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Geriatrische Syndrome: Exsikkose/Dehydratation

SpringerReference Innere Medizin

Part of the book series: SpringerReference Medizin ((SRM))

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Zusammenfassung

Aufgrund eines regelhaft verminderten Durstgefühls und anderer Faktoren weisen alte Menschen eine besondere Vulnerabilität für einen Flüssigkeitsmangel auf. Exsikkose und Dehydratation gehören daher zu den häufigsten Diagnosen bei alten Patienten. Alle diagnostischen Kriterien weisen eine geringe Sensitivität und Spezifität auf, so dass die Diagnose eher aufgrund des Gesamtbildes, im Zweifel auch nach einer probatorischen Therapie, gestellt wird. Pathophysiologisch lassen sich zwei Typen der Dehydratation unterscheiden. Der Mangel an freiem Wasser führt zur hypertonen Dehydratation, die aufgrund der osmotischen Kompensation zu schwerwiegenden Konsequenzen für den gesamten Organismus führt. Der Verlust von Wasser mit Elektrolyten führt vordringlich zu den Symptomen einer Hypovolämie und lässt sich klinisch leichter erkennen und ausgleichen. Insgesamt kann die Symptomatik der Dehydratation sehr variabel und vielfältig sein. Wird die Dehydratation nicht erkannt, so entsteht rasch ein Teufelskreis, da die abnehmende Leistungsfähigkeit des Patienten weiterhin die Flüssigkeitsaufnahme verschlechtert. Dies kann binnen kurzer Zeit zu einer dramatischen Symptomatik führen.

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Literatur

  • Battistini N, Facchini F et al (1995) The prediction of extracellular and total body water from bioelectric impedance in a non-Caucasian population from central Asia. Ann Hum Biol 22(4):315–320

    Article  CAS  PubMed  Google Scholar 

  • Blehar DJ, Resop D et al (2012) Inferior vena cava displacement during respirophasic ultrasound imaging. Crit Ultrasound J 4(1):18

    Article  PubMed Central  PubMed  Google Scholar 

  • Buffa R, Floris G et al (2010) Nutritional status in the healthy longeval population from Sardinia (Italy). J Nutr Health Aging 14(2):97–102

    Article  CAS  PubMed  Google Scholar 

  • Cheriex EC, Leunissen KM et al (1989) Echography of the inferior vena cava is a simple and reliable tool for estimation of 'dry weight' in haemodialysis patients. Nephrol Dial Transplant 4(6):563–568

    CAS  PubMed  Google Scholar 

  • Colling JC, Owen TR et al (1994) Urine volumes and voiding patterns among incontinent nursing home residents. Residents at highest risk for dehydration are often the most difficult to track. Geriatr Nurs 15(4):188–192

    Article  CAS  PubMed  Google Scholar 

  • Eaton D, Bannister P et al (1994) Axillary sweating in clinical assessment of dehydration in ill elderly patients. BMJ 308(6939):1271

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Go M, Amino A et al (1994) A case of central pontine myelinolysis and extrapontine myelinolysis during rapid correction of hypernatremia. Rinsho Shinkeigaku 34(11):1130–1135

    CAS  PubMed  Google Scholar 

  • Leischker AH (2012) Subcutaneous infusions for geriatric patients: rediscovery of an "old" technique. Z Gerontol Geriatr 45(7):665–670, quiz 671–662

    Article  CAS  PubMed  Google Scholar 

  • Levin J, Hogen T et al (2012) Pontine and extrapontine myolinolysis associated with hypernatraemia. Clin Neurol Neurosurg 114(9):1290–1291

    Article  PubMed  Google Scholar 

  • Martinoli R, Mohamed EI et al (2003) Total body water estimation using bioelectrical impedance: a meta-analysis of the data available in the literature. Acta Diabetol 40(Suppl 1):203–206

    Article  Google Scholar 

  • Mazza AD, Morley JE (2007) Update on diabetes in the elderly and the application of current therapeutics. J Am Med Dir Assoc 8(8):489–492

    Article  PubMed  Google Scholar 

  • McCann RM, Hall WJ et al (1994) Comfort care for terminally ill patients. The appropriate use of nutrition and hydration. JAMA 272(16):1263

