9 Interesting Facts of Hypervolemia
1. Hypervolemia is synonymous with ECF volume overload.
2. ECF volume overload is due to an excess of total body sodium.
3. To correct ECF volume overload, sodium output must exceed sodium intake. Sodium output is typically augmented by diuretics. Excessive dietary sodium intake can negate the effects of a diuretic regimen.
4. To correct ECF volume overload, an effective dose of diuretic must be determined, and, in some circumstances, more than one diuretic may need to be administered.
5. ECF volume contraction implies a deficit of sodium and water. Dehydration implies a deficit of water. A deficit of water is less likely to produce manifestations of ECF volume contraction than is a deficit of sodium and water.
6. To assess volume status, the clinician gathers evidence from the history, physical examination, and laboratory investigations. Each type of evidence has its limitations, and, in many cases, the evidence is conflicting.
7. A low urine sodium concentration does not necessarily imply the presence of volume contraction. A high urine sodium concentration does not necessarily imply the absence of volume contraction.
8. Immediate and rapid volume repletion is indicated in hypovolemic shock in order to prevent shock from becoming irreversible.
9. Crystalloids are preferred over colloid-containing solutions in the treatment of hypovolemia not due to hemorrhage.