Classification of dehydration
On the basis of osmolality dehydration classified into 3 category;
1. Isotonic dehydration
2. Hypotonic dehydration
3. Hypertonic dehydration
1. Isotonic dehydration
Condition when electrolyte and water deficits are present in equal amount.
Plasma sodium remains between normal, between 130 to 150 mEq/L.
Characterized by hypovolemic shock.
2. Hypotonic dehydration
Condition occurs when electrolyte deficit exceeds water deficit.
In hypotonic dehydration water moves extracellular compartment to intra cellular space.
Intracellular fluid (ICF) is more concentrated then extra cellular fluid (ECF).
Serum sodium level falls below 130mEq/L.
In hypotonic dehydration, shock is frequent.
3. Hypertonic dehydration
Condition when water loss exceeds the electrolyte loss caused by larger loss of water or larger intake of electrolytes.
In hypertonic dehydration, fluid shift from intracellular compartment to extracellular compartment.
Plasma sodium level rises, greater than 150 mEq/L.
Hypertonic dehydration, occur in children who received high protein nasogastric tube feeding.
Shock is less, neurologic disturbance may present;
Alteration in consciousness, lethargy, increased muscle tone with hyper-reflexia and hyper- irritability to stimuli, alteration in pulse, thirst, tachycardia.
Hypotonic dehydration; primarily a loss of electrolytes
Hypertonic dehydration; primarily loss of water
Isotonic dehydration; equal loss of water and electrolytes
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