Clinical features

• Dehydration is a common presentation in the elderly and can present with nonspecific symptoms
• Examination findings have poor sensitivity and specificity
• They include dry mucous membranes, loss of skin turgor, sunken eyes, and in severe dehydration tachycardia, hypotension and delirium

Signs

• ↓ JVP
• Tachycardia
• Weak pulse
• ↓ Blood pressure and ↓pulse pressure
• ↓ Urine output

Management

In the 2013 guidelines NICE recommend the following requirements for maintenance fluids:

• 25-30 ml/kg/day of water and
• Approximately 1 mmol/kg/day of potassium, sodium and chloride and
• Approximately 50-100 g/day of glucose to limit starvation ketosis