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Need Dehydration Management? Here’s What You Should Know About IV Fluids for Dehydration

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Need Dehydration Management? Here’s What You Should Know About IV Fluids for Dehydration

When most people think of dehydration, they think of a dry mouth and possibly one monster of a dehydration headache

Here’s the thing: as far as your body is concerned, dehydration is not an annoyance to be ignored. And if you’re dehydrated due to a major sporting event, illness, or a night out of intense drinking, restoring your fluid balance is even more important. 

Sometimes, though, you can’t afford to wait for water to make its way through your system. This is where IV fluids for dehydration can help, whether you need to get chronic dehydration under control or you need to recover from the hangover of the year. 

The Physiology of Fluid Balance

Before we talk about getting an IV for dehydration, you should first understand the basic physiology that’s being addressed. 

On average, humans are about 60% water. The brain and heart are 73% water, while the lungs, which we usually think of as a dry organ, are a whopping 83% water. 

This is because of our ancestors. Once upon a time, a long, long time ago, primitive marine unicellular organisms evolved into multicellular organisms. When they eventually emerged from the sea to live on land, they carried their own internal sea with them in the form of extracellular fluid, which would keep their cells bathed in a constant chemical environment. 

This allowed cells to retain the energy needed to do their jobs. It worked so well that humans are still using that basic system. And while fluid balance is generally discussed as human and external environment, it’s also internal–diseases disrupt your bodily fluids, which is why, for example, you’re always told to drink a lot of water when you get a cold. 

Normal Anatomy

We said earlier that humans are about 60% water on average. That varies depending on gender and how old you are. 

Adult males are about 60% water, while adult females are only about 55% water. Children are 65% water, and infants are up to 75% water. However, your exact water percentage varies based on your body composition. Fat contains less water than lean muscle, so people with more fat have lower water levels than people with more muscle. 

You might think that means we can afford to lose a lot of water. Quite the opposite. You feel thirsty when you lose 2-3% of your hydration level, but mental performance declines at just 1% dehydration. 

That’s because your cells rely heavily on your fluid levels to function. Your total body water content is split between extracellular and intracellular fluids, and you need both in equal measure for your cells to remain in balance. 

Intake and Output

Under normal circumstances, our fluid intake comes from food and drinks containing fluids and electrolytes. 

On average, we take in roughly 1200 mL of water from beverages, another 1000 mL from solid food, and 300 mL from metabolic oxidation, which sounds like a lot until you realize that we lose roughly 1500 mL through urine, 100 mL through feces, and another 500 to 1000 mL due to insensible losses through the skin and lungs. 

Insensible losses are perfectly normal–it’s the natural evaporation of water from the skin and lungs, and it occurs all the time without our knowledge of it. 

It does, however, mean that your body has high fluid demands. If you fail to meet them, you’ll start facing serious health issues. 

Understanding Dehydration

This is where dehydration comes into play. 

Dehydration is when you lose more fluid than you take in. It doesn’t sound like a big deal, but it does become a problem when your body doesn’t have enough fluid to carry out normal functions. 

Considering that mental performance declines at just 2-3% dehydration, it doesn’t take much for your body to peter out. 

Dangers of Dehydration

Medically speaking, dehydration is when there is more liquid moving out of your cells than liquid moving into your cells. This means that your body begins protesting the lack of fluid and trying to conserve resources if there’s no sign that more fluid is coming. 

You have to remember that at least half of your body weight is water. Your body is not in any way designed to deal with dehydration in the long term, which is why dehydration can kill you in about three days (less if you’re exposed to extreme heat). No one normally lives more than five or six days without water. 

Short-Term Effects

Your body knows what it is and is not designed to handle. Lack of fluid is not one of the things it can handle, so the short-term effects of dehydration kick in pretty quickly. 

