Dehydration

<h1 id="firstHeading" class="firstHeading" lang="en" >Dehydration</h1>

<div id="siteSub" >From Wikipedia, the free encyclopedia</div>

<div class="hatnote" >For other uses, see <a href="http://en.wikipedia.org/wiki/Dehydration_(disambiguation)" title="Dehydration (disambiguation)" >Dehydration (disambiguation)</a>.</div>

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<th >[<a id="collapseButton0" href="http://en.wikipedia.org/wiki/Dehydration#" >hide</a>]This article has multiple issues. Please help <b><a class="external text" href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit" >improve it</a></b> or discuss these issues on the <b><a href="http://en.wikipedia.org/wiki/Talk:Dehydration" title="Talk:Dehydration" >talk page</a></b>.</th>

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<td class="mbox-text" >This article's <b>factual accuracy is <a href="http://en.wikipedia.org/wiki/Wikipedia:Accuracy_dispute" title="Wikipedia:Accuracy dispute" >disputed</a></b>. <small><i>(February 2014)</i></small></td>

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<td class="mbox-text" >This article <b>may need to be rewritten entirely to comply with Wikipedia's <a href="http://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style" title="Wikipedia:Manual of Style" >quality standards</a></b>. <small><i>(February 2011)</i></small></td>

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<th colspan="2" >Dehydration</th>

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<td colspan="2" ><i>Classification and external resources</i></td>

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<div>Nurses encourage a patient to drink an oral rehydration (water or antibiotic liquid) solution to reduce dehydration he acquired from <a href="http://en.wikipedia.org/wiki/Cholera" title="Cholera" >cholera</a>.</div>

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<th scope="row" ><a href="http://en.wikipedia.org/wiki/MedlinePlus" title="MedlinePlus" >MedlinePlus</a></th>

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<p >Dehydration is the removal of <a href="http://en.wikipedia.org/wiki/Water" title="Water" >water</a> (<a href="http://en.wikipedia.org/wiki/Ancient_Greek" title="Ancient Greek" >Ancient Greek</a>: ὕδωρ <i>hýdōr</i>) from an object; however, in humans and animals, it entails an excessive loss of <a href="http://en.wikipedia.org/wiki/Body_water" title="Body water" >body water</a>. Deficiency of fluids can sometimes result in a disruption of <a href="http://en.wikipedia.org/wiki/Metabolism" title="Metabolism" >metabolic processes</a>. Dehydration of <a href="http://en.wikipedia.org/wiki/Human_skin" title="Human skin" >skin</a> and <a href="http://en.wikipedia.org/wiki/Mucous_membranes" title="Mucous membranes" class="mw-redirect" >mucous membranes</a> can be called <a href="http://en.wikipedia.org/wiki/Dryness_(medical)" title="Dryness (medical)" >medical dryness</a>.

Dehydration occurs when water loss in the body exceeds the water intake. Most people can tolerate a three to four percent decrease in body water without difficulty. A five to eight percent decrease can cause fatigue and dizziness. Over ten percent can cause physical and mental deterioration, accompanied by severe thirst. A decrease more than fifteen to twenty-five percent of the body water is invariably fatal.<sup id="cite_ref-1" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-1" >[1]</a></sup>

Water goes out of the body in many ways, and they can be categorized into either “sensible” water loss or “insensible" water loss. “Sensible” water loss means it can be perceived by the senses. There are many forms of sensible water loss, such as feces secretion, sweating and vomiting. “Insensible" water loss cannot be perceived, for the water is lost without one being conscious of it. Insensible water loss is mainly through skin and respiratory tract.<sup id="cite_ref-2" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-2" >[2]</a></sup>

Some authors have reported three types of dehydration based on serum sodium levels: hypotonic or hyponatremic (referring to this as primarily a loss of<a href="http://en.wikipedia.org/wiki/Electrolyte" title="Electrolyte" >electrolytes</a>, <a href="http://en.wikipedia.org/wiki/Sodium" title="Sodium" >sodium</a> in particular), hypertonic or hypernatremic (referring to this as primarily a loss of water), and isotonic or isonatremic (referring to this as equal loss of water and electrolytes).<sup id="cite_ref-3" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-3" >[3]</a></sup> In reality however, it emerges that by "hyponatremic" and "eunatremic" dehydration these authors are actually referring to "hypovolemia" (see definition below). In humans, it is thought that the most commonly seen type of dehydration by far is isotonic (isonatraemic) dehydration, but this effectively refers to <a href="http://en.wikipedia.org/wiki/Hypovolemia" title="Hypovolemia" >hypovolemia</a>. "Dehydration", is thus a term that has loosely been used to mean loss of water, regardless of whether it is as water and solutes (mainly sodium) or free water. Those who refer to hypotonic dehydration therefore refer to solute loss and thus loss of intravascular volume but in the presence of exaggerated intravascular volume depletion for a given amount of total body water gain. It is true that neurological complications can occur in hypotonic and hypertonic states. The former can lead to <a href="http://en.wikipedia.org/wiki/Seizure" title="Seizure" class="mw-redirect" >seizures</a>, while the latter can lead to <a href="http://en.wikipedia.org/wiki/Osmotic_cerebral_edema" title="Osmotic cerebral edema" class="mw-redirect" >osmotic cerebral edema</a> upon rapid <a href="http://en.wikipedia.org/wiki/Rehydration" title="Rehydration" class="mw-redirect" >rehydration</a>.<sup id="cite_ref-4" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-4" >[4]</a></sup> It is thus important to distinguish "dehydration" from "hypovolemia" and maybe limit the term "dehydration" to states of "hypernatremia" and call all other usage "hypovolemia" as that would greatly facilitate management.

