Insensible fluid losses in severe tetanus

Insensible fluid losses were estimated using fluid balances and body weight changes in twelve artificially ventilated patients with severe tetanus. Studies were carried out over initial twenty day periods of treatment on six patients aged between 26 and 49 years and six aged 63 to 78. Nine of the 12 patients lost weight over the study period (the younger losing an average of nearly 10% of their body weight) and all patients had positive fluid balances ranging between 15 and 53 1. The discrepancy between these findings was explained on the basis of considerable and continuing fluid losses in the form of sweat and saliva. When quantified, insensible fluid losses appeared greatest in the younger patients (up to 3.81 per day) and increased throughout the period of study. Dehydration will tend to occur unless the magnitude of these insensible losses is appreciated and taken into account when managing fluids.