L) = up hematocrit value × weight (kg) × 0.25 normal hematocrit
In addition, supply daily dosages, the general water 2.0L and sodium 4.5g. Isotonic saline containing Na + and Cl-the 154mmol / L, and serum Na + and Cl-separately for the content of 142mmol / L and 103mmol / L. Both compared to isotonic saline than the Cl-content of the Cl-content of serum high-50mmol / L, or at severe water shortage in a state of shock, renal blood flow reduction in the impact of chlorine emission features, substantial loss from the intravenous isotonic saline, blood Cl-cause there is too high, causing a high chlorine risk of acidosis. Application of isotonic saline, therefore the treatment of water there are a number of shortcomings. Balanced salt solution and the electrolyte content in plasma is similar to the health of search content, for the treatment of water more in line with the physical, to avoid excessive importation of Cl-, and acidosis must have the correct help. In addition, after correcting the water shortage, increased excretion of potassium, K + concentration will also be a result of increased extracellular fluid and diluted to lower, it should be noted that the incidence of hypokalemia. Should generally be in the urine up to 40ml / h after the potassium chloride supplement.