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<h2 >Contents</h2>

  [<a href="http://en.wikipedia.org/wiki/Dehydration#" class="internal" id="togglelink" >hide</a>] </div>

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<li class="toclevel-1 tocsection-1" ><a href="http://en.wikipedia.org/wiki/Dehydration#Definition" >1 Definition</a></li>

<li class="toclevel-1 tocsection-2" ><a href="http://en.wikipedia.org/wiki/Dehydration#Signs_and_symptoms" >2 Signs and symptoms</a></li>

<li class="toclevel-1 tocsection-3" ><a href="http://en.wikipedia.org/wiki/Dehydration#Differential_diagnosis" >3 Differential diagnosis</a></li>

<li class="toclevel-1 tocsection-4" ><a href="http://en.wikipedia.org/wiki/Dehydration#Prevention" >4 Prevention</a></li>

<li class="toclevel-1 tocsection-5" ><a href="http://en.wikipedia.org/wiki/Dehydration#Treatment" >5 Treatment</a></li>

<li class="toclevel-1 tocsection-7" ><a href="http://en.wikipedia.org/wiki/Dehydration#Notes" >7 Notes</a></li>

<li class="toclevel-1 tocsection-8" ><a href="http://en.wikipedia.org/wiki/Dehydration#References" >8 References</a></li>

<li class="toclevel-1 tocsection-9" ><a href="http://en.wikipedia.org/wiki/Dehydration#External_links" >9 External links</a></li>

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<h2 >Definition[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=1" title="Edit section: Definition" >edit</a>]</h2>

<p ><a href="http://en.wikipedia.org/wiki/Hypovolemia" title="Hypovolemia" >Hypovolemia</a> is specifically a decrease in volume of <a href="http://en.wikipedia.org/wiki/Blood_plasma" title="Blood plasma" >blood plasma</a>.<sup id="cite_ref-5" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-5" >[5]</a></sup><sup id="cite_ref-6" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-6" >[6]</a></sup> and dehydration is specifically a decrease in total body water, that for the most part spares blood plasma volume. Humans can lose water from the body — of any aetiology — but that loss can only occur in two distinct patterns with separate mechanisms:</p>

<li >Loss of blood volume</li>

<li >Loss of tissue water</li>

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<p >Not only do both have different manifestations, the mechanism of the water loss that leads to a) or b) is distinct. a) can only occur if sodium is lost and the water loss is secondary to this sodium loss and mainly blood plasma water. b) can only occur if <a href="http://en.wikipedia.org/wiki/Pure" title="Pure" >pure</a> water loss is independent of sodium loss and mainly derived from intracellular water. Both can co-exist i.e. sodium and water loss that is not balanced i.e. more water loss than expected for sodium loss. Dehydration then refers to pure (tissue) water loss and hypovolemia to sodium loss and thus loss of blood volume. This is the correct and pure definition<sup id="cite_ref-7" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-7" >[7]</a></sup> but unfortunately gets wildly mixed up. Very interestingly the opposite can also occur i.e. overhydration as well as hypervolemia. Finally they do not need to move in the same direction i.e. a person can be hypervolemic and dehydrated at the same time and any combination of these six states can coexist — if we count euvolemia and normal hydration.</p>

<h2 >Signs and symptoms[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=2" title="Edit section: Signs and symptoms" >edit</a>]</h2>

<p ><a href="http://en.wikipedia.org/wiki/Symptom" title="Symptom" >Symptoms</a> may include <a href="http://en.wikipedia.org/wiki/Headache" title="Headache" >headaches</a><sup id="cite_ref-8" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-8" >[8]</a></sup> similar to what is experienced during a <a href="http://en.wikipedia.org/wiki/Hangover" title="Hangover" >hangover</a>, decreased <a href="http://en.wikipedia.org/wiki/Blood_pressure" title="Blood pressure" >blood pressure</a> (<a href="http://en.wikipedia.org/wiki/Hypotension" title="Hypotension" >hypotension</a>), and <a href="http://en.wikipedia.org/wiki/Dizziness" title="Dizziness" >dizziness</a> or <a href="http://en.wikipedia.org/wiki/Fainting" title="Fainting" class="mw-redirect" >fainting</a> when standing up due to <a href="http://en.wikipedia.org/wiki/Orthostatic_hypotension" title="Orthostatic hypotension" >orthostatic hypotension</a>. Untreated dehydration generally results in <a href="http://en.wikipedia.org/wiki/Delirium" title="Delirium" >delirium</a>, <a href="http://en.wikipedia.org/wiki/Unconsciousness" title="Unconsciousness" >unconsciousness</a>, swelling of the tongue and, in extreme cases, <a href="http://en.wikipedia.org/wiki/Death" title="Death" >death</a>.

Dehydration symptoms generally become noticeable after 2% of one's normal water volume has been lost. Initially, one experiences <a href="http://en.wikipedia.org/wiki/Thirst" title="Thirst" >thirst</a> and discomfort, possibly along with loss of <a href="http://en.wikipedia.org/wiki/Appetite" title="Appetite" >appetite</a> and <a href="http://en.wikipedia.org/wiki/Dry_skin" title="Dry skin" class="mw-redirect" >dry skin</a>. This can be followed by <a href="http://en.wikipedia.org/wiki/Constipation" title="Constipation" >constipation</a>. <a href="http://en.wikipedia.org/wiki/Sportsperson" title="Sportsperson" >Athletes</a> may suffer a loss of performance of up to 30%<sup id="cite_ref-9" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-9" >[9]</a></sup> and experience <a href="http://en.wikipedia.org/wiki/Flushing(physiology)" title="Flushing (physiology)" >flushing</a>, low endurance, rapid <a href="http://en.wikipedia.org/wiki/Heart_rate" title="Heart rate" >heart rates</a>, elevated body temperatures, and rapid onset of<a href="http://en.wikipedia.org/wiki/Fatigue(medical)" title="Fatigue (medical)" >fatigue</a>.

