Gipergidratace: what is it, symptoms, causes, treatment
Gipergidratace is a pathological condition of body associated with violation of water-salt (electrolyte) replacement. It is characterized by excess accumulation of water in the tissues of individual organs and body parts and whole body. The main sign by which to assume a person is disease – obvious swelling.
The types of the disease and why it develops
To understand how it develops and what is gipergidratace, consider the forms of water exchange.
Water inside the body is in the cells and space between cells. The intercellular substance is:
- intravascular – plasma;
- transcellular water contained in the brain, the joints, the liquid medium of the eye;
- interstitial is an intermediate substance for two-way exchange of substances between cells and blood.
The balance of water in the body depends on many factors – the number of the received liquid with the drink and food, her education during metabolic processes, excretion of water. Gipergidratace develops if the body enters a liquid more than output. In medicine this condition is called positive water balance.
There are some types of fluid overload depending on the osmolarity (concentration of soluble particles to 1 liter of fluid):
- Hypo – volume of all the liquid, both external and intracellular increases, while the osmolarity is reduced;
- hyperosmolar – increases extracellular fluid volume and osmolarity;
- isoosmolar – increase in extracellular water with the maintenance of normal osmolarity.
Each of these forms, their causes and development.
Why do I get the Hypo gipergidratace:
- excessive intake of fluids with low salt content, for example, the use of fresh water in large quantities (there is such term – "water poisoning");
- the lack of functionality of kidneys, which leads to a decrease in daily diuresis and subsequently anuria (absence of urine);
- the high content of antidiuretic hormone in the blood due to the enhanced generation in the hypothalamus (cells intermediate of the brain responsible for homeostasis – the persistence of the physiological processes).
Etiology hyperosmolar hyperhydration:
- the use of sea water inside in large quantities;
- kidney disease, in which the release of salts low – tubulopathy (violation of the transport of organic substances in the tubules of the kidneys), fermentopathy (decrease of enzyme activity);
- uncontrolled introduction of hyperosmolar solutions – disol, Trisol, ringer solution, lactosa;
- hyperaldosteronism – adrenal hyperplasia, in which there is excessive absorption of sodium in the kidneys.
Isoosmolar etiology of fluid overload:
- infusion of large volumes of isotonic solutions of NaCl 0,9%, glucose;
- increased capillary permeability, making the filtration of the liquid easier, for example, during late toxicosis in pregnant women, poisoning, infections;
- chronic insufficiency of blood circulation in which increases the amount of extracellular water;
- hypoproteinemia – abnormally low protein content in plasma, the fluid in the extracellular space has been delayed;
- chronic lymph congestion, hindering the flow of interstitial water in the vessels.
Signs of fluid overload
Each of the types of pathology has similar symptoms and distinctive (specific) characteristics. Their severity depends on the type of pathology and severity.
The main symptom of fluid overload is edema. They always occur when the metabolism of salts and are the result of accumulation of fluid in the different cavities of the body. Types of edema – exudate and transudate. Exudate is a fluid that has formed because of an inflammatory reaction under the action of mediators (biologically active substances). A transudate is a fluid that builds up in the cavities as a result of violations of circulation of blood and lymph, and the tissues are not inflamed.
Given the location of the swelling are of two types – anasarca (swelling of subcutaneous tissue) and edema (accumulation of water inside the cavities and tissues).
The types of hydrocephalus:
- ascites – fluid in abdominal cavity;
- hydrocephalus – water in the brain, leading to abnormal development;
- hydrothorax – fluid in the pleural cavity of the chest;
- hydroperiod – shirts dropsy heart (pericardium);
- hydrocele – dropsy of the testicle.
Edema of the compressed tissue and blood vessels, impaired blood flow and lymph. Due to the displacement of the tissues and irritation of the nerve endings patients experience pain.
Impaired metabolism causes the development of dystrophy. In the swelling starts to grow the connective tissue with subsequent sclerosis. Often associated infection. This is facilitated by such a mechanism: on the background of hypoxia changes the metabolism, and then decreases the activity of the immune system.
Swelling may occur slowly over several days or even weeks. It's a chronic form, which occurs when kidney damage or prolonged starvation. Acute edema develops within 1-2 hours, for example, acute heart failure or edema of the lung. Lightning puffinessdevelops in just a few seconds (the bites of poisonous insects, snakes).
Other signs characteristic of this disease:
- from the nervous system – apathetic state, lethargy, weakness, muscle cramps, disturbance of consciousness;
- gastrointestinal – vomiting and diarrhea;
- from the vessels and the heart – increased blood pressure, heart failure;
- the blood – increase BCC (volume of circulating blood in the body), reduced hemoglobin concentration and red blood cells, hemolysis (destruction) of red blood cells;
- the kidneys – high filtration pressure, causing polyuria (increased urine formation).
Therapy with fluid overload
Treatment of fluid overload is a complex, on several fronts.
Initially, carry out activities aimed at reduction of the causes of pathology – failure of internal organs, excessive intake of water in organism, endocrine violations.
For removing fluid from the body patients are prescribed diuretics (diuretics):
For the shortage of ions used polyelectrolyte solutions – peroxidase, polyoxidonium, chitosan.
If fluid overload it is important to normalize the heart, blood vessels, stabilize blood circulation, improve physical and chemical characteristics of blood. To do this, patients are prescribed these drugs:
- cardiotropic – ivabradine, aliskiren, Actovegin, sicomac, Neoton;
- vasoactive – reserpine, propranolol, pirroksan, phentolamine, papaverine, aminophylline, dipyridamole;
- blood components;
- the plasma substitutes – polides, gemodez, polyglukin, reopoligljukin, use adsorbents, gelatinol.
To eliminate edema, a treatment of the underlying pathology – disease of the kidneys, liver, heart, block the primary and secondary mechanism of development of edema.
- edema of the lungs eliminates the hypoxia – antipsychotics, hypothermia, anticoagulants (improves microcirculation of blood vessels), oxygen therapy (saturation of oxygen);
- elimination of ascites, diuretics with potassium, abdominal puncture;
- the removal of fluid from the pleural cavity – a chest drain;
- the removal of fluid from the joint capsule – arthrocentesis.
In order to remove all the excess fluid from the body, patients are prescribed dehydration therapy – activities aimed at the elimination of excess water. For this prescribed diuretics – diuretics, saluretics. In severe cases, acute renal failure, resort to such methods of blood purification:
- peritoneal dialysis introduction to peritoneal cavity detoxifying solution;
- forced diuresis – simultaneous intravenous injection of a large volume of liquid (5-6 l);
- hemodialysis – cleansing the blood and its saturation with necessary microelements, by sweep through apparatus "artificial kidney".
During treatment it is important to keep drinking regime. Can't drink a lot of fluid at one time. If the patient will drink about 3 liters of water in a short period of time, it will cause uremic toxicity – poisoning with products of disintegration of proteins. Intoxication will result in swelling of the brain and lungs, and often fatal.
The risk group includes people with diseases of the cardiovascular system, kidneys, exposed to heavy physical activity, athletes, patients are forced to comply with a long salt-free diet.
Preventive measures prevent the development of disease – drinking regime and diet. The diet should be balanced according to the recommendations of the doctor. People with endocrine disorders is necessary to control your weight. It is important to observe the mode of work and rest, avoid heavy physical exertion. Patients with chronic cardiac and renal pathology in mandatory twice a year and undergo medical treatment in a hospital and a medical examination in the clinic.