Hypotonic dehydration

Description:

Hypotonic dehydration is called the condition of GIO at which against the background of deficit of water in an organism osmotic concentration of ETsZh is lower than normal.

Symptoms of Hypotonic dehydration:

Due to hypotonicity of plasma water moves from vnekletochyony space to cells therefore in a clinical picture domiyonirut hemodynamic frustration which can quickly priyovest to shock. There is no thirst. Quickly the general weakness, a goloyovokruzheniye, an orthostatic collapse increase. Elasticity of fabrics and turgor of skin are lowered. Eyeballs are soft. In process of increase of a defiyotsit of salts weakness amplifies, dizziness, a toshyonota, vomiting, consciousness oppression develop. Arterial pressure decreases, tachycardia accrues. Skin is cold, cyanochroic, veins спадают­ся. Shock develops. Weight of a state is defined by hyponatremia degree.

Reasons of Hypotonic dehydration:

It develops when the organism loses liquid with bigger concentration of ions, generally sodium, than in ETsZh.

It leads to reduction of the general content of water and ions in an organism, and the last goes more intensively concerning reduction of content of water, decrease in concentration of ions in ETsZh and ITsZh is a consequence of what.

The size of reduction of content of water and ions in an organism, and also concentration of the last in water of various water spaces, depends on the volume of losses, a look and concentration of ions in the lost liquid. Intensity of development of disturbances depends on the volume speed of losses and intensity of compensatory reactions.

Hypotonic dehydration develops when liquid from upper parts of digestive tract, more precisely from those departments where there is a process of active release of intestinal juice or its absorption is lost. It can occur at impassability of average departments of intestines, at drainage of these departments, existence of intestinal fistulas in them, at colienterites, at allocation of a large amount of hypertensive urine, at plentiful and frequent vomiting.
Development of hypotonic dehydration — process difficult. It includes interspace redistribution of water, a transmineralization (an exit of intracellular cations from cells and their substitution by extracellular cations, as for generally sodium, potassium, magnesium and protons).

These changes lead to extracellular dehydration and an intracellular overhydratation, change of active reaction of extra-and intracellular liquids, decrease in OTsP and according to deterioration in function of blood circulation, disturbance of transport of oxygen, power substrates, end products of metabolism is a consequence of what. Osmotic pressure decreases in both water sectors of an organism.

Treatment of Hypotonic dehydration:

The complex of actions at treatment of hypotonic dehydration is one of the most difficult and serious sections of an intensive care. Slowly struyno to enter 1 — 2 ml on 1 kg of MT of strong solution of sodium chloride. On our observations and data of other authors, it gives the expressed positive effect [Weile W. Century, Bailie M. D., 1977].

In this case it is necessary to enter at least 10 ml of 10% of solution of sodium chloride that will provide introduction of 1,71 mmol / мл*10 to ml of =17,1 mmol of sodium that will increase concentration of sodium in plasma approximately by 11 mmol/l.

To eliminate a hypovolemia with any available volyumrekonstruktivny drug: plasma, albumine solution, Polyglucinum, reopoliglyukiny, and for lack of such — Ringer or Hartman's solution. Due to the liquid translocation from ETsZh in ITsZh OTsP, as a rule, at a big size in comparison with the relative size of dehydration is lowered.