Language Guiding Therapy: The Case of Dehydration versus Volume Depletion

@article{Mange1997LanguageGT,
  title={Language Guiding Therapy: The Case of Dehydration versus Volume Depletion},
  author={Kevin C. Mange and Dean Matsuura and Borut {\vC}i{\vz}man and Haydee Soto and Fuad Ziyadeh and Stanley Goldfarb and Eric Neilson},
  journal={Annals of Internal Medicine},
  year={1997},
  volume={127},
  pages={848-853}
}
Patients presenting with orthostatic hypotension and normal plasma sodium concentrations are frequently admitted to the hospital with a diagnosis of dehydration. If they are fortunate, they receive fluids containing sodium chloride instead of free water to correct obvious extracellular fluid volume depletion. Confusing this diagnosis highlights the growing and pernicious habit of using the terms dehydration and volume depletion interchangeably at the bedside when the two describe clearly… 
Dehydration versus volume depletion.
To the Editor: In his recent Nephrology Forum, Dr. Friedman1 makes a number of interesting and cogent observations regarding enteral and parenteral fluid and electrolyte therapy in infants and
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References

SHOWING 1-10 OF 34 REFERENCES
Anatomy of body water and electrolytes.
Body Water in Man. The Acquisition and Maintenance of the Body Fluids
  • F. Epstein
  • Medicine
    The Yale Journal of Biology and Medicine
  • 1957
TLDR
The excellence of much of the discussion justifies its use as a reference book, particularly for biochemists and medical students who will find the absence of formally presented biochemical concepts less of a problem than the medical practitioner.
Mechanisms of salt and water retention in heart failure.
  • A. Merrill
  • Medicine
    The American journal of medicine
  • 1949
THE RELATION BETWEEN BLOOD OSMOTIC PRESSURE, FLUID DISTRIBUTION AND VOLUNTARY WATER INTAKE
TLDR
Observations on voluntary water intake were correlated with changes in blood osmotic pressure and the general distribution of the body fluids in the present study.
The Body Cell Mass and Its Supporting Environment; Body Composition in Health and Disease.
TLDR
This volume, based on the multiple isotope dilution technique, is a much more complete treatise on body composition and begins with sections on methodology, interpretation, calculation, and statistical methods, which are carefully described but are not easy reading compared to the rest of the text.
The role of sodium in the production of edema.
TLDR
The simplest example of the formation of edema without change of the volume of fluid in the body is the swelling of the feet of a subject who stands still or rests in a relaxed position against a board at an angle of 60°.
Physiology of the kidney and body fluids; an introductory text
TLDR
This excellent book is one of a projected, and partially completed, series of monographs in physiology being brought out by Year Book Medical Publishers, designed to serve the needs of both the medical student in physiology and the practitioner requiring a relatively short, readable, upto-date treatment of the subject.
On the Absorption of Fluids from the Connective Tissue Spaces
TLDR
It is inquired whether the blood vessels do absorb such isotonic fluids, and the manner in which this absorption takes place.
Nonosmolar factors affecting renal water excretion (second of two parts).
TLDR
These investigators clearly showed that an increase in plasma osmotic pressure as small as 1 to 2 per cent by the intracarotid injection of hypertonic saline causes the release of an amount of vasopressin capable of dramatically decreasing renal water excretion.
...
...