Fluid excess can occur in two main ways in the body, water intoxication and edema. [1] Show
[2] Prevalence[edit | edit source]Water intoxication is seen in a variety of situations, but most commonly occurs in:
In a study by Almond et al. of the 2002 Boston Marathon it was found that: [4]
In a study by Speedy et al. of athletes who finished an ultramarathon, it was found that: [4]
Characteristics/Clinical Presentation[edit | edit source]Water Intoxication Clinical S&S: [1] Water intoxication presents with symptoms that are largely neurologic due to the shifting of water into brain tissues and resultant dilution of sodium in the vascular space.
In severe imbalances:
Edema Clinical Signs and Symptoms: [1]
Associated Co-morbidities [1][edit | edit source]Medications[edit | edit source]
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]Below are some of the most common laboratory tests that are used to assess a person’s hydration status:
- Osmolality decreases with overhydration [10]
- Hyponatremia (low amounts of sodium in the blood) results from overhydration [10]
- Hematocrit decreases with overhydration [10]
- BUN decreases with overhydration [10] Etiology/Causes[edit | edit source]Due to the etiologic complex, symptoms, and outcomes that are related to the two major forms of fluid excess being substantially different, they will be broken down individually. [1]
Systemic Involvement[edit | edit source]
Medical Management[edit | edit source]
Physical Therapy Management[edit | edit source]Physical therapy management is largely responsible for patient education and edema control in these individuals. Below are some common physical therapy treatment strategies: Education on fluid consumption: [17]
Managing edema: [17] [18]
Note: Some of the strategies to reduce edema may be contraindicated in CHF Differential Diagnosis[edit | edit source]The following are some of the most common diagnoses that present with similar signs and symptoms of excess fluid/intoxication:
Case Reports/ Case Studies[edit | edit source]Forensic aspects of water intoxication: Four case reports and review of relevant literature Resources[edit | edit source]Hyperhydration? Hyponatremia Caused by Polydipsia Fried or Soaked? Strange but True: Drinking Too Much Water Can Kill References[edit | edit source] |