    Article  CAS  PubMed  Google Scholar 

  • McGee S, Abernethy WB 3rd et al (1999) The rational clinical examination. Is this patient hypovolemic? JAMA 281(11):1022–1029

    Article  CAS  PubMed  Google Scholar 

  • Mentes JC, Wakefield B et al (2006) Use of a urine color chart to monitor hydration status in nursing home residents. Biol Res Nurs 7(3):197–203

    Article  PubMed  Google Scholar 

  • Molaschi M, Ponzetto M et al (1997) Hypernatremic dehydration in the elderly on admission to hospital. J Nutr Health Aging 1(3):156–160

    CAS  PubMed  Google Scholar 

  • Nakajima N, Hata Y et al (2013) A clinical study on the influence of hydration volume on the signs of terminally ill cancer patients with abdominal malignancies. Journal of palliative medicine 16:185–189

    Article  PubMed  Google Scholar 

  • Phillips PA, Rolls BJ et al (1984) Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 311(12):753–759

    Article  CAS  PubMed  Google Scholar 

  • Phillips PA, Bretherton M et al (1991) Reduced osmotic thirst in healthy elderly men. Am J Physiol 261(1 Pt 2):R166–R171

    CAS  PubMed  Google Scholar 

  • Rösler A, Lehmann F et al (2010) Nutritional and hydration status in elderly subjects: clinical rating versus bioimpedance analysis. Arch Gerontol Geriatr 50(3):e81–e85

    Article  PubMed  Google Scholar 

  • Sienz M, Ignee A et al (2012) Sonography today: reference values in abdominal ultrasound: aorta, inferior vena cava, kidneys. Z Gastroenterol 50(3):293–315

    Article  CAS  PubMed  Google Scholar 

  • Stookey JD, Pieper CF et al (2005) Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years. Public Health Nutr 8(8):1275–1285

    Article  PubMed  Google Scholar 

  • Thomas DR, Cote TR et al (2008) Understanding clinical dehydration and its treatment. J Am Med Dir Assoc 9(5):292–301

    Article  PubMed  Google Scholar 

  • Volkert D, Kreuel K et al (2005) Fluid intake of community-living, independent elderly in Germany–a nationwide, representative study. J Nutr Health Aging 9(5):305–309

    CAS  PubMed  Google Scholar 

  • Wakefield B, Mentes J et al (2002) Monitoring hydration status in elderly veterans. West J Nurs Res 24(2):132–142

    Article  PubMed  Google Scholar 

  • Wakefield BJ, Mentes J et al (2008) Risk factors and outcomes associated with hospital admission for dehydration. Rehabil Nurs 33(6):233–241

    Article  PubMed  Google Scholar 

  • Wehling M (2013) Morbus Diureticus in the Elderly: Epidemic Overuse of a Widely Applied Group of Drugs. J Am Med Dir Assoc 14:437–442

    Article  PubMed  Google Scholar 

  • Whelan K (2001) Inadequate fluid intakes in dysphagic acute stroke. Clin Nutr 20(5):423–428

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. St. Marien-Hospital Borken, Klinik für Geriatrie, Am Boltenhof 7, 46322, Borken, Deutschland

    Rainer Wirth

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  1. Rainer Wirth
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Correspondence to Rainer Wirth .

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Editors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Hoslstein, Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Hendrik Lehnert

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Wirth, R. (2014). Geriatrische Syndrome: Exsikkose/Dehydratation. In: Lehnert, H. (eds) SpringerReference Innere Medizin. SpringerReference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_451-1

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  • DOI: https://doi.org/10.1007/978-3-642-54676-1_451-1

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  • Online ISBN: 978-3-642-54676-1

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Chapter history

  1. Latest

    Geriatrische Syndrome: Exsikkose/Dehydratation
    Published:
    28 July 2023

    DOI: https://doi.org/10.1007/978-3-642-54676-1_451-2

  2. Original

    Geriatrische Syndrome: Exsikkose/Dehydratation
    Published:
    17 December 2014

    DOI: https://doi.org/10.1007/978-3-642-54676-1_451-1

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