<a href="http://en.wikipedia.org/wiki/Symptom" title="Symptom" >Symptoms</a> of mild dehydration include <a href="http://en.wikipedia.org/wiki/Thirst" title="Thirst" >thirst</a>, decreased <a href="http://en.wikipedia.org/wiki/Urine" title="Urine" >urine</a> volume, abnormally dark urine, unexplained tiredness, irritability, lack of tears when crying, <a href="http://en.wikipedia.org/wiki/Headache" title="Headache" >headache</a>, <a href="http://en.wikipedia.org/wiki/Dry_mouth" title="Dry mouth" class="mw-redirect" >dry mouth</a>, <a href="http://en.wikipedia.org/wiki/Dizziness" title="Dizziness" >dizziness</a> when standing due to <a href="http://en.wikipedia.org/wiki/Orthostatic_hypotension" title="Orthostatic hypotension" >orthostatic hypotension</a>, and in some cases insomnia. Other possible symptoms include cloudy urine and stinging during urination. Blood tests may show <a href="http://en.wikipedia.org/wiki/Hyperalbuminemia" title="Hyperalbuminemia" class="mw-redirect" >hyperalbuminemia</a>. Mild dehydration also has been shown to negatively impact people’s moods. Experiments by the <a href="http://en.wikipedia.org/wiki/USDA" title="USDA" class="mw-redirect" >USDA</a>'s <a rel="nofollow" class="external text" href="http://www.ars.usda.gov/main/main.htm" >Agricultural Research Service</a> have shown that dehydration is associated with <a href="http://en.wikipedia.org/wiki/Confusion" title="Confusion" class="mw-redirect" >confusion</a>, <a href="http://en.wikipedia.org/wiki/Fatigue_(medical)" title="Fatigue (medical)" >fatigue</a>, and negative moods.<sup id="cite_ref-10" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-10" >[10]</a></sup>Mild dehydration, which includes water losses between 1% and 2%, observed in the experiment are comparable to mild dehydration experienced by people in their everyday lives.

In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include <a href="http://en.wikipedia.org/wiki/Lethargy" title="Lethargy" >lethargy</a> or extreme sleepiness, <a href="http://en.wikipedia.org/wiki/Seizure" title="Seizure" class="mw-redirect" >seizures</a>, sunken <a href="http://en.wikipedia.org/wiki/Fontanel" title="Fontanel" class="mw-redirect" >fontanel</a> (soft spot) in infants, <a href="http://en.wikipedia.org/wiki/Fainting" title="Fainting" class="mw-redirect" >fainting</a>, and sunken eyes.

The symptoms become increasingly severe with greater water loss. One's heart and <a href="http://en.wikipedia.org/wiki/Respiration_(physiology)" title="Respiration (physiology)" >respiration</a> rates begin to increase to compensate for decreased <a href="http://en.wikipedia.org/wiki/Blood_plasma" title="Blood plasma" >plasma</a> volume and <a href="http://en.wikipedia.org/wiki/Blood_pressure" title="Blood pressure" >blood pressure</a>, while body temperature may rise because of decreased sweating. At around 5% to 6% water loss, one may become groggy or sleepy, experience headaches or <a href="http://en.wikipedia.org/wiki/Nausea" title="Nausea" >nausea</a>, and may feel tingling in one's limbs (<a href="http://en.wikipedia.org/wiki/Paresthesia" title="Paresthesia" >paresthesia</a>). With 10% to 15% fluid loss, muscles may become spastic, skin may shrivel and wrinkle (decreased skin turgor), vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal.<sup class="noprint Inline-Template" >[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Please_clarify" title="Wikipedia:Please clarify" >how?</a></i>]</sup>

In people over age 50, the body’s <a href="http://en.wikipedia.org/wiki/Thirst" title="Thirst" >thirst</a> sensation diminishes and continues diminishing with age. Many senior citizens suffer symptoms of dehydration. Dehydration along with <a href="http://en.wikipedia.org/wiki/Hyperthermia" title="Hyperthermia" >hyperthermia</a> results in the elderly dying suddenly during extreme hot weather.

Diseases of the gastrointestinal tract can lead to dehydration in various ways. Often, dehydration becomes the major problem in an otherwise self-limited illness. Fluid loss may even be severe enough to become life-threatening.

In studies of terminally ill patients who have chosen to die, it has been shown that deaths by <a href="http://en.wikipedia.org/wiki/Terminal_dehydration" title="Terminal dehydration" >terminal dehydration</a> are generally peaceful, and are not associated with suffering when supplemented with adequate pain medication.<sup id="cite_ref-11" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-11" >[11]</a></sup><sup id="cite_ref-12" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-12" >[12]</a></sup></p>

<h2 >Differential diagnosis[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=3" title="Edit section: Differential diagnosis" >edit</a>]</h2>

<p >In humans, dehydration can be caused by a wide range of diseases and states that impair water <a href="http://en.wikipedia.org/wiki/Homeostasis" title="Homeostasis" >homeostasis</a> in the body. These include:</p>

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<li >External or <a href="http://en.wikipedia.org/wiki/Stress_(medicine)" title="Stress (medicine)" class="mw-redirect" >stress</a>-related causes

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<li >Prolonged physical activity with <a href="http://en.wikipedia.org/wiki/Sweating" title="Sweating" class="mw-redirect" >sweating</a> without consuming adequate water, especially in a hot and/or dry environment</li>

