-
Journal of Gerontological Nursing Sep 2015Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and... (Review)
Review
Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further. [Journal of Gerontological Nursing, 41(9), 8-13.].
Topics: Adult; Aged; Aged, 80 and over; Dehydration; Female; Humans; Male; Middle Aged
PubMed: 26375144
DOI: 10.3928/00989134-20150814-02 -
Scandinavian Journal of Medicine &... Oct 2010Dehydration, if sufficiently severe, impairs both physical and mental performance, and performance decrements are greater in hot environments and in long-lasting... (Review)
Review
Dehydration, if sufficiently severe, impairs both physical and mental performance, and performance decrements are greater in hot environments and in long-lasting exercise. Athletes should begin exercise well hydrated and should drink during exercise to limit water and salt deficits. Many athletes are dehydrated to some degree when they begin exercise. During exercise, most drink less than their sweat losses, some drink too much and a few develop hyponatraemia. Athletes should learn to assess their hydration needs and develop a personalized hydration strategy that takes account of exercise, environment and individual needs. Pre-exercise hydration status can be assessed from urine frequency and volume, with additional information from urine color, specific gravity or osmolality. Changes in hydration status during exercise can be estimated from the change in body mass: sweat rate can be estimated if fluid intake and urinary losses are also measured. Sweat salt losses can be determined by collection and analysis of sweat samples. An appropriate, individualized drinking strategy will take account of pre-exercise hydration status and of fluid, electrolyte and substrate needs before, during and after a period of exercise.
Topics: Competitive Behavior; Dehydration; Exercise; Exercise Tolerance; Fluid Therapy; Humans; Oxygen Consumption; Sports; Sweat; Water-Electrolyte Balance
PubMed: 21029189
DOI: 10.1111/j.1600-0838.2010.01207.x -
Journal of the American College of... Apr 2012No matter how mild, dehydration is not a desirable condition because there is an imbalance in the homeostatic function of the internal environment. This can adversely... (Review)
Review
No matter how mild, dehydration is not a desirable condition because there is an imbalance in the homeostatic function of the internal environment. This can adversely affect cognitive performance, not only in groups more vulnerable to dehydration, such as children and the elderly, but also in young adults. However, few studies have examined the impact of mild or moderate dehydration on cognitive performance. This paper reviews the principal findings from studies published to date examining cognitive skills. Being dehydrated by just 2% impairs performance in tasks that require attention, psychomotor, and immediate memory skills, as well as assessment of the subjective state. In contrast, the performance of long-term and working memory tasks and executive functions is more preserved, especially if the cause of dehydration is moderate physical exercise. The lack of consistency in the evidence published to date is largely due to the different methodology applied, and an attempt should be made to standardize methods for future studies. These differences relate to the assessment of cognitive performance, the method used to cause dehydration, and the characteristics of the participants.
Topics: Attention; Cognition; Dehydration; Executive Function; Exercise; Humans; Memory, Short-Term
PubMed: 22855911
DOI: 10.1080/07315724.2012.10720011 -
The Journal of the Association of... Dec 2023Dehydration, like many other aspects of an aging body, is often neglected by patients and physicians alike. Not only does it sometimes become difficult to clinically... (Review)
Review
Dehydration, like many other aspects of an aging body, is often neglected by patients and physicians alike. Not only does it sometimes become difficult to clinically assess and identify dehydration in the elderly, but it also becomes difficult to attribute gross changes in functioning to something as simple as water depletion. This can be counterproductive to the overall health and even survival of elderly patients if diagnosis is delayed. We propose a comprehensive hydration stewardship program, with public health and clinical interventions, to prevent dehydration and its complications in vulnerable segments of society, such as the elderly. This short review summarizes current evidence available for the diagnosis and identification of dehydration in the elderly and shares preventive strategies to prevent its occurrence and complications.
Topics: Humans; Dehydration; Aged; Fluid Therapy; Geriatric Assessment
PubMed: 38736054
DOI: 10.59556/japi.71.0332 -
American Journal of Kidney Diseases :... Aug 2011Although often used interchangeably, dehydration and volume depletion are not synonyms. Dehydration refers to loss of total-body water, producing hypertonicity, which...
