23/02/2023 - Blog 3 Dehydration

Foto:Judith Judith Beurskens is a Nursing Specialist at the department of Stomach, Bowel and Liver Diseases of the Radboud University Medical Center in Nijmegen (Netherlands). Here she researches the self-measurement of urine samples at home by patients with severe intestinal failure. In several blogs, Judith tells about her experiences with these 'Point-of-Care' measurements during this research.

“The fluid balance in patients with severe intestinal failure can change quickly,” Judith explains. “The flu or other illness can already cause an imbalance. But also in warm weather. At a temperature above 25 degrees Celsius, people start to perspire. So also people with a high output stoma, as many patients with severe intestinal failure have. Then they definitely need half a liter of extra moisture. But maybe more.”

If patients can measure urine samples themselves at home, they will have a better insight into their sodium balance. “For example, if they have a headache, this may indicate a starting form of dehydration. In practice se know, patients often wait too long to have a urine sample examined. And if the results of the lab test also take a few days to arrive, there is often already a more serious form of dehydration. Then a lot must be done to regain the balance," Judith explains.

When Judith started in this department in 2014, she was busy sending letters to patients having urine determined, who reported complaints. When the lab results come in after a few days, the whole situation surrounding the patient is already outdated. This is possible because it has taken in extra fluid or has lost even more fluid. "At the moment we do not know exactly how much fluid they should take per day per patient. Perhaps you can manage it all much better with half a liter more or less extra fluid one day," the thought of Judith about this. But then you need to know faster whether and how you can make adjustments.

"Then I did some searching on the internet and came across Fisic-Medimate. At that time, measurements were being carried out for monitoring low-salt diets in people with high blood pressure. The idea was to provide feedback on the salt intake of the food to lower blood pressure and thereby prevent heart and kidney damage. I then called Steven Staal and asked whether it was also possible to measure low sodium levels.

In cooperation with the Medical Faculty of Utrecht, Fisic then investigated whether lower sodium values ​​could also be determined with the Medimate. The results of those tests were good. All the more reason for Judith to look internally for financial resources for a project to carry out measurements of sodium levels with the Medimate in practice in patients with a high output stoma.

This resulted in an 'Affordable Better' project from the Radboud UMC together with health insurance company VGZ. In doing so, both organizations jointly look at innovations that make healthcare better and cheaper. Better for the patient and better for society.

More experiences - in Dutch - in this article which is published in Kronhniek. A magazine for patients with severe intestinal failure.