<li >Prolonged exposure to dry air, e.g., in high-flying airplanes (5%–12% relative humidity)</li>

<li ><a href="http://en.wikipedia.org/wiki/Blood_loss" title="Blood loss" class="mw-redirect" >Blood loss</a> or <a href="http://en.wikipedia.org/wiki/Hypotension" title="Hypotension" >hypotension</a> due to <a href="http://en.wikipedia.org/wiki/Physical_trauma" title="Physical trauma" class="mw-redirect" >physical trauma</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Diarrhea" title="Diarrhea" >Diarrhea</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Hyperthermia" title="Hyperthermia" >Hyperthermia</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Shock_(circulatory)" title="Shock (circulatory)" >Shock</a> (hypovolemic)</li>

<li ><a href="http://en.wikipedia.org/wiki/Vomiting" title="Vomiting" >Vomiting</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Burn_(injury)" title="Burn (injury)" class="mw-redirect" >Burns</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Lacrimation" title="Lacrimation" class="mw-redirect" >Lacrimation</a></li>

<li >Use of <a href="http://en.wikipedia.org/wiki/Methamphetamine" title="Methamphetamine" >methamphetamine</a>, <a href="http://en.wikipedia.org/wiki/Amphetamine" title="Amphetamine" >amphetamine</a> and other stimulants</li>

<li >Excessive consumption of <a href="http://en.wikipedia.org/wiki/Alcoholic_beverages" title="Alcoholic beverages" class="mw-redirect" >alcoholic beverages</a></li>

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<li ><a href="http://en.wikipedia.org/wiki/Infectious_diseases" title="Infectious diseases" class="mw-redirect" >Infectious diseases</a>

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<li ><a href="http://en.wikipedia.org/wiki/Cholera" title="Cholera" >Cholera</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Gastroenteritis" title="Gastroenteritis" >Gastroenteritis</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Shigellosis" title="Shigellosis" >Shigellosis</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Yellow_fever" title="Yellow fever" >Yellow fever</a></li>

</ul>

</li>

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<li ><a href="http://en.wikipedia.org/wiki/Malnutrition" title="Malnutrition" >Malnutrition</a>

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<li ><a href="http://en.wikipedia.org/wiki/Electrolyte_disturbance" title="Electrolyte disturbance" class="mw-redirect" >Electrolyte disturbance</a>

<ul >

<li ><a href="http://en.wikipedia.org/wiki/Hypernatremia" title="Hypernatremia" >Hypernatremia</a> (also caused by dehydration)</li>

<li ><a href="http://en.wikipedia.org/wiki/Hyponatremia" title="Hyponatremia" >Hyponatremia</a>, especially from restricted <a href="http://en.wikipedia.org/wiki/Sodium_chloride" title="Sodium chloride" >salt</a> <a href="http://en.wikipedia.org/wiki/Dieting" title="Dieting" >diets</a></li>

</ul>

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<li ><a href="http://en.wikipedia.org/wiki/Fasting" title="Fasting" >Fasting</a></li>

<li >Recent rapid <a href="http://en.wikipedia.org/wiki/Weight_loss" title="Weight loss" >weight loss</a> may reflect progressive depletion of fluid volume (the loss of 1 L of fluid results in a weight loss of 1 kg (2.2 lb)).<sup id="cite_ref-13" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-13" >[13]</a></sup></li>

<li ><a href="http://en.wikipedia.org/wiki/Patient_refusal_of_nutrition_and_hydration" title="Patient refusal of nutrition and hydration" class="mw-redirect" >Patient refusal of nutrition and hydration</a></li>

<li >Inability to swallow (obstruction of the esophagus)</li>

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<p >Other causes of obligate water loss</p>

<ul >

<li >Severe <a href="http://en.wikipedia.org/wiki/Hyperglycemia" title="Hyperglycemia" >hyperglycemia</a>, especially in <a href="http://en.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus" >diabetes mellitus</a>

<ul >

<li ><a href="http://en.wikipedia.org/wiki/Glycosuria" title="Glycosuria" >Glycosuria</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Uremia" title="Uremia" >Uremia</a></li>

</ul>

</li>

<li ><a href="http://en.wikipedia.org/wiki/Diabetes_insipidus" title="Diabetes insipidus" >Diabetes insipidus</a></li>

<li >Acute emergency dehydration event</li>

<li ><a href="http://en.wikipedia.org/wiki/Foodborne_illness" title="Foodborne illness" >Foodborne illness</a></li>

</ul>

<h2 >Prevention[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=4" title="Edit section: Prevention" >edit</a>]</h2>

<p >Dehydration is avoided by <a href="http://en.wikipedia.org/wiki/Drinking" title="Drinking" >drinking</a> sufficient <a href="http://en.wikipedia.org/wiki/Water" title="Water" >water</a>. The greater the amount of water lost through perspiration, the more water must be consumed to replace it and avoid dehydration. Since the body cannot tolerate large deficits or excesses in total body water, consumption of water must be roughly concurrent with the loss (in other words, if one is perspiring, one should also be drinking some water frequently).

For routine activities in which a person is not perspiring to any large degree, drinking when one is thirsty is sufficient to maintain hydration. However, during exercise, relying on thirst alone may be insufficient to prevent dehydration from occurring. This is particularly true in hot environments or for those older than 65. For an exercise session, an accurate determination of how much fluid is necessary to consume during the workout can be made by performing appropriate weight measurements before and after a typical exercise session, to determine how much fluid is lost during the workout.<sup id="cite_ref-14" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-14" >[14]</a></sup><sup id="cite_ref-15" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-15" >[15]</a></sup><sup id="cite_ref-Exercise_and_Fluid_Replacement_16-0" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-Exercise_and_Fluid_Replacement-16" >[16]</a></sup><sup id="cite_ref-17" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-17" >[17]</a></sup><sup id="cite_ref-18" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-18" >[18]</a></sup>

Drinking water beyond the needs of the body entails little risk when done in moderation, since the kidneys will efficiently remove any excess water through the urine with a large margin of safety.

