Exsikkose

Exsikkose, commonly referred to as dehydration, is the state in which the body's total water content is reduced. It can involve loss of water with or without accompanying electrolyte loss and may lead to a rise in plasma osmolality. Exsikkose is described in clinical medicine as a condition resulting from inadequate fluid intake, excessive water loss, or both, and it can range from mild to life-threatening.

Causes include insufficient fluid intake, heat exposure, fever, intense physical activity, sweating, diarrhea, vomiting, burns, diuretic use, diabetes insipidus, and osmotic diuresis. Infants, young children, the elderly, and individuals with impaired thirst or mobility are particularly at risk.

Pathophysiology and manifestations: When water loss exceeds intake, extracellular volume contracts and plasma osmolality increases. Dehydration can be isotonic, hypertonic (hypernatremic), or hypotonic (hyponatremic) depending on the relative loss of water and electrolytes. Clinical signs include thirst, dry mouth and mucous membranes, reduced skin turgor, sunken eyes, oliguria or anuria, tachycardia, hypotension, and, in severe cases, confusion or lethargy.

Diagnosis and management: Diagnosis relies on history, physical examination, and laboratory tests (serum electrolytes, BUN/creatinine, urine osmolality, and urine sodium). Treatment aims to restore fluid balance and correct electrolyte disturbances. Mild to moderate exsikkose is treated with oral rehydration solutions or increased fluid intake; severe dehydration requires prompt intravenous fluids, typically isotonic saline (0.9% NaCl) or Ringer's lactate, with gradual correction of hypernatremia when present. Address the underlying cause and monitor vital signs, urine output, and labs during rehydration.