Understanding Clinical Dehydration and Its Treatment

David R. Thomas, Todd R. Cote, Larry Lawhorne, Steven A. Levenson, Laurence Z. Rubenstein, David A. Smith, Richard G. Stefanacci, Eric George Tangalos, John E. Morley

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Dehydration in clinical practice, as opposed to a physiological definition, refers to the loss of body water, with or without salt, at a rate greater than the body can replace it. We argue that the clinical definition for dehydration, ie, loss of total body water, addresses the medical needs of the patient most effectively. There are 2 types of dehydration, namely water loss dehydration (hyperosmolar, due either to increased sodium or glucose) and salt and water loss dehydration (hyponatremia). The diagnosis requires an appraisal of the patient and laboratory testing, clinical assessment, and knowledge of the patient's history. Long-term care facilities are reluctant to have practitioners make a diagnosis, in part because dehydration is a sentinel event thought to reflect poor care. Facilities should have an interdisciplinary educational focus on the prevention of dehydration in view of the poor outcomes associated with its development. We also argue that dehydration is rarely due to neglect from formal or informal caregivers, but rather results from a combination of physiological and disease processes. With the availability of recombinant hyaluronidase, subcutaneous infusion of fluids (hypodermoclysis) provides a better opportunity to treat mild to moderate dehydration in the nursing home and at home.

Original languageEnglish (US)
Pages (from-to)292-301
Number of pages10
JournalJournal of the American Medical Directors Association
Volume9
Issue number5
DOIs
StatePublished - Jun 2008

Fingerprint

Dehydration
Therapeutics
Body Water
Hypodermoclysis
Salts
Physiological Phenomena
Subcutaneous Infusions
Hyaluronoglucosaminidase
Hyponatremia
Water
Long-Term Care
Nursing Homes
Caregivers
Sodium
Glucose

Keywords

  • Dehydration
  • education
  • hyperosmolar dehydration
  • hypodermoclysis
  • hyponatremia dehydration
  • long-term care
  • prevention
  • recombinant hyaluronidase
  • subcutaneous infusion of fluid

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Thomas, D. R., Cote, T. R., Lawhorne, L., Levenson, S. A., Rubenstein, L. Z., Smith, D. A., ... Morley, J. E. (2008). Understanding Clinical Dehydration and Its Treatment. Journal of the American Medical Directors Association, 9(5), 292-301. https://doi.org/10.1016/j.jamda.2008.03.006

Understanding Clinical Dehydration and Its Treatment. / Thomas, David R.; Cote, Todd R.; Lawhorne, Larry; Levenson, Steven A.; Rubenstein, Laurence Z.; Smith, David A.; Stefanacci, Richard G.; Tangalos, Eric George; Morley, John E.

In: Journal of the American Medical Directors Association, Vol. 9, No. 5, 06.2008, p. 292-301.

Research output: Contribution to journalArticle

Thomas, DR, Cote, TR, Lawhorne, L, Levenson, SA, Rubenstein, LZ, Smith, DA, Stefanacci, RG, Tangalos, EG & Morley, JE 2008, 'Understanding Clinical Dehydration and Its Treatment', Journal of the American Medical Directors Association, vol. 9, no. 5, pp. 292-301. https://doi.org/10.1016/j.jamda.2008.03.006
Thomas DR, Cote TR, Lawhorne L, Levenson SA, Rubenstein LZ, Smith DA et al. Understanding Clinical Dehydration and Its Treatment. Journal of the American Medical Directors Association. 2008 Jun;9(5):292-301. https://doi.org/10.1016/j.jamda.2008.03.006
Thomas, David R. ; Cote, Todd R. ; Lawhorne, Larry ; Levenson, Steven A. ; Rubenstein, Laurence Z. ; Smith, David A. ; Stefanacci, Richard G. ; Tangalos, Eric George ; Morley, John E. / Understanding Clinical Dehydration and Its Treatment. In: Journal of the American Medical Directors Association. 2008 ; Vol. 9, No. 5. pp. 292-301.
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