A person's body, during an average day in a temperate climate such as the <a href="http://en.wikipedia.org/wiki/United_Kingdom" title="United Kingdom" >United Kingdom</a>, loses approximately 2.5 <a href="http://en.wikipedia.org/wiki/Litre" title="Litre" >litres</a> of water.<sup class="noprint Inline-Template Template-Fact" >[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed" >citation needed</a></i>]</sup> This can be through the lungs as <a href="http://en.wikipedia.org/wiki/Water_vapor" title="Water vapor" >water vapor</a> (about 350ml), through the skin by <a href="http://en.wikipedia.org/wiki/Perspiration" title="Perspiration" >perspiration</a> (100ml) and by diffusion through the skin (350ml), or through the <a href="http://en.wikipedia.org/wiki/Kidney" title="Kidney" >kidneys</a> as <a href="http://en.wikipedia.org/wiki/Urine" title="Urine" >urine</a> (1000–2000ml, about 900ml of which is obligatory water excretion that gets rid of solutes). Some water (about 150–200ml, in the absence of <a href="http://en.wikipedia.org/wiki/Diarrhea" title="Diarrhea" >diarrhea</a>) is also lost through the <a href="http://en.wikipedia.org/wiki/Bowel" title="Bowel" class="mw-redirect" >bowels</a>.<sup id="cite_ref-19" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-19" >[19]</a></sup> In warm or humid weather or during heavy exertion, however, the water loss can increase by a factor of 10 or more<sup class="noprint Inline-Template Template-Fact" >[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed" >citation needed</a></i>]</sup> through perspiration; all of which must be promptly replaced. In extreme cases, the losses may be great enough to exceed the body's ability to absorb water from the gastrointestinal tract; in these cases, it is not possible to drink enough water to stay hydrated, and the only way to avoid dehydration is to either pre-hydrate<sup id="cite_ref-Exercise_and_Fluid_Replacement_16-1" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-Exercise_and_Fluid_Replacement-16" >[16]</a></sup> or find ways to reduce perspiration (through rest, a move to a cooler environment, etc.)

A useful rule of thumb for avoiding dehydration in hot or humid environments or during strenuous activity involves monitoring the frequency and character of urination. If one develops a full bladder at least every 3–5 hours and the urine is only lightly colored or colorless, chances are that dehydration is not occurring; if urine is deeply colored or urination occurs only after many hours or not at all, water intake may not be adequate to maintain proper hydration.<sup class="noprint Inline-Template Template-Fact" >[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed" >citation needed</a></i>]</sup>

When large amounts of water are being lost through perspiration and concurrently replaced by drinking, maintaining proper electrolyte balance becomes an issue. Drinking fluids that are <a href="http://en.wikipedia.org/wiki/Hypertonicity" title="Hypertonicity" class="mw-redirect" >hypertonic</a> or<a href="http://en.wikipedia.org/wiki/Hypotonicity" title="Hypotonicity" class="mw-redirect" >hypotonic</a> with respect to perspiration may have grave consequences (<a href="http://en.wikipedia.org/wiki/Hyponatremia" title="Hyponatremia" >hyponatremia</a> or <a href="http://en.wikipedia.org/wiki/Hypernatremia" title="Hypernatremia" >hypernatremia</a>, principally) as the total volume of water turnover increases.

If water is being lost through mechanisms such as <a href="http://en.wikipedia.org/wiki/Vomiting" title="Vomiting" >vomiting</a> or <a href="http://en.wikipedia.org/wiki/Diarrhea" title="Diarrhea" >diarrhea</a>, an imbalance can develop very quickly into a medical emergency.

During sports events such as <a href="http://en.wikipedia.org/wiki/Marathon" title="Marathon" >marathons</a>, athletes take frequent <a href="http://en.wikipedia.org/wiki/Water_stop_(sports)" title="Water stop (sports)" >water stops</a> and <a href="http://en.wikipedia.org/wiki/Water_break" title="Water break" class="mw-redirect" >water breaks</a> to avoid dehydration. The claim that pure water without isotonic additives can prevent dehydration is questioned, however, and the <a href="http://en.wikipedia.org/wiki/European_Food_Safety_Authority" title="European Food Safety Authority" >European Food Safety Authority</a> states that reduced body water content is only a symptom of dehydration and not what drinking water controls.<sup id="cite_ref-20" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-20" >[20]</a></sup> Drinking water without replenishing electrolytes may instead lead to developing hypotonic dehydration.</p>

<h2 >Treatment[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=5" title="Edit section: Treatment" >edit</a>]</h2>

<div class="hatnote relarticle mainarticle" >Main article: <a href="http://en.wikipedia.org/wiki/Management_of_dehydration" title="Management of dehydration" >Management of dehydration</a></div>

<p >The treatment for minor dehydration, often considered the most effective, is drinking water and stopping fluid loss. Plain water restores only the volume of the blood plasma, inhibiting the thirst mechanism before solute levels can be replenished.<sup id="cite_ref-21" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-21" >[21]</a></sup> Solid foods can contribute to fluid loss from vomiting and diarrhea.<sup id="cite_ref-22" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-22" >[22]</a></sup>

