Violation of the water-electrolyte balance

Violation of water-electrolyte balance in the body happens in the following situations:

• When hyperhydration - excessive accumulation of water in the body and its slow release. The liquid medium begins to accumulate in the intercellular space and because of this its level inside the cell begins to build up and it swells. If hyperhydration involves nerve cells, then convulsions arise and nervous centers are excited.
• With dehydration - lack of moisture or dehydration, the blood begins to thicken, because of the viscosity, thrombi form and the blood flow to the tissues and organs is disturbed. With its lack of more than 20% of the body weight, death occurs in the body.

It is manifested by a decrease in body weight, dryness of the skin, cornea. With a high level of deficiency, the skin can be collected in creases, subcutaneous fatty fiber is similar in appearance to the dough, eyes fall. The percentage of circulating blood also decreases, it manifests itself in the following symptoms:

• facial features become aggravated;
• cyanosis of the lips and nail plates;
• hands and feet freeze;
• the pressure decreases, the pulse is weak and frequent;
• hypofunction of the kidneys, high level of nitrogenous bases as a result of disturbed protein metabolism;
• disturbance of the heart, respiratory depression (according to Kussmaul), vomiting is possible.

It is often fixed isotonic dehydration - water and sodium are lost in an equal proportion. This condition is common in acute poisoning - the necessary volume of liquid medium and electrolytes is lost when vomiting and diarrhea.

The causes of disturbance of the water-electrolyte balance

The causes of disturbance of the water-electrolyte balance are the redistribution of body fluids and external fluid loss.

Causes of decreased calcium in the blood :

• damage thyroid;
• treatment with preparations of radioactive iodine;
• removal of the thyroid gland;
• with pseudohypoparathyroidism.

Causes of sodium reduction :

• long-term severe illness with decreased urinary output;
• condition in postoperative time;
• self-medication and uncontrolled use of diuretics.

Reasons for potassium reduction :

• intracellular movement of potassium;
• confirmation of alkalosis;
• the presence of aldosteronism;
• use of corticosteroids.
• alcohol abuse;
• pathology of the liver;
• operations on the small intestine;
• insulin injections;
• hypothyroidism of the thyroid gland.

Causes of increased potassium levels :

• increase in cationons and retention of potassium compounds;
• damage to cells and the release of potassium from them.

Symptoms of water-electrolyte balance disturbance

The first symptoms of water-electrolyte balance disturbance depend on what pathological process occurs in the body (hydration, dehydration). This is increased thirst, and swelling, vomiting, diarrhea. Often there is a changed acid-base balance, low pressure, arrhythmic heartbeat. Neglect these signs can not be, because they lead to cardiac arrest and death, if medical assistance is not provided on time.

With a lack of calcium in the blood there are convulsions of smooth muscles, especially dangerous spasm of the larynx, large vessels. With an increase in the content of Ca - pain in the stomach, a feeling of thirst, vomiting, increased urination, inhibition of blood circulation.

Lack of K is manifested by atony, alkalosis, CRF, brain pathologies, intestinal obstruction, ventricular fibrillation and other heart rate changes. An increase in the potassium content is manifested by ascending paralysis, nausea, vomiting. The danger of this condition is that ventricular fibrillation and atrial arrest rapidly develop.

High Mg in the blood happens with renal dysfunction, abuse of antacids. There is nausea, vomiting, the temperature rises, the heart rhythm slows down.

Symptoms of disturbance of the water-electrolyte balance suggest that the conditions described require immediate medical attention in order to avoid even more serious complications and death.

Diagnosis of disturbance of water-electrolyte balance

Diagnosis of disturbance of the water-electrolyte balance at the initial intake is approximately, further treatment is affected by the body's reaction to the introduction of electrolytes, anti-shock drugs (depending on the severity of the condition).

The necessary information about a person and the state of his health upon hospitalization is established by:

• According to anamnesis. In the course of the survey (if the patient is conscious), the data on the existing disturbances of water-salt metabolism are clarified (peptic ulcer, diarrhea, narrowing of the pylorus, some forms of ulcerative colitis, severe intestinal infections, dehydration of another etiology, ascites, low-salt diet).
• Establishment of the degree of aggravation of the current disease and further measures to eliminate complications.
• General, serological and bacteriological analysis of blood, to identify and confirm the root cause of the current pathological condition. Additional instrumental and laboratory studies are also being prescribed to clarify the cause of the ailment.

