• Fluid balance

    Fluid balance

    • Fluid balance is an aspect of the homeostasis of living organisms in which the amount of water in the organism needs to be controlled, via osmoregulation and behavior, such that the concentrations of electrolytes (salts in solution) in the various body fluids are kept within healthy ranges. The core principle of fluid balance is that the amount of water lost from the body must equal the amount of water taken in; for example, in human homeostasis, the output (via respiration, perspiration, urination, defecation, and expectoration) must equal the input (via eating, drinking, and parenteral intake). Euvolemia is the state of normal body fluid volume, including blood volume, interstitial fluid volume, and intracellular fluid volume; hypovolemia and hypervolemia are imbalances. Water is necessary for all life on Earth. Humans can survive for 4 to 6 weeks without food but only for a few days without water.

      Profuse sweating can increase the need for electrolyte replacement. Water-electrolyte imbalance produces headache and fatigue if mild; illness if moderate, and sometimes even death if severe. For example, water intoxication (which results in hyponatremia), the process of consuming too much water too quickly, can be fatal. Deficits to body water result in volume contraction and dehydration. Diarrhea is a threat to both body water volume and electrolyte levels, which is why diseases that cause diarrhea are great threats to fluid balance.

      • If fluid loss is greater than fluid gain (for example if the patient vomits and has diarrhea), the patient is said to be in negative fluid balance. In this case, fluid is often given intravenously to compensate for the loss.
      • On the other hand, a positive fluid balance (where fluid gain is greater than fluid loss) might suggest a problem with either the renal or cardiovascular system.
      • The majority of fluid output occurs via the urine, approximately 1500 ml/day (approx 1.59 qt/day) in the normal adult resting state.
      • Some fluid is lost through perspiration (part of the body's temperature control mechanism) and as water vapor in expired air. These are termed "insensible fluid losses" as they cannot be easily measured. Some sources say insensible losses account for 500 to 650 ml/day (0.5 to 0.6 qt.) of water in adults, while other sources put the minimum value at 800 ml (0.8 qt.). In children, one calculation used for insensible fluid loss is 400 ml/m2body surface area.
      • In addition, an adult loses approximately 100 ml/day of fluid through feces.
      • For females, an additional 50 ml/day is lost through vaginal secretions.
      • If the body is becoming fluid-deficient, there will be an increase in the secretion of these hormones, causing fluid to be retained by the kidneys and urine output to be reduced.
      • Conversely, if fluid levels are excessive, secretion of these hormones is suppressed, resulting in less retention of fluid by the kidneys and a subsequent increase in the volume of urine produced.
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    • Fluid balance