Signs of mild to moderate dehydration include: 

  • Headache
  • Thirst
  • Dry mouth
  • Sore throat
  • Fatigue
  • Dark yellow urine (when properly hydrated, your urine should be almost clear)
  • Muscle cramps
  • Dizziness with position changes, going from seated to standing

Signs of severe dehydration include: 

  • Not urinating or having very dark concentrated urine
  • Rapid heartbeat at rest
  • Rapid breathing
  • Sunken eyes
  • Confusion and irritability
  • Lethargy
  • Fainting
  • Dry skin
  • Confusion

The short-term effects of dehydration will be more or less severe depending on your fluid deficit. 

Dehydration also affects children and babies differently than adults. Remember, babies and children have a higher water content than adults. They may be irritable and lethargic but unable to form tears when they cry, and may have sunken eyes, sunken cheeks, or a soft spot on their skull. 

Effects of Chronic Dehydration

Since we’ve already covered that you cannot physically survive without water, let’s be blunt: chronic dehydration will kill you. If you’re not consuming any fluid at all, it won’t even take that long to kill you. 

However, if you’re consuming enough water to skate by but not enough to be properly hydrated, there’s a wide spectrum of ways that chronic dehydration can present itself. 

You’re most likely to experience: 

  • Dark-colored urine
  • Extreme thirst and dry mouth
  • Dizziness
  • Fatigue

If you’re drinking enough water to be alright but not enough to be hydrated, your body can learn to make do with the fluids it has. You may not notice that you’re low on fluids as your body becomes accustomed to operating on a deficit. 

This doesn’t mean it’s a good idea to go without water. Your body is functioning, but it’s not functioning well. You’ll still have various health issues, including: 

  • Dry or flaky skin
  • Chronic fatigue
  • Muscle weakness
  • Frequent headaches

When left untreated, chronic non-fatal dehydration can lead to other health problems, like kidney stones and high blood pressure. 

Is Drinking Water Enough?

If a lack of fluid is the problem, it begs the question: do you need intravenous rehydration, or is drinking water sufficient? 

That depends on the situation. 

In mild cases, it should be enough to drink plenty of fluid. Water is your first choice, but there are other things that can be used with water to help restore your fluid and electrolyte balance. Go for a combination of water, fruit juice, and salty soups or broths. 

More severe cases may require medical attention, as you may not be able to process fluids fast enough. It takes between five minutes and 120 minutes from the time of drinking for water to pass into your bloodstream. Intravenous rehydration allows you to sidestep the natural digestion process if dehydration is so severe that you can’t afford to wait. 

When to Seek Medical Care

Severe dehydration is considered a medical emergency and should be treated immediately at a hospital. You should see a doctor if: 

  • You haven’t produced urine in eight hours
  • You have a rapid pulse
  • You’re disoriented and confused
  • You feel dizzy when you stand
  • You’re too sick, due to nausea or vomiting, to consume fluids normally
  • You are unable to hydrate orally

That said, if you’re seeing signs of dehydration, you should take steps to treat it before it progresses this far. 

What is Intravenous Rehydration?

With all of that in mind, let’s talk about intravenous rehydration. 

Intravenous rehydration is used to treat moderate to severe cases of dehydration. When prescribed by hospitals, it’s more commonly used to treat children and infants, as they are more likely to become dangerously dehydrated than adults. 

This is done in cases when oral rehydration is insufficient, which can happen if dehydration is advanced or in cases of illness, like diarrhea, vomiting, or high fever. 

What Does It Do?

Intravenous rehydration is designed to sidestep the normal digestive process to get fluids into your system ASAP. 

When you consume liquids normally, it passes through your digestive system and eventually percolates into your bloodstream, where it is carried around the body for various uses. In cases of moderate to severe dehydration, fluid and electrolytes may not be able to pass through your body fast enough to counteract the danger. 

Fluids delivered through an IV line allow doctors to pump fluid directly into your bloodstream, which means that the fluid and electrolytes are available for your body to use right away. This will help stabilize you in the meantime and, over the duration of the treatment, restore you to normal hydration. 