Timely diagnosis of water-electrolyte balance disturbance makes it possible to identify the severity of the disorder as soon as possible and to organize the appropriate treatment in a timely manner.

[1], [2], [3], [4], [5], [6]

Treatment of water-electrolyte balance disorders

Treatment violations of water-electrolyte balance should take place according to this scheme:

• Eliminate the likelihood of progressive development of a life-threatening condition:
  • bleeding, acute loss of blood;
  • eliminate hypovolaemia;
  • eliminate hyper- or hypokalemia.
• Resume normal water-salt metabolism. The most commonly used drugs for normalizing water-salt metabolism are NaCl 0.9%, glucose solution 5%, 10%, 20%, 40%, polyionic solutions (Ringer-Locka, lactasol, Hartman and others .), erythrocyte mass, polyglucin, 4% soda, 4% KCl, 10% CaCl2, 25% MgSO4, and others.
• To prevent possible complications of iatrogenic nature (epilepsy, heart failure, especially when injecting sodium preparations).
• If necessary, in parallel with the intravenous administration of medicines, diet therapy.
• With intravenous administration of saline solutions, it is necessary to control the level of BSR, CBS, monitor hemodynamics, monitor kidney function.

An important point is that before the intravenous injection of salt components, it is necessary to calculate the probable loss of fluid and draw up a plan for restoring normal BSR. Calculate the loss by the formulas: •

Water (mmol) = 0.6 x Weight (kg) x (140 / Na true (mmol / L) + glucose / 2 (mmol / l)),

Where 0.6 x Weight (kg) - the amount of water in the body

140 - average% Na (norm)

Na is the true concentration of sodium.

Water deficit (l) = (Htist - HtN): (100 - HtN) x 0.2 x Weight (kg),

Where 0.2 x Weight (kg) - volume of extracellular fluid

HtN = 40 for females, 43 for males.

• The content of electrolytes is 0.2 x Weight x (Normal (mmol / l) is the true content (mmol / l).

Prevention of disturbance of water-electrolyte balance

Prevention of disturbance of the water-electrolyte balance is to maintain a normal water-salt balance. Salt metabolism can be disturbed not only in severe pathologies (3-4 degree burns, peptic ulcer, ulcerative colitis, acute blood loss, food intoxication, gastrointestinal infections, mental disorders accompanied by eating disorders - bulimia, anorexia, etc.), but also with excessive sweating, accompanied by overheating, systematic uncontrolled use of diuretics, a long-term salt-free diet.

In prophylactic purposes, it is worthwhile to monitor the state of health, monitor the current diseases that can provoke salt imbalance, not prescribe self-medications that affect the transit of liquid, replenish the necessary daily rate of fluid under conditions close to dehydration, and eat properly and balanced.

Prevention of the disturbance of water-electrolyte balance also lies in the right diet - the use of oatmeal, bananas, chicken breast, carrots, nuts, dried apricots, figs, grape and orange juice is not only useful in itself, but also helps maintain the proper balance of salts and trace elements .

Forecast violation of water-electrolyte balance

The forecast of the disturbance of the water-electrolyte balance, with timely docking and elimination of the underlying cause, is favorable. If treatment is not adhered to or untimely treatment for help, life-threatening conditions may develop, as well as:

• with hyperhydration, there are tonic convulsions, choking, puffiness of soft tissues, edema of the brain, lungs;
• decrease in the level of potassium, a decrease in the percentage of sodium in the bloodstream, which affects the viscosity of the blood and its fluidity;
• the cornea drains, the skin. With a lack of fluid over 20% of the body weight, death occurs;
• because of changes in blood aggregation, arrhythmia develops and cardiac arrest is possible;
• oppression of respiratory function, violation or cessation of blood circulation.
• when hyperhydration there are tonic convulsions, suffocation.

Also, a violation of the water-salt balance often develops in those who have a long-term salt-free diet or drink little liquid in the heat and high physical exertion. In such cases, it is very useful to drink 1-1.5 liters of mineral water per day - to maintain the optimum salt balance. In this case, the forecast of the disturbance of the water-electrolyte balance will be positive in the future.

[7], [8], [9], [10]