Although often used interchangeably, dehydration and volume depletion are not synonyms. Dehydration refers to loss of total-body water, producing hypertonicity, which now is the preferred term in lieu of dehydration, whereas volume depletion refers to a deficit in extracellular fluid volume. In particular, hypertonicity implies intracellular volume contraction, whereas volume depletion implies blood volume contraction. Using a case of hyperglycemic hypertonic nonketosis as an example, we examine the changing composition of body fluid spaces to explore the distinction between dehydration and hypertonicity from volume depletion.
Topics: Adult; Dehydration; Extracellular Fluid; Fluid Therapy; Humans; Male; Terminology as Topic
PubMed: 21705120
DOI: 10.1053/j.ajkd.2011.02.395 -
Journal of Neurology Oct 2018Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more... (Review)
Review
BACKGROUND AND PURPOSE
Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke.
METHODS
Studies of hospitalized ischemic stroke patients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst.
RESULTS
Twenty-five studies of 8699 acute stroke patients were included. Nineteen studies reported on the diagnostic approach to dehydration. Findings are synthesized into four main categories of available research including studies that specify: (1) biological mechanisms using animal models to investigate the relationship between dehydration and stroke; (2) measures of dehydration in the acute human stroke population; (3) rehydration therapies after stroke; and (4) outcomes after stroke in dehydrated patients.
CONCLUSIONS
We found considerable variation in terminology specific to hydration status, diagnostic approach to dehydration, and few prospective studies of treatment strategies with varying results. This review supports the need for consensus development of operational diagnostic criteria, standardization of language, and the opportunity for prospective study of rehydration strategies to impact outcome after stroke.
Topics: Brain Ischemia; Dehydration; Humans; Stroke
PubMed: 29497817
DOI: 10.1007/s00415-018-8799-6 -
Annual Review of Biomedical Engineering Jun 2023The need for hydration monitoring is significant, especially for the very young and elderly populations who are more vulnerable to becoming dehydrated and suffering from... (Review)
Review
The need for hydration monitoring is significant, especially for the very young and elderly populations who are more vulnerable to becoming dehydrated and suffering from the effects that dehydration brings. This need has been among the drivers of considerable effort in the academic and commercial sectors to provide a means for monitoring hydration status, with a special interest in doing so outside the hospital or clinical setting. This review of emerging technologies provides an overview of many technology approaches that, on a theoretical basis, have sensitivity to water and are feasible as a routine measurement. We review the evidence of technical validation and of their use in humans. Finally, we highlight the essential need for these technologies to be rigorously evaluated for their diagnostic potential, as a necessary step to meet the need for hydration monitoring outside of the clinical environment.
Topics: Humans; Aged; Dehydration; Water
PubMed: 36854261
DOI: 10.1146/annurev-bioeng-062117-121028 -
The Cochrane Database of Systematic... May 2023Although acute diarrhoea is a self-limiting disease, dehydration may occur in some children. Dehydration is the consequence of an increased loss of water and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although acute diarrhoea is a self-limiting disease, dehydration may occur in some children. Dehydration is the consequence of an increased loss of water and electrolytes (sodium, chloride, potassium, and bicarbonate) in liquid stools. When these losses are high and not replaced adequately, severe dehydration appears. Severe dehydration is corrected with intravenous solutions. The most frequently used solution for this purpose is 0.9% saline. Balanced solutions (e.g. Ringer's lactate) are alternatives to 0.9% saline and have been associated with fewer days of hospitalization and better biochemical outcomes. Available guidelines provide conflicting recommendations. It is unclear whether 0.9% saline or balanced intravenous fluids are most effective for rehydrating children with severe dehydration due to diarrhoea.
OBJECTIVES
To evaluate the benefits and harms of balanced solutions for the rapid rehydration of children with severe dehydration due to acute diarrhoea, in terms of time in hospital and mortality compared to 0.9% saline.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 4 May 2022.
SELECTION CRITERIA
We included randomized controlled trials in children with severe dehydration due to acute diarrhoea comparing balanced solutions, such as Ringer's lactate or Plasma-Lyte with 0.9% saline solution, for rapid rehydration.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were 1. time in hospital and 2.
MORTALITY
Our secondary outcomes were 3. need for additional fluids, 4. total amount of fluids received, 5. time to resolution of metabolic acidosis, 6. change in and the final values of biochemical measures (pH, bicarbonate, sodium, chloride, potassium, and creatinine), 7. incidence of acute kidney injury, and 8.
ADVERSE EVENTS
We used GRADE to assess the certainty of the evidence.
