The pathophysiology of fluid and electrolyte balance in the older adult surgical patient

Background & aims: Age-related physiological changes predispose even the healthy older adult to fluid and electrolyte abnormalities which can cause morbidity and mortality. The aim of this narrative review is to highlight key aspects of age-related pathophysiological changes that affect flui...

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Main Authors: El-Sharkawy, Ahmed M., Sahota, Opinder, Maughan, Ron J., Lobo, Dileep N.
Format: Article
Published: Elsevier 2013
Subjects:
Online Access:https://eprints.nottingham.ac.uk/2777/
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author El-Sharkawy, Ahmed M.
Sahota, Opinder
Maughan, Ron J.
Lobo, Dileep N.
author_facet El-Sharkawy, Ahmed M.
Sahota, Opinder
Maughan, Ron J.
Lobo, Dileep N.
author_sort El-Sharkawy, Ahmed M.
building Nottingham Research Data Repository
collection Online Access
description Background & aims: Age-related physiological changes predispose even the healthy older adult to fluid and electrolyte abnormalities which can cause morbidity and mortality. The aim of this narrative review is to highlight key aspects of age-related pathophysiological changes that affect fluid and electrolyte balance in older adults and underpin their importance in the perioperative period. Methods: The Web of Science, MEDLINE, PubMed and Google Scholar databases were searched using key terms for relevant studies published in English on fluid balance in older adults during the 15 years preceding June 2013. Randomised controlled trials and large cohort studies were sought; other studieswere used when these were not available. The bibliographies of extracted papers were also searched for relevant articles. Results: Older adults are susceptible to dehydration and electrolyte abnormalities, with causes ranging from physical disability restricting access to fluid intake to iatrogenic causes including polypharmacy and unmonitored diuretic usage. Renal senescence, as well as physical and mental decline, increase this susceptibility. Older adults are also predisposed to water retention and related electrolyte abnormalities, exacerbated at times of physiological stress. Positive fluid balance has been shown to be an independent risk factor for morbidity and mortality in critically ill patients with acute kidney injury. Conclusions: Age-related pathophysiological changes in the handling of fluid and electrolytes make older adults undergoing surgery a high-risk group and an understanding of these changes will enable better management of fluid and electrolyte therapy in the older adult.
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spelling nottingham-27772020-05-04T16:39:45Z https://eprints.nottingham.ac.uk/2777/ The pathophysiology of fluid and electrolyte balance in the older adult surgical patient El-Sharkawy, Ahmed M. Sahota, Opinder Maughan, Ron J. Lobo, Dileep N. Background & aims: Age-related physiological changes predispose even the healthy older adult to fluid and electrolyte abnormalities which can cause morbidity and mortality. The aim of this narrative review is to highlight key aspects of age-related pathophysiological changes that affect fluid and electrolyte balance in older adults and underpin their importance in the perioperative period. Methods: The Web of Science, MEDLINE, PubMed and Google Scholar databases were searched using key terms for relevant studies published in English on fluid balance in older adults during the 15 years preceding June 2013. Randomised controlled trials and large cohort studies were sought; other studieswere used when these were not available. The bibliographies of extracted papers were also searched for relevant articles. Results: Older adults are susceptible to dehydration and electrolyte abnormalities, with causes ranging from physical disability restricting access to fluid intake to iatrogenic causes including polypharmacy and unmonitored diuretic usage. Renal senescence, as well as physical and mental decline, increase this susceptibility. Older adults are also predisposed to water retention and related electrolyte abnormalities, exacerbated at times of physiological stress. Positive fluid balance has been shown to be an independent risk factor for morbidity and mortality in critically ill patients with acute kidney injury. Conclusions: Age-related pathophysiological changes in the handling of fluid and electrolytes make older adults undergoing surgery a high-risk group and an understanding of these changes will enable better management of fluid and electrolyte therapy in the older adult. Elsevier 2013-11-25 Article PeerReviewed El-Sharkawy, Ahmed M., Sahota, Opinder, Maughan, Ron J. and Lobo, Dileep N. (2013) The pathophysiology of fluid and electrolyte balance in the older adult surgical patient. Clinical Nutrition, 33 (1). pp. 6-13. ISSN 0261-5614 Fluid and electrolytes Older adults Dehydration Fluid overload Pathophysiology Clinical outcome http://www.clinicalnutritionjournal.com/article/S0261-5614(13)00316-6/abstract doi:10.1016/j.clnu.2013.11.010 doi:10.1016/j.clnu.2013.11.010
spellingShingle Fluid and electrolytes
Older adults
Dehydration
Fluid overload
Pathophysiology
Clinical outcome
El-Sharkawy, Ahmed M.
Sahota, Opinder
Maughan, Ron J.
Lobo, Dileep N.
The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title_full The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title_fullStr The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title_full_unstemmed The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title_short The pathophysiology of fluid and electrolyte balance in the older adult surgical patient
title_sort pathophysiology of fluid and electrolyte balance in the older adult surgical patient
topic Fluid and electrolytes
Older adults
Dehydration
Fluid overload
Pathophysiology
Clinical outcome
url https://eprints.nottingham.ac.uk/2777/
https://eprints.nottingham.ac.uk/2777/
https://eprints.nottingham.ac.uk/2777/