In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and <a href="http://en.wikipedia.org/wiki/Electrolyte" title="Electrolyte" >electrolytes</a> (through <a href="http://en.wikipedia.org/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy" >oral rehydration therapy</a> or <a href="http://en.wikipedia.org/wiki/Fluid_replacement" title="Fluid replacement" >fluid replacement</a> by <a href="http://en.wikipedia.org/wiki/Intravenous_therapy" title="Intravenous therapy" >intravenous therapy</a>). As oral rehydration is less painful, less invasive, less expensive, and easier to provide, it is the treatment of choice for mild dehydration. Solutions used for intravenous rehydration must be <a href="http://en.wikipedia.org/wiki/Isotonicity" title="Isotonicity" class="mw-redirect" >isotonic</a>or <a href="http://en.wikipedia.org/wiki/Hypotonicity" title="Hypotonicity" class="mw-redirect" >hypotonic</a>. Pure water injected into the veins will cause the breakdown (<a href="http://en.wikipedia.org/wiki/Lysis" title="Lysis" >lysis</a>) of red blood cells (<a href="http://en.wikipedia.org/wiki/Erythrocytes" title="Erythrocytes" class="mw-redirect" >erythrocytes</a>).

When <a href="http://en.wikipedia.org/wiki/Fresh_water" title="Fresh water" >fresh water</a> is unavailable (e.g., at sea or in a desert), <a href="http://en.wikipedia.org/wiki/Seawater" title="Seawater" >seawater</a> and <a href="http://en.wikipedia.org/wiki/Alcohol" title="Alcohol" >alcohol</a> will worsen the condition. <a href="http://en.wikipedia.org/wiki/Urine" title="Urine" >Urine</a> contains a similar solute concentration to seawater, and numerous guides advise against its consumption in survival situations.<sup id="cite_ref-23" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-23" >[23]</a></sup><sup id="cite_ref-24" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-24" >[24]</a></sup><sup id="cite_ref-25" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-25" >[25]</a></sup><sup id="cite_ref-26" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-26" >[26]</a></sup>

For severe cases of dehydration where <a href="http://en.wikipedia.org/wiki/Fainting" title="Fainting" class="mw-redirect" >fainting</a>, <a href="http://en.wikipedia.org/wiki/Unconsciousness" title="Unconsciousness" >unconsciousness</a>, or other severely inhibiting symptom is present (the patient is incapable of standing or thinking clearly), emergency attention is required. Fluids containing a proper balance of replacement electrolytes are given orally or intravenously with continuing assessment of electrolyte status; complete resolution is the norm in all but the most extreme cases.

Some research indicates that artificial hydration to alleviate symptoms of <a href="http://en.wikipedia.org/wiki/Xerostomia" title="Xerostomia" >dry mouth</a> and thirst in the dying patient may be futile.<sup id="cite_ref-27" class="reference" ><a href="http://en.wikipedia.org/wiki/Dehydration#cite_note-27" >[27]</a></sup></p>

<ul >

<li ><a href="http://en.wikipedia.org/wiki/Hydrational_fluid" title="Hydrational fluid" class="mw-redirect" >Hydrational fluids</a></li>

<li ><a href="http://en.wikipedia.org/wiki/Terminal_dehydration" title="Terminal dehydration" >Terminal dehydration</a></li>

</ul>

<h2 >Notes[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=7" title="Edit section: Notes" >edit</a>]</h2>

<li id="cite_note-1" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-1" >Jump up^{</a></b>&nbsp};Ashcroft F, Life Without Water in Life at the Extremes. Berkeley and Los Angeles, 2000, 134-138.</li>

<li id="cite_note-2" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-2" >Jump up^{</a></b>&nbsp};Alok K. Maintenance Fluid Therapy in Children [Online]. University of Texas Medical Branch.<a rel="nofollow" class="external free" href="http://www.utmb.edu/pedi_ed/CORE/Fluids%26Electyrolytes/page_02.htm" >http://www.utmb.edu/pedi_ed/CORE/Fluids&Electyrolytes/page_02.htm</a>[16 March,2014]</li>

<li id="cite_note-3" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-3" >Jump up^{</a></b> Fleisher}, Gary Robert; Ludwig, Stephen (2010). <a rel="nofollow" class="external text" href="http://books.google.com/books?id=a7CqcE1ZrFkC&pg=PA811" ><i>Textbook of Pediatric Emergency Medicine</i></a>. Lippincott Williams & Wilkins. p. 811. <a href="http://en.wikipedia.org/wiki/International_Standard_Book_Number" title="International Standard Book Number" >ISBN</a> <a href="http://en.wikipedia.org/wiki/Special:BookSources/978-1-60547-159-4" title="Special:BookSources/978-1-60547-159-4" >978-1-60547-159-4</a>.</li>

<li id="cite_note-4" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-4" >Jump up^{</a></b> <i>}<a rel="nofollow" class="external text" href="http://emedicine.medscape.com/article/906999-overview" >Dehydration</a></i> at <a href="http://en.wikipedia.org/wiki/EMedicine" title="EMedicine" >eMedicine</a></li>

<li id="cite_note-5" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-5" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.medterms.com/script/main/art.asp?articlekey=3871" >MedicineNet > Definition of Hypovolemia</a> Retrieved on July 2, 2009</li>

<li id="cite_note-6" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-6" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://medical-dictionary.thefreedictionary.com/hypovolemia" >TheFreeDictionary.com --> hypovolemia</a> Citing Saunders Comprehensive Veterinary Dictionary, 3 ed. Retrieved on July 2, 2009</li>

