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Types of Dehydration

Isotonic dehydration

• Equal water and Na+ loss.
• Most common type of dehydration• Fluid loss mainly from ECF
• Causes hypovolemia
• It leads to shock
• Serum electrolyte WNL ( Na+ level NL)
• V/S: orthostatic hypotension, tachycardia, tachypnea
• The blood will be hemoconcentrated
• Causes:
  1. Hemorrhage
  2. Fluid loss form GIT ( N, V, D)
  3. Diuretic
  4. Compensatory mechanism: increase aldosteron
  5. Treatment: isotonic fluid like NS, blood for hemorrhage.

Hypertonic Dehydration

• Loss H2O > Na+
• Second most common type
• Will cause increase in ECF and decrease of ICF
• Causes water loss hypernatremia
• V/S: BP and pulse WNL
• Causes:
  1. Large insensible loss
  2. hyperventilation
  3. administration of IV fluid with high electrolytes
  4. ketoacidosis
  5. Fever
  6. DI
  7. Watery diarrhea
  8. Tube feeding
• Compensatory mechanism: increase ADH, thirst
• Treatment: hypotonic fluid slowly ( D5W, 0.45% NS)

Hypotonic Dehydration

• Loss of Na+ > H2O
• Least common
• Causes decrease ECF and increase ICF
• Na+ loss hyponatremia
• Blood will be hemoconcentrated
• V/S: hypotension, tachycardia, and tachypnea
• Causes:
  1. Chronic illness
  2. Malnutrition
  3. Heat stroke
  4. Renal disease
  5. Burn
  6. In adequate water intake
• compensatory mechanism: increase aldosteron secretion
• Treatment: NS with additional K+, or hypertonic solution with caution.