If such treatment is needed, doctors will get an IV bag filled with a saline solution and a combination of fluids and electrolytes. This bag is attached to a thin plastic tube, an intravenous line, which is inserted into a vein with a needle. The amount of fluid entering the body is regulated with an automated pump or manually adjusted valve on the IV line. 

Nurses will usually look for veins in your arm since these are easy to access and usually wide enough to hit easily, but if you have narrow veins (often due to genetics) or collapsed veins (usually resulting from chronic use of intravenous injections) they may need to look for veins in other areas. 

The exact fluid solution in the IV bag will depend on the person. A doctor will look at the patient’s current condition, any pre-existing health problems, and their age to determine the right fluid combination. 

You’ll feel a bit of discomfort when the nurse inserts the needle, and having the tube under your skin will feel a bit odd at first, but otherwise, you won’t feel any discomfort. All of our IV statrts are 20g or smaller IV caths, we also use lidocaine spray to numb & clean the site before the insertion.  If anything, you may feel a bit cold under your skin as the fluid distributes in your system, since the liquid is below your normal body temperature. We heat out fluids in the winter months to help our patients remain warm and comfortable.  

Common IV Fluids for Dehydration

If your goal is to use IV fluids for dehydration rather than nutrition (as in the Myers cocktail), then your IV solution will be targeted toward restoring fluid balance. 

IV solutions are typically crystalloids or colloids. 

Crystalloid solutions are isotonic plasma volume expanders containing electrolytes. Because they’re isotonic, they can increase your circulatory volume without changing your vascular chemical balance. Basically, because crystalloid solutions chemically resemble blood, they don’t alter your blood chemical content. 

Because of this, crystalloid solutions are most commonly used to increase your fluid volume, usually in response to things like fluid loss during surgery, hemorrhages, or dehydration. 

Colloid solutions, on the other hand, are gelatinous and used to maintain osmotic pressure. Basically, the particles of colloids are too large to pass through cellular membranes, which means they stay extracellular and draw water out of the cells and into your plasma. They also stay in the blood longer because they can’t pass into cells like crystalloids. 

We’ll be focusing on crystalloid solutions here. They’re the most commonly ordered IV solution, as they carry no risk of anaphylaxis, are less expensive, and pose no risk to vegetarian or vegan patients (some colloids contain gelatin, which is derived from animal bones). 

0.9% Normal Saline

Most crystalloid solutions contain 0.9% normal saline, also known as sodium chloride 0.9%. 

If you remember basic high school chemistry, you’ll recognize sodium as salt. Normal saline is an isotonic crystalloid containing 0.9% sodium chloride dissolved in sterile water. 

Basically, this is a solution made of water and salt. 

It’s the most common intravenous fluid because it works well for most hydration needs, whether you’re dealing with basic dehydration, hemorrhage, vomiting, diarrhea, or even shock. It’s also the fluid of choice for intravenous fluid resuscitation. 

Doctors and nurses will sometimes use this solution cautiously (or avoid it altogether) when treating patients with cardiac issues or renal compromise, as the sodium (which causes fluid retention) may place extra stress on the heart and kidneys. 

To be clear, this solution will force your heart and kidneys to work a little bit harder, since sodium causes water retention in anyone. For most people, this is a non-issue. It’s only a risk for people whose heart and kidneys are already compromised. 

45% Normal Saline

Then, there’s 45% normal saline, also known as half normal saline. 

Like 0.9% normal saline, 45% normal saline is a solution made of sodium chloride dissolved in sterile water. Unlike 0.9% normal saline, 45% normal saline is a hypotonic crystalloid solution. 

All that means is that it has a lower osmotic pressure than another solution (in this case, your blood). That’s a good thing since it’s meant to treat intracellular dehydration. 

Basically, because 45% normal saline is hypotonic, it’s able to cross cellular membranes easily, drawing water into cells instead of out of them. 