MAIN RESULTS
Characteristics of the included studies We included five studies with 465 children. Data for meta-analysis were available from 441 children. Four studies were conducted in low- and middle-income countries and one study in two high-income countries. Four studies evaluated Ringer's lactate, and one study evaluated Plasma-Lyte. Two studies reported the time in hospital, and only one study reported mortality as an outcome. Four studies reported final pH and five studies reported bicarbonate levels. Adverse events reported were hyponatremia and hypokalaemia in two studies each. Risk of bias All studies had at least one domain at high or unclear risk of bias. The risk of bias assessment informed the GRADE assessments. Primary outcomes Compared to 0.9% saline, the balanced solutions likely result in a slight reduction of the time in hospital (mean difference (MD) -0.35 days, 95% confidence interval (CI) -0.60 to -0.10; 2 studies; moderate-certainty evidence). However, the evidence is very uncertain about the effect of the balanced solutions on mortality during hospitalization in severely dehydrated children (risk ratio (RR) 0.33, 95% CI 0.02 to 7.39; 1 study, 22 children; very low-certainty evidence). Secondary outcomes Balanced solutions probably produce a higher increase in blood pH (MD 0.06, 95% CI 0.03 to 0.09; 4 studies, 366 children; low-certainty evidence) and bicarbonate levels (MD 2.44 mEq/L, 95% CI 0.92 to 3.97; 443 children, four studies; low-certainty evidence). Furthermore, balanced solutions likely reduces the risk of hypokalaemia after the intravenous correction (RR 0.54, 95% CI 0.31 to 0.96; 2 studies, 147 children; moderate-certainty evidence). Nonetheless, the evidence suggests that balanced solutions may result in no difference in the need for additional intravenous fluids after the initial correction; in the amount of fluids administered; or in the mean change of sodium, chloride, potassium, and creatinine levels.
AUTHORS' CONCLUSIONS
The evidence is very uncertain about the effect of balanced solutions on mortality during hospitalization in severely dehydrated children. However, balanced solutions likely result in a slight reduction of the time in the hospital compared to 0.9% saline. Also, balanced solutions likely reduce the risk of hypokalaemia after intravenous correction. Furthermore, the evidence suggests that balanced solutions compared to 0.9% saline probably produce no changes in the need for additional intravenous fluids or in other biochemical measures such as sodium, chloride, potassium, and creatinine levels. Last, there may be no difference between balanced solutions and 0.9% saline in the incidence of hyponatraemia.
Topics: Child; Humans; Bicarbonates; Creatinine; Dehydration; Diarrhea; Hypokalemia; Potassium; Potassium Chloride; Ringer's Lactate; Saline Solution; Sodium
PubMed: 37196992
DOI: 10.1002/14651858.CD013640.pub2 -
Nursing Standard (Royal College of...This article discusses the nurse's role in the treatment and prevention of dehydration and electrolyte imbalance. (Review)
Review
This article discusses the nurse's role in the treatment and prevention of dehydration and electrolyte imbalance.
Topics: Dehydration; Humans; Nursing Assessment; Water-Electrolyte Imbalance
PubMed: 10085921
DOI: 10.7748/ns.13.19.48.s45 -
Clinical Journal of Sport Medicine :... 1995The belief that dehydration poses significant health risks for endurance athletes, especially marathon and ultramarathon runners, stems from the classical 1969 study of... (Review)
Review
The belief that dehydration poses significant health risks for endurance athletes, especially marathon and ultramarathon runners, stems from the classical 1969 study of Wyndham and Strydom entitled "The Danger of an Inadequate Water Intake During Marathon Running." The subsequent influence of the paper relates more to its incorrect title than to its scientific content. For the authors did not study nor did they identify any dangers resulting from an inadequate water intake during marathon running. In fact, the most dehydrated runners in their studies were also the most successful, as they won the competitive races that were studied. The positive result of the study was to influence international rule changes to allow increased fluid intake during competitive running races. The less desirable effect was to induce a dogmatic zeal among sports medicine practitioners who began to extol the dangers of dehydration during exercise. The (il)logic spurring this zeal seems to have been the conclusion that progressive dehydration during exercise will cause heatstroke, which is the most important cause of collapse during exercise. Hence, (i) heatstroke during running can only be avoided if dehydration is prevented, and (ii) all persons who collapse in association with exercise will have a heat disorder, which must be treated with intravenous fluid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Dehydration; Exercise; Humans; Physical Endurance; Running
PubMed: 7882113
DOI: No ID Found