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PloS One 2014To prospectively validate three popular clinical dehydration scales and overall physician gestalt in children with vomiting or diarrhea relative to the criterion... (Comparative Study)
Comparative Study
OBJECTIVE
To prospectively validate three popular clinical dehydration scales and overall physician gestalt in children with vomiting or diarrhea relative to the criterion standard of percent weight change with rehydration.
METHODS
We prospectively enrolled a non-consecutive cohort of children ≤ 18 years of age with an acute episode of diarrhea or vomiting. Patient weight, clinical scale variables and physician clinical impression, or gestalt, were recorded before and after fluid resuscitation in the emergency department and upon hospital discharge. The percent weight change from presentation to discharge was used to calculate the degree of dehydration, with a weight change of ≥ 5% considered significant dehydration. Receiver operating characteristics (ROC) curves were constructed for each of the three clinical scales and physician gestalt. Sensitivity and specificity were calculated based on the best cut-points of the ROC curve.
RESULTS
We approached 209 patients, and of those, 148 were enrolled and 113 patients had complete data for analysis. Of these, 10.6% had significant dehydration based on our criterion standard. The Clinical Dehydration Scale (CDS) and Gorelick scales both had an area under the ROC curve (AUC) statistically different from the reference line with AUCs of 0.72 (95% CI 0.60, 0.84) and 0.71 (95% CI 0.57, 0.85) respectively. The World Health Organization (WHO) scale and physician gestalt had AUCs of 0.61 (95% CI 0.45, 0.77) and 0.61 (0.44, 0.78) respectively, which were not statistically significant.
CONCLUSION
The Gorelick scale and Clinical Dehydration Scale were fair predictors of dehydration in children with diarrhea or vomiting. The World Health Organization scale and physician gestalt were not helpful predictors of dehydration in our cohort.
Topics: Adolescent; Child; Child, Preschool; Cohort Studies; Dehydration; Female; Gestalt Theory; Humans; Infant; Male; Prospective Studies; Treatment Outcome; World Health Organization
PubMed: 24788134
DOI: 10.1371/journal.pone.0095739 -
Nutrients Mar 2023Maintenance of hydration status requires a tight balance between fluid input and output. An increase in water loss or a decrease in fluid intake is responsible for... (Review)
Review
Maintenance of hydration status requires a tight balance between fluid input and output. An increase in water loss or a decrease in fluid intake is responsible for dehydration status, leading to kidney water reabsorption. Thus, urine volume decreases and concentration of the different solutes increases. Urine dilution is the main recommendation to prevent kidney stone recurrence. Monitoring hydration status and urine dilution is key to preventing stone recurrence. This monitoring could either be performed via spot urine or 24 h urine collection with corresponding interpretation criteria. In laboratory conditions, urine osmolality measurement is the best tool to evaluate urine dilution, with less interference than urine-specific gravity measurement. However, this evaluation is only available during time lab examination. To improve urine dilution in nephrolithiasis patients in daily life, such monitoring should also be available at home. Urine color is of poor interest, but reagent strips with urine-specific gravity estimation are currently the only available tool, even with well-known interferences. Finally, at home, fluid intake monitoring could be an alternative to urine dilution monitoring. Eventually, the use of a connected device seems to be the most promising solution.
Topics: Humans; Drinking; Urinalysis; Kidney Calculi; Water; Dehydration; Osmolar Concentration; Water-Electrolyte Balance
PubMed: 37049482
DOI: 10.3390/nu15071642 -
PloS One 2012The negative effects of dehydration on aerobic activities are well established. However, it is unknown how dehydration affects intermittent sports performance. The...
BACKGROUND
The negative effects of dehydration on aerobic activities are well established. However, it is unknown how dehydration affects intermittent sports performance. The purpose of this study was to identify the level of dehydration in elite badminton players and its relation to muscle strength and power production.
METHODOLOGY
Seventy matches from the National Spanish badminton championship were analyzed (46 men's singles and 24 women's singles). Before and after each match, jump height and power production were determined during a countermovement jump on a force platform. Participants' body weight and a urine sample were also obtained before and after each match. The amount of liquid that the players drank during the match was also calculated by weighing their individual drinking bottles.
