A multidisciplinary consensus on dehydration: definitions, diagnostic methods and clinical implications

Lacey, Jonathan, Corbett, Jo, Forni, Lui, Hooper, Lee ORCID: https://orcid.org/0000-0002-7904-3331, Hughes, Fintan, Minto, Gary, Moss, Charlotte, Price, Susanna, Whyte, Greg, Woodcock, Tom, Mythen, Michael and Montgomery, Hugh (2019) A multidisciplinary consensus on dehydration: definitions, diagnostic methods and clinical implications. Annals of Medicine, 51 (3-4). pp. 232-251. ISSN 0785-3890

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Abstract

Background: Dehydration appears prevalent, costly and associated with adverse outcomes. We sought to generate consensus on such key issues and elucidate need for further scientific enquiry. Materials and Methods: A modified Delphi process combined expert opinion and evidence appraisal. 12 relevant experts addressed dehydration’s definition, objective markers and impact on physiology and outcome. Results: Fifteen consensus statements and seven research recommendations were generated. Key findings, evidenced in detail, were that there is no universally-accepted definition for dehydration; hydration assessment is complex and requires combining physiological and laboratory variables; ‘dehydration’ and ‘hypovolaemia’ are incorrectly used interchangeably; abnormal hydration status includes relative and/or absolute abnormalities in body water and serum/plasma osmolality (pOsm); raised pOsm usually indicates dehydration; direct measurement of pOsm is the gold standard for determining dehydration; pOsm >300 and ≤280 mOsm/kg classifies a person as hyper or hypo-osmolar; outside extremes, signs of adult dehydration are subtle and unreliable; dehydration is common in hospitals and care homes and associated with poorer outcomes. Discussion: Dehydration poses risk to public health. Dehydration is under-recognised and poorly managed in hospital and community-based care. Further research is required to improve assessment and management of dehydration and the authors have made recommendations to focus academic endeavours.

Item Type: Article
Uncontrolled Keywords: dehydration,osmolar concentration,body fluid compartments,consensus,body water,water-electrolyte balance,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 29 May 2019 08:30
Last Modified: 21 Oct 2022 22:42
URI: https://ueaeprints.uea.ac.uk/id/eprint/71153
DOI: 10.1080/07853890.2019.1628352

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