It’s commonly used in hospitals to treat diabetic ketoacidosis and hypernatremia but is always avoided in burn patients, trauma patients, and patients with liver complications. Because it draws fluid from the outside of cells to the inside of cells, it causes intravascular fluid depletion that can be harmful to these patients. 

5% Dextrose in Water

A solution of 5% dextrose in water is an isotonic carbohydrate solution using dextrose as the solute. Dextrose is a form of glucose, a simple sugar made from corn. 

If you remember high school chemistry, you’ll recall that glucose is basically sugar. 

So, in plain English, it’s hospital-approved sugar water. 

When a solution like this is injected into your bloodstream, your cells snatch up the dextrose/glucose/sugar and use it for quick energy. This leaves behind a hypotonic water solution. 

Since it’s designed to give your cells quick energy, 5% dextrose in water is typically used to treat hypoglycemia (low blood sugar), insulin shock, and dehydration, though it may also be given to patients who cannot obtain nutrition through normal means for whatever reason. In fact, it’s often used to treat diabetic patients who can’t eat. 

This solution is always avoided if patients have a compromised heart, renal failure, or risk of increased intracranial pressure. In cardiac and renal patients, it can lead to fluid overload (remember, the solution becomes hypotonic water once the dextrose is gone). In patients with intracranial pressure issues, it can lead to cerebral edema (brain swelling). 

Lactated Ringer’s

Lactated Ringer’s solution, or LR, is a sterile solution containing, among other things: 

  • Calcium
  • Potassium
  • Lactate
  • Sodium
  • Chloride

It’s named for a physician named Sydney Ringer, who was the first to create the solution. 

It’s commonly used in hospitals in fluid resuscitation, which is when the patient needs aggressive fluid replacement due to blood loss, fluid loss, or both. 

Like normal saline, LR is isotonic (has the same osmotic pressure as blood). This is why it’s used like normal saline to increase fluid volume in the body. 

However, the content of LR means that it doesn’t last as long in your body, which can be beneficial if doctors are trying to avoid fluid overload. This also means that LR isn’t used as ongoing fluid replacement, though it is suitable for both children and adults and has fewer potential side effects than normal saline. 

In addition, doctors may choose LR over normal saline in cases where they’re trying to reduce your overall acidity, as with conditions like sepsis (a life-threatening response to severe infection) where your body is far more acidic than normal. This is because LR contains sodium lactate, which the body synthesizes into bicarbonate. 

Because LR is quite similar to the body’s natural plasma composition, it’s often used in burn patients or those with hypovolemia. It is avoided in patients with liver disease, as the liver may not be able to effectively process the lactate. LR is also the fluid of choice for pregnant women.  

Why Get an IV on Demand?

You know about dehydration, you know why your body is shouting at you to drink more liquids, and you know how IV fluids for dehydration work. 

Now, let’s talk about why IV fluids can sometimes be a beneficial quick-fix. 

Most people associate IVs with hospitals, which is reasonable. Most people don’t encounter IVs outside of hospitals (unless you happen to follow a celebrity on Instagram who ascribes to the restorative powers of IV therapy). 

So, the question is, why get an IV for dehydration? 

Well, for one thing, it’s a faster fix than water–and sometimes, you need fluid and electrolytes to hit your system ASAP. Maybe you’re traveling and trying to recover from your flight, maybe you got sick on a business trip, maybe you’ve got a hangover because you probably shouldn’t have been drinking the night before your big presentation. 

It’s also faster than visiting a hospital or doctor’s office. The procedure time is about the same (25 to 45 minutes), all from the comfort of your couch! 

Considering IV Fluids for Dehydration?

If you’re considering IV fluids for dehydration, we’re here to help. 
Our trained medical professionals, Rn’s and Paramedics to deliver you the IV solutions you need 😉 (pun intended). If you have questions or want to set up an appointment, click here to get in touch. 623-521-5034 azivmedics@gmail.com

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