RESULTS AND DISCUSSION
Sweat rate during the game was 1.14 ± 0.46 l/h in men and 1.02 ± 0.64 l/h in women. The players rehydrated at a rate of 1.10 ± 0.55 l/h and 1.01 ± 0.44 l/h in the male and female groups respectively. Thus, the dehydration attained during the game was only 0.37 ± 0.50% in men and 0.32 ± 0.83% in women. No differences were found in any of the parameters analyzed during the vertical jump (men: from 31.82 ± 5.29 to 32.90 ± 4.49 W/kg; p>0.05, women: from 26.36 ± 4.73 to 27.25 ± 4.44 W/kg; p>0.05). Post-exercise urine samples revealed proteinuria (60.9% of cases in men and 66.7% in women), leukocyturia (men = 43.5% and women = 50.0%) and erythrocyturia (men = 50.0% and women = 21.7%).
CONCLUSIONS
Despite a moderate sweat rate, badminton players adequately hydrated during a game and thus the dehydration attained was low. The badminton match did not cause muscle fatigue but it significantly increased the prevalence of proteinuria, leukocyturia and erythrocyturia.
Topics: Athletes; Dehydration; Female; Fluid Therapy; Hand Strength; Humans; Male; Muscle Strength; Racquet Sports; Sex Factors; Young Adult
PubMed: 22666396
DOI: 10.1371/journal.pone.0037821 -
BMC Geriatrics Dec 2022Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal...
BACKGROUND
Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings.
METHODS
A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis.
RESULTS
One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status.
CONCLUSIONS
Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients.
Topics: Humans; Aged; Dehydration; Electric Impedance; Sensitivity and Specificity; Comorbidity; Hospitalization
PubMed: 36510185
DOI: 10.1186/s12877-022-03589-0 -
European Journal of Sport Science Aug 2018Urine specific gravity (U) is the most commonly reported biochemical marker used in research and applied settings to detect fluid deficits in athletes, including those... (Review)
Review
Urine specific gravity (U) is the most commonly reported biochemical marker used in research and applied settings to detect fluid deficits in athletes, including those participating in combat sports. Despite the popularity of its use, there has been a growing debate regarding the diagnostic accuracy and the applicability of U in characterizing whole-body fluid status and fluctuations. Moreover, recent investigations report universally high prevalence of hypohydration (∼90%) via U assessment in combat sport athletes, often in spite of stable body-mass. Given the widespread use in both research and practice, and its use in a regulatory sense as a 'hydration test' in combat sports as a means to detect dehydration at the time of weigh-in; understanding the limitations and applicability of U assessment is of paramount importance. Inconsistencies in findings of U readings, possibly as a consequence of diverse methodological research approaches and/or overlooked confounding factors, preclude a conclusive position stand within current combat sports research and practice. Thus the primary aim of this paper is to critically review the literature regarding U assessment of hydration status in combat sports research and practice. When taken on balance, the existing literature suggests: the use of laboratory derived benchmarks in applied settings, inconsistent sampling methodologies, the incomplete picture of how various confounding factors affect end-point readings, and the still poorly understood potential of renal adaptation to dehydration in combat athletes; make the utility of hydration assessment via U measurement quite problematic, particularly when diet and training is not controlled.
Topics: Athletes; Boxing; Competitive Behavior; Dehydration; Drinking; Humans; Specific Gravity; Urinalysis; Wrestling
PubMed: 29746803
DOI: 10.1080/17461391.2018.1468483 -
PloS One 2013The objectives of this study were to investigate and compare the responses of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in the circulation of...
The objectives of this study were to investigate and compare the responses of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in the circulation of hydrated, dehydrated, and dehydrated losartan - treated camels; and to document the cardiac storage form of B-type natriuretic peptide in the camel heart. Eighteen male camels were used in the study: control or hydrated camels (n = 6), dehydrated camels (n = 6) and dehydrated losartan-treated camels (n = 6) which were dehydrated and received the angiotensin II (Ang II) AT-1 receptor blocker, losartan, at a dose of 5 mg/kg body weight intravenously for 20 days. Control animals were supplied with feed and water ad-libitum while both dehydrated and dehydrated-losartan treated groups were supplied with feed ad-libitum but no water for 20 days. Compared with time-matched controls, dehydrated camels exhibited a significant decrease in plasma levels of both ANP and BNP. Losartan-treated camels also exhibited a significant decline in ANP and BNP levels across 20 days of dehydration but the changes were not different from those seen with dehydration alone. Size exclusion high performance liquid chromatography of extracts of camel heart indicated that proB-type natriuretic peptide is the storage form of the peptide. We conclude first, that dehydration in the camel induces vigorous decrements in circulating levels of ANP and BNP; second, blockade of the renin-angiotensin system has little or no modulatory effect on the ANP and BNP responses to dehydration; third, proB-type natriuretic peptide is the storage form of this hormone in the heart of the one-humped camel.
