Emergency fluid management for hypovolemia

Pflederer, Timothy A.

doi:10.3810/pgm.1996.09.80

Cited by 2 publications

(16 citation statements)

References 13 publications

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“…Capillary refill can be checked by applying pressure to a fingernail for 5 s. Normally, the color will return in less [44,55,56,82,92,105,106] than 1-2 s after releasing the pressure [46,74,100]. Delayed capillary refill also suggests anemia, cigarette smoking, cold environmental temperature, decreased cardiac output, or peripheral vasoconstriction [74].…”

Section: Physical Examinationmentioning

confidence: 98%

“…If the fluid deficit is severe (more than 20% of the intravascular volume), reduced tissue perfusion leads to shock [11,91,92,118]. Increased sympathetic activity occurs, with tachycardia, cold extremities, cyanosis, oliguria or anuria, confusion, and agitation [11,91,92,118].…”

Section: Fluid Deficit Shockmentioning

confidence: 99%

“…Increased sympathetic activity occurs, with tachycardia, cold extremities, cyanosis, oliguria or anuria, confusion, and agitation [11,91,92,118]. Therapy must restore tissue perfusion sufficiently to prevent ischemia and irreversible shock [11,91,92,118] Laboratory findings in fluid deficit Changes in the urine and blood chemistries give clues to the underlying cause and treatment [11,91].…”

Section: Fluid Deficit Shockmentioning

confidence: 99%

“…The goals are to correct fluid deficit and any associated electrolyte disorders [20,92]. In mild dehydration, water or any solution may suffice.…”

Section: Managementmentioning

confidence: 99%

“…More water than sodium should be given for hypernatremic VD and the opposite is true in the case of mild hyponatremia. The World Health Organization solution is safe and effective [20,92]. Oral solutions containing glucose and electrolytes can be used if a ratio of less than two parts carbohydrate to one part sodium is present [20,91,92,110].…”

Section: Managementmentioning

confidence: 99%

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Evaluation and treatment of cancer-related fluid deficits: volume depletion and dehydration

Sarhill

Walsh

Nelson

et al. 2001

Support Care Cancer

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Fluid deficits should be divided into two categories (dehydration and volume depletion) according to pathophysiology and into 3 categories (hyponatremic, hypernatremic, and isotonic) according to the plasma sodium concentration. Dehydration (total water deficit especially intracellular) is always hypernatremic, while volume depletion (intravascular water and sodium deficit) is either hyponatremic, hypernatremic, or isotonic. There are no clear clinical differences among the various categories, but a delay of capillary refill, tachycardia, and orthostatic hypotension are more common with early volume depletion. An Evans blue and mannitol test can be used to distinguish between hypernatremic volume depletion and dehydration. Careful clinical assessment and laboratory tests (especially serum sodium) are the key to diagnosis and effective management. According to the type (hypernatremic, hyponatremic, or isotonic), severity of fluid deficit, and associated symptoms, oral or parenteral fluid should be given along with treatment of the underlying cause. In hemodynamically compromised individuals with orthostatic hypotension and oliguria, replacement with isotonic saline until hemodynamic stabilization is crucial. Terminal hydration is still controversial. Important ethical principles govern clinical decision-making about hydration at the end of life.

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Section: Physical Examinationmentioning

confidence: 98%

Section: Fluid Deficit Shockmentioning

confidence: 99%

Section: Fluid Deficit Shockmentioning

confidence: 99%

“…The goals are to correct fluid deficit and any associated electrolyte disorders [20,92]. In mild dehydration, water or any solution may suffice.…”

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation and treatment of cancer-related fluid deficits: volume depletion and dehydration

Sarhill

Walsh

Nelson

et al. 2001

Support Care Cancer

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Assessment of nutritional status and fluid deficits in advanced cancer

Sarhill

Mahmoud

Christie

et al. 2003

Am J Hosp Palliat Care

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Malnutrition and cachexia are frequent manifestations of cancer and are major contributors to morbidity and mortality. The assessment of nutrition status in cancer patients can be easily accomplished. The first step is to record a complete medical history and to perform a thorough clinical examination to uncover signs of nutritional deficiency. Simple and inexpensive tests are available to assess the body composition, such as: anthropometric measurements, skinfold thickness, arm muscle circumference and area, and weight and body mass index (BMI). Biochemical measurements are also available, such as serum albumin, transferring, and prealbumin. Fluid deficit is divided into two categories based on pathophysiology (dehydration and volume depletion) and to three subtypes based on plasma sodium concentration (hyponatremic, hypernatremic, and isotonic). Dehydration (total water deficit, especially intracellular) is always hypernatremic, while volume depletion (intravascular water and sodium deficit) is either hyponatremic, hypernatremic, or isotonic. There are no clear clinical differences among the various categories, but a delay of capillary refill, tachycardia, and orthostatic hypotension is more common with volume depletion. Careful clinical assessment and laboratory tests, especially serum sodium, are the keystones for diagnosis and effective management. Bioelectrical impedance (BEI) is an easy way to assess both nutrition status and fluid deficits in advanced cancer and should be used more often than it currently is. This article reviews the subjective and objective methods of assessing fluid deficit and nutrition in advanced cancer.

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Emergency fluid management for hypovolemia

Cited by 2 publications

References 13 publications

Evaluation and treatment of cancer-related fluid deficits: volume depletion and dehydration

Evaluation and treatment of cancer-related fluid deficits: volume depletion and dehydration

Assessment of nutritional status and fluid deficits in advanced cancer

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