endocrine and metabolic disorders
Volume Depletion
Treatment of Volume Depletion
Replacement of sodium and water The cause of volume depletion is corrected and fluids are given to replace existing volume deficits as well as any ongoing fluid losses and to provide daily fluid requirements. Mild-to-moderate volume deficits may be replaced by increased oral intake of sodium and water when patients are conscious and not vomiting; Oral Rehydration are discussed elsewhere. Tube feedings can also be used if oral intake is limited or not safe for some reason. When volume deficits are severe or when oral fluid replacement is impractical, IV 0.9% saline or a buffered electrolyte solution (eg, Ringer's lactate) is given. Both are well tolerated and safe, but Ringer’s lactate and other buffered solutions have lower chloride concentrations and may reduce development of hyperchloremic metabolic acidosis. Recent evidence seems to favor use of Ringer's lactate over saline, but the issue is not settled. Because both of these solutions distribute evenly into the extracellular space, three to four times the deficit in intravascular volume needs to be given. Intravenous Fluid Resuscitation are given elsewhere. 