Eukovolämie

Eukovolämie, more commonly spelled Euvolämie (German) or euvolemia (English), is a clinical state defined by normal extracellular fluid volume and adequate tissue perfusion. It denotes a balance between fluid intake, renal excretion, and hormonal regulation that maintains intravascular, interstitial, and intracellular compartments near their normal volumes. The term is used primarily in nephrology and critical care to distinguish true volume depletion or excess from a physiologic or compensated state where volume status appears normal on examination.

Pathophysiology and context: Euvolämie may occur in conditions where water and sodium balance are appropriate but other derangements exist, such as hyponatremia with SIADH, where total body water is increased but circulatory volume is not reduced. In fluid management, achieving euvolemia is a common goal in dehydration, heart failure, cirrhosis, and postoperative care.

Assessment: Determining euvolemia is clinical and often challenging. Assessment includes vital signs, mucous membranes, skin turgor, edema, jugular venous pressure, and lung auscultation; dynamic tests such as passive leg raise or changes in stroke volume can help. Point-of-care ultrasound of the inferior vena cava and renal Doppler can aid. Laboratory tests include serum sodium, osmolality, BUN/creatinine, uric acid, natriuretic peptide levels, and urine sodium/osmolarity.

Management: The objective is to maintain or restore euvolemia; in hyponatremia with euvolemia due to SIADH, fluid restriction and treating underlying cause are typical; in dehydration, cautious fluid replacement; in hypervolemic states, diuretics and salt restriction; ongoing assessment is critical.

See also: Euvolemic hyponatremia, hypovolemia, hypervolemia.