Topics: Angiotensin II Type 1 Receptor Blockers; Animals; Atrial Natriuretic Factor; Camelus; Dehydration; Losartan; Male; Myocardium; Natriuretic Peptide, Brain; Renin-Angiotensin System
PubMed: 23516417
DOI: 10.1371/journal.pone.0057806 -
Cellular & Molecular Biology Letters 2006Dehydrins (DHNs) are part of a large group of highly hydrophilic proteins known as LEA (Late Embryogenesis Abundant). They were originally identified as group II of the... (Review)
Review
Dehydrins (DHNs) are part of a large group of highly hydrophilic proteins known as LEA (Late Embryogenesis Abundant). They were originally identified as group II of the LEA proteins. The distinctive feature of all DHNs is a conserved, lysine-rich 15-amino acid domain, EKKGIMDKIKEKLPG, named the K-segment. It is usually present near the C-terminus. Other typical dehydrin features are: a track of Ser residues (the S-segment); a consensus motif, T/VDEYGNP (the Y-segment), located near the N-terminus; and less conserved regions, usually rich in polar amino acids (the Phi-segments). They do not display a well-defined secondary structure. The number and order of the Y-, S-and K-segments define different DHN sub-classes: Y(n)SK(n), Y(n)Kn, SK(n), K(n) and K(n)S. Dehydrins are distributed in a wide range of organisms including the higher plants, algae, yeast and cyanobacteria. They accumulate late in embryogenesis, and in nearly all the vegetative tissues during normal growth conditions and in response to stress leading to cellular dehydration (e.g. drought, low temperature and salinity). DHNs are localized in different cell compartments, such as the cytosol, nucleus, mitochondria, vacuole, and the vicinity of the plasma membrane; however, they are primarily localized to the cytoplasm and nucleus. The precise function of dehydrins has not been established yet, but in vitro experiments revealed that some DHNs (YSK(n)-type) bind to lipid vesicles that contain acidic phospholipids, and others (K(n)S) were shown to bind metals and have the ability to scavenge hydroxyl radicals [Asghar, R. et al. Protoplasma 177 (1994) 87-94], protect lipid membranes against peroxidation or display cryoprotective activity towards freezing-sensitive enzymes. The SK(n)-and K-type seem to be directly involved in cold acclimation processes. The main question arising from the in vitro findings is whether each DHN structural type could possess a specific function and tissue distribution. Much recent in vitro data clearly indicates that dehydrins belonging to different subclasses exhibit distinct functions.
Topics: Amino Acid Sequence; Dehydration; Molecular Sequence Data; Organ Specificity; Plant Physiological Phenomena; Plant Proteins; Protein Structure, Tertiary
PubMed: 16983453
DOI: 10.2478/s11658-006-0044-0 -
Nutrients Jun 2022The effect of oropharyngeal dysphagia (OD) and thickened fluid (TF) therapy on hydration status has not been well defined in the literature. We aimed to assess the... (Review)
Review
The Hydration Status of Adult Patients with Oropharyngeal Dysphagia and the Effect of Thickened Fluid Therapy on Fluid Intake and Hydration: Results of Two Parallel Systematic and Scoping Reviews.
BACKGROUND
The effect of oropharyngeal dysphagia (OD) and thickened fluid (TF) therapy on hydration status has not been well defined in the literature. We aimed to assess the hydration status in patients with OD and the effect TF therapy has on it.
METHODS
Two literature reviews following PRISMA methodology (each one including a systematic and a scoping review) were performed: (R1) hydration status in adult patients with OD; (R2) effect of TF therapy on fluid intake and dehydration. Narrative and descriptive methods summarized both reviews. Quality assessment was assessed by Joanna Briggs Institute tools and GRADE.
RESULTS
(R1) Five out of twenty-two studies using analytical parameters or bioimpedance showed poorer hydration status among OD and 19-100% prevalence of dehydration; (R2) two high quality studies (total of 724 participants) showed positive effects of TF on hydration status. Among the articles included, nine out of ten studies that evaluated fluid intake reported a reduced TF intake below basal water requirements.