<li id="cite_note-7" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-7" >Jump up^{</a></b>&nbsp};Mange K, Matsuura D, Cizman B, et al. (November 1997).<a rel="nofollow" class="external text" href="http://www.annals.org/article.aspx?volume=127&page=848" >"Language guiding therapy: the case of dehydration versus volume depletion"</a>. <i>Ann. Intern. Med.</i> <b>127</b> (9): 848–53. <a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.7326%2F0003-4819-127-9-199711010-00020" >10.7326/0003-4819-127-9-199711010-00020</a>. <a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/9382413" >9382413</a>.</li>

<li id="cite_note-8" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-8" >Jump up^{</a></b>&nbsp};Shirreffs SM, Merson SJ, Fraser SM, Archer DT (June 2004). <a rel="nofollow" class="external text" href="http://journals.cambridge.org/abstract_S0007114504001163" >"The effects of fluid restriction on hydration status and subjective feelings in man"</a>. <i>Br. J. Nutr.</i> <b>91</b> (6): 951–8. <a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1079%2FBJN20041149" >10.1079/BJN20041149</a>.<a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/15182398" >15182398</a>.</li>

<li id="cite_note-9" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-9" >Jump up^{</a></b> Bean}, Anita (2006). <i>The Complete Guide to Sports Nutrition</i>. A & C Black Publishers Ltd. pp. 81–83. <a href="http://en.wikipedia.org/wiki/International_Standard_Book_Number" title="International Standard Book Number" >ISBN</a> <a href="http://en.wikipedia.org/wiki/Special:BookSources/0-7136-7558-6" title="Special:BookSources/0-7136-7558-6" >0-7136-7558-6</a>.</li>

<li id="cite_note-10" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-10" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.ars.usda.gov/is/pr/2009/091123.htm#_top" >"Dehydration Affects Mood, Not Just Motor Skills / November 23, 2009 / News from the USDA Agricultural Research Service"</a>. Ars.usda.gov. Retrieved 2012-11-09.</li>

<li id="cite_note-11" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-11" >Jump up^{</a></b>&nbsp};Printz LA (April 1992). <a rel="nofollow" class="external text" href="http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=1373053" >"Terminal dehydration, a compassionate treatment"</a>. <i>Archives of Internal Medicine</i> <b>152</b> (4): 697–700.<a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1001%2Farchinte.152.4.697" >10.1001/archinte.152.4.697</a>. <a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/1373053" >1373053</a>.</li>

<li id="cite_note-12" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-12" >Jump up^{</a></b>&nbsp};Sullivan RJ (April 1993). "Accepting death without artificial nutrition or hydration". <i>Journal of General Internal Medicine</i> <b>8</b> (4): 220–224.<a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1007%2FBF02599271" >10.1007/BF02599271</a>. <a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/8515334" >8515334</a>.</li>

<li id="cite_note-13" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-13" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.heartspring.net/symptoms_of_dehydration.html" >Dehydration Symptoms — Benefits of Drinking Water — Signs of Fluid Imbalance</a></li>

<li id="cite_note-14" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-14" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.webmd.com/balance/features/water-water-everywhere" >"Water, Water, Everywhere"</a>. WebMD.</li>

<li id="cite_note-15" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-15" >Jump up^{</a></b> Dr}. Mark Dedomenico. <a rel="nofollow" class="external text" href="http://health.msn.com/blogs/healthy-diet-fit-body-post.aspx?post=1188190" >"Metabolism Myth #5"</a>. MSN Health.<sup class="noprint Inline-Template" >[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Link_rot" title="Wikipedia:Link rot" >dead link</a></i>]</sup></li>

<li id="cite_note-Exercise_and_Fluid_Replacement-16" >^ <a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-Exercise_and_Fluid_Replacement_16-0" >Jump up to:<sup ><i><b>a</b></i></sup></a> <a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-Exercise_and_Fluid_Replacement_16-1" ><sup ><i><b>b</b></i></sup></a> Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS (February 2007). <a rel="nofollow" class="external text" href="http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0195-9131&volume=39&issue=2&spage=377" >"American College of Sports Medicine position stand. Exercise and fluid replacement"</a>. <i>Med Sci Sports Exerc</i> <b>39</b> (2): 377–90.<a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1249%2Fmss.0b013e31802ca597" >10.1249/mss.0b013e31802ca597</a>. <a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/17277604" >17277604</a>.</li>

<li id="cite_note-17" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-17" >Jump up^{</a></b>&nbsp};Nancy Cordes (April 2, 2008). <a rel="nofollow" class="external text" href="http://www.cbsnews.com/stories/2008/04/02/eveningnews/main3991145.shtml" >"Busting The 8-Glasses-A-Day Myth"</a>. CBS.</li>

<li id="cite_note-18" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-18" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://dms.dartmouth.edu/news/2002_h2/08aug2002_water.shtml" >""Drink at Least 8 Glasses of Water a Day" — Really?"</a>. Dartmouth Medical School.</li>

<li id="cite_note-19" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-19" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.sparknotes.com/health/minerals/major/section1.html" ><i>Major Minerals</i></a>. SparkNotes.</li>

<li id="cite_note-20" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-20" >Jump up^{</a></b>&nbsp};Victoria Ward and Nick Collins (November 18, 2011). <a rel="nofollow" class="external text" href="http://www.telegraph.co.uk/news/worldnews/europe/eu/8897662/EU-bans-claim-that-water-can-prevent-dehydration.html" >"EU bans claim that water can prevent dehydration"</a>. The Telegraph.</li>

