How can we calculate the daily deficit of fluids?
By recognizing the level of
signs and symptoms
we have three levels of dehydration:1-
Grade I (mild):
-The loss is about 4% of the body fluids,
it’s only have
clinical symptomsand there are no signs.
e.g people who are fasting , anorexia “loss of appetite” , vomiting
, diarrhea those are symptoms but if we examine the patient you will find nothing !2-
Grade II (moderate):
- The loss is about 8% of the body fluids, it have all symptoms of thefirst grade and only one sign which is postural tachycardia (will increase 15 beats perminute) and postural hypotension (if the patient is Laing and you measure the bloodpressure is normal but if the patient stands up the pressure will decrease 10mmHG.
Grade III (sever) :-
The loss is about 10% or more of the body fluids, it has symptoms andmany signs, the first sign is true hypotension and tachycardia and the next system will beaffected is the
brain because it’s sensitive to hypoxia, the patient will start to sleepstoppers (when you leave him he’ll fall in sleep, but once you awake him he’ll wake up),
but if the hypoxia is so sever the patient may go into coma, then the kidney start to beaffected, decreased urine volume, abnormally dark urine,
*60% of the body mass is fluid.So to calculate how much fluid the patient needs, you have to multiply his weight by60% by
the percentage of loss of fluid “B.W×60%×degree of dehydration”(e.g.: 70 Kg
patient with a moderate dehydration??
He’ll need 70 × 0.6× 0.08 = 3.36 L)
*so we should replace the fluid quality and quantity, the quantity as calculated above, and thequality is according to what the patient has lost, in most of the patient the loss is isotonic (thesame as the plasma) so we replace is by isotonic solution, but if you want to be more precise,you have to do serum electrolytes test and calculate the amount of electrolytes (sodium) youneed to add.