What monitoring parameters should I use to evaluate the effectiveness

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Monitoring parameters to evaluate the effectiveness of fluid therapy in a dehydrated patient include:

Clinical assessment of hydration status, including pulse, blood pressure, capillary refill, and presence of oedema, to observe improvements in hydration and perfusion (see table 1 in ).
Urine output, to assess renal perfusion and hydration status (see ).
Fluid balance charts, recording input and output hourly, with running totals, and 12-hourly and 24-hourly fluid balance totals (see ).
Weight measurement, ideally twice weekly, to monitor changes in fluid status (see ).
Laboratory tests including plasma electrolyte concentrations, urea, creatinine, and blood glucose, measured at least every 24 hours or more frequently if indicated, to assess electrolyte balance and renal function (see , ).
Additional laboratory parameters such as venous lactate levels, arterial pH, and base excess in critically ill patients, for ongoing assessment of perfusion and metabolic status (see ).

What monitoring parameters should I use to evaluate the effectiveness of fluid therapy in a dehydrated patient?