<li id="cite_note-21" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-21" >Jump up^{</a></b> ".}" Murray, R. & , J. (2001)Maughan, Ron J.; Murray, Robert, eds. (2001). <a rel="nofollow" class="external text" href="http://books.google.com/books?id=bS12dnUsGJcC&pg=PA197" >"Ch. 8: Formulating carbohydrate-electrolyte drinks for optimal efficacy"</a>. <i>Sports Drinks: Basic Science and Practical Aspects</i>. CRC Press. pp. 197–224. <a href="http://en.wikipedia.org/wiki/International_Standard_Book_Number" title="International Standard Book Number" >ISBN</a> <a href="http://en.wikipedia.org/wiki/Special:BookSources/978-0-8493-7008-3" title="Special:BookSources/978-0-8493-7008-3" >978-0-8493-7008-3</a>.</li>

<li id="cite_note-22" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-22" >Jump up^{</a></b> }"Healthwise Handbook," Healthwise, Inc. 1999</li>

<li id="cite_note-23" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-23" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.simplesurvival.net/water.htm" >water</a></li>

<li id="cite_note-24" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-24" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://trackertrail.com/publications/motherearthnews/72/index.html" >Tracker Trail - Mother Earth News - Issue #72</a></li>

<li id="cite_note-25" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-25" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.equipped.com/primer.htm" >EQUIPPED TO SURVIVE (tm) - A Survival Primer</a></li>

<li id="cite_note-26" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-26" >Jump up^{</a></b> }<a rel="nofollow" class="external text" href="http://www.adventuresportsonline.com/5basic.htm" >Five Basic Survival Skills in the Wilderness</a></li>

<li id="cite_note-27" ><b><a href="http://en.wikipedia.org/wiki/Dehydration#cite_ref-27" >Jump up^{</a></b>&nbsp};Ellershaw JE, Sutcliffe JM, Saunders CM (April 1995). <a rel="nofollow" class="external text" href="http://linkinghub.elsevier.com/retrieve/pii/0885-3924(94)00123-3" >"Dehydration and the dying patient"</a>. <i>J Pain Symptom Manage</i> <b>10</b> (3): 192–7.<a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1016%2F0885-3924%2894%2900123-3" >10.1016/0885-3924(94)00123-3</a>. <a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/7629413" >7629413</a>.</li>

</ol>

</div>

<h2 >References[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=8" title="Edit section: References" >edit</a>]</h2>

<ul >

<li ><a href="http://en.wikipedia.org/wiki/Ira_Byock" title="Ira Byock" >Ira R. Byock</a>, M.D., "<a rel="nofollow" class="external text" href="http://www.dyingwell.com/prnh.htm" >Patient Refusal of Nutrition and Hydration: Walking the Ever-Finer Line</a>." <i>American Journal Hospice & Palliative Care</i>, pp. 8–13. (March/April 1995)</li>

</ul>

<h2 >External links[<a href="http://en.wikipedia.org/w/index.php?title=Dehydration&action=edit&section=9" title="Edit section: External links" >edit</a>]</h2>

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<td class="mbox-text plainlist" >Look up <i><b><a href="http://en.wiktionary.org/wiki/Special:Search/dehydration" class="extiw" title="wiktionary:Special:Search/dehydration" >dehydration</a></b></i> in Wiktionary, the free dictionary.</td>

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<li ><a rel="nofollow" class="external text" href="http://www.nlm.nih.gov/medlineplus/ency/article/000982.htm#visualContent" >Definition of dehydration by the U.S. National Institutes of Health's MedlinePlus medical encyclopedia</a></li>

<li ><a rel="nofollow" class="external text" href="http://rehydrate.org/index.html" >Rehydration Project at rehydrate.org</a></li>

<li ><a rel="nofollow" class="external text" href="http://dehydration.net/" >About dehydration</a></li>

<li ><a rel="nofollow" class="external text" href="http://www.doctorsend.info/2011/03/dehydration-causes-symptoms-and.html" >Dehydration Causes, Symptoms and Treatment</a></li>

<li >Steiner, MJ; DeWalt, DA; Byerley, JS (Jun 9, 2004). "Is this child dehydrated?". <i>JAMA: the Journal of the American Medical Association</i> <b>291</b> (22): 2746–54. <a href="http://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" >doi</a>:<a rel="nofollow" class="external text" href="http://dx.doi.org/10.1001%2Fjama.291.22.2746" >10.1001/jama.291.22.2746</a>.<a href="http://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" >PMID</a> <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/pubmed/15187057" >15187057</a>.</li>

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<div ><a href="http://en.wikipedia.org/wiki/Water-electrolyte_imbalance" title="Water-electrolyte imbalance" >Water-electrolyte imbalance</a> and <a href="http://en.wikipedia.org/wiki/Acid-base_imbalance" title="Acid-base imbalance" class="mw-redirect" >acid-base imbalance</a> (<a href="http://en.wikipedia.org/wiki/ICD-10_Chapter_IV:Endocrine,nutritional_and_metabolic_diseases#.28E79.E2.80.93E90.29_Other_metabolic_disorders" title="ICD-10 Chapter IV: Endocrine, nutritional and metabolic diseases" >E86–E87</a>, <a href="http://en.wikipedia.org/wiki/List_of_ICD-9_codes_240%E2%80%93279:endocrine,nutritional_and_metabolic_diseases,and_immunity_disorders#Other_metabolic_and_immunity_disorders.28270.E2.80.93279.29" title="List of ICD-9 codes 240–279: endocrine, nutritional and metabolic diseases, and immunity disorders" >276</a>)</div>

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<div >Diving medicine, physiology, physics and environment</div>

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<div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="http://en.wikipedia.org/wiki/Help:Category" title="Help:Category" >Categories</a>: 

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<li ><a href="http://en.wikipedia.org/wiki/Category:Dehydration" title="Category:Dehydration" >Dehydration</a></li>

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Dehydration

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