CONCLUSIONS
Dehydration is a highly prevalent complication in OD. There is scientific evidence on the positive effect of TF therapy on the hydration status of patients with OD. However, strict monitoring of fluid volume intake is essential due to the low consumption of TF in these patients.
Topics: Adult; Deglutition Disorders; Dehydration; Drinking; Fluid Therapy; Humans; Prevalence
PubMed: 35745228
DOI: 10.3390/nu14122497 -
Nutrients Feb 2023The physiological, perceptual, and functional effects of dehydration may depend on how it is incurred (e.g., intense exercise releases endogenous water via... (Randomized Controlled Trial)
Randomized Controlled Trial
The physiological, perceptual, and functional effects of dehydration may depend on how it is incurred (e.g., intense exercise releases endogenous water via glycogenolysis) but this basic notion has rarely been examined. We investigated the effects of active (exercise) heat- vs. passive heat-induced dehydration, and the kinetics of ad libitum rehydration following each method. Twelve fit participants (five females and seven males) completed four trials in randomised order: DEHydration to -3% change in body mass (∆BM) under passive or active heat stress, and EUHydration to prevent ∆BM under passive or active heat stress. In all trials, participants then sat in a temperate-controlled environment, ate a standard snack and had free access to water and sports drink during their two-hour recovery. During mild dehydration (≤2% ∆BM), active and passive heating caused comparable increases in plasma osmolality (P: ~4 mOsmol/kg, interaction: = 0.138) and reductions in plasma volume (PV: ~10%, interaction: = 0.718), but heat stress per se was the main driver of hypovolaemia. Thirst in DEHydration was comparably stimulated by active than passive heat stress ( < 0.161) and shared the same relation to P (r ≥ 0.744) and ∆BM (r ≥ 0.882). Following heat exposures, at 3% gross ∆BM, PV reduction was approximately twice as large from passive versus active heating ( = 0.003), whereas P perturbations were approximately twice as large from EUHydration versus DEHydration ( < 0.001). Rehydrating ad libitum resulted in a similar net fluid balance between passive versus active heat stress and restored PV despite the incomplete replacement of ∆BM. In conclusion, dehydrating by 2% ∆BM via passive heat stress generally did not cause larger changes to PV or P than via active heat stress. The heat stressors themselves caused a greater reduction in PV than dehydration did, whereas ingesting water to maintain euhydration produced large reductions in P in recovery and therefore appears to be of more physiological significance.
Topics: Female; Humans; Male; Dehydration; Heat-Shock Response; Osmolar Concentration; Plasma Volume; Water; Water-Electrolyte Balance
PubMed: 36839262
DOI: 10.3390/nu15040904 -
Danish Medical Journal Nov 2020Patients are frequently admitted to hospital on suspicion of dehydration. The diagnosis is widely used for referral to admittance departments. We aimed to prospectively...
INTRODUCTION
Patients are frequently admitted to hospital on suspicion of dehydration. The diagnosis is widely used for referral to admittance departments. We aimed to prospectively evaluate patients admitted with a diagnosis of dehydration in terms of the accuracy of this diagnosis, to evaluate clinical and biochemical data and to evaluate the outcome and provide a review of the concept of dehydration.
METHODS
Patients who had dehydration as their primary referral diagnosis were prospectively included over a 70-day period. We defined dehydration based on osmolality > 295 mmol/kg. Biochemistry, imaging and outcome were examined.
RESULTS
A total of 128 patients were admitted on suspicion of dehydration, accounting for 7.5% of all patients admitted. In all, 82 of the 128 (64%) were dehydrated. The diagnoses at discharge included infections mainly, but also diagnoses such as cancers and stroke were registered. Mortality during hospitalisation was 9%. Mortality at six months was 27% for the entire group; 37% in the dehydration group versus 11% in the non-dehydration group (p = 0.002). Older age was the strongest predictor of death.
CONCLUSIONS
Suspicion of dehydration is a frequent admittance diagnosis. We suspect that a referral diagnosis of dehydration often reflects an unspecified concern rather than a real suspicion of dehydration. Patients with dehydration had a high in-hospital and six-month mortality, reflecting the severity of this diagnosis.
FUNDING
not relevant.
TRIAL REGISTRATION
The Danish Data Protection Agency, R. no. 05380, BFH-2017-029.
Topics: Aged; Dehydration; Hospital Departments; Hospitalization; Humans; Osmolar Concentration; Referral and Consultation
PubMed: 33269691
DOI: No ID Found