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Sauna, shower, and ice water immersion. Physiological responses to brief exposures to heat, cool, and cold. Part I. Body fluid balance.

Nine men were subjected to four temperature exposures to detect changes in weight, hemoglobin, hematocrit, and relative volumes of plasma. The exposures were: (A) sauna and head-out ice water immersion; (B) sauna and 15 degrees C shower; (C) sauna and room temperature; (D) head-out ice water immersion and room temperature. All experiments were repeated and ended with recovery at room temperature. The greatest weight loss (mean +/- S.D.) (i.e. sweating) was observed in C, 544 +/- 207 g. The weight losses (mean +/- S.D.) in A and B were equal, 417 +/- 253 g and 437 +/- 221 g. The relative post-exposure plasma volumes decreased 7.2% in A, 8.0% in B, and 5.6% in C; the decrease in D (1.3%) was statistically not significant. Combinations of heat and cold or cool (A and B) reduced the plasma volumes more than mere heat (C), suggesting a disturbance of cutaneous circulation producing transient edema in the skin.

Adult↗

Hydration assessment during cold-weather military field training exercises.

To quantify the magnitude of dehydration and to identify predictors of dehydration by utilizing changes in total body water (TBW), 24 male Marines were studied during an 8d moderately cold-weather (1-3 degrees C) training exercise. Training consisted of approximately 12 h/d of moderately intense activity. Variables examined included body composition, TBW, and various blood and urinary parameters indicative of hydration. Dietary food and fluid records were also maintained. Body composition changes were consistently with the high energy expenditure and insufficient energy intake. Despite a decrease in TBW, significant dehydration as assessed by blood and urinary parameters did not occur over the 8d period, therefore no relationships were found between TBW and any of the clinical indicators of dehydration. The change in TBW was reflective of a decrease in lean body mass. These data suggest that during cold-weather military field exercise, despite high activity levels and a negative energy balance, body fluid balance can be maintained when particular attention is paid to fluid intake.

Adult↗

Hana Kai II: a 17-day dry saturation dive at 18.6 ATA. I. Objectives, design, and scope.

The dive (Hana Kai II) described in these papers was designed to determine the effects on man of a prolonged exposure to a dry helium-oxygen hyperbaric environment. Comprehensive studies on energy balance, body fluid balance, cardiorespiratory functions, maximal oxygen uptake, psychological performance, and physiological responses to cold were performed at a simulated depth of 580 ft (18.6 ATA) over a 30-day period in March-April 1975. Following a 3-day predive control period at 1 ATA air (period 1), 5 male divers spent 17 days at 18.6 ATA in a helium-oxygen environment (periods 2-6), and returned to 1 ATA air after 7 days of decompression (periods 7-8). They stayed an additional 3 days inside the chamber for postdive control measurements (period 9). The chamber temperature was maintained at 25-27 degrees C during periods 1 and 9, 30-31 degrees C during periods 2-5, and 27-28 degrees C during period 6. At 18.6 ATA, the PO2 and PCO2 of the chamber gas were maintained at approximately 225 and 2 mmHg, respectively. In this introductory paper, physical and physiological characteristics of individual subjects, the major daily activity schedule, and the scope of investigation are presented.

Activities of Daily Living↗

Body composition changes in marrow transplant recipients receiving total parenteral nutrition.

Nine patients with acute lymphocytic leukemia in remission, aged 12-35 years, undergoing allogeneic bone marrow transplantation (BMT) were studied for changes in body fluid balance and body composition. Body composition and fluids were assessed the first 4 weeks following BMT, using isotope dilution and anthropometry. Oral and parenteral nutrient intakes were recorded daily. Tracer dilution techniques were used to assess body fluid volumes and estimate body cell, lean body, and body fat masses. Body cell mass was lost (mean -1.62 kg, P less than 0.05) without significant changes in body fat or lean body masses. There was an expansion of the extracellular fluid compartment (mean +0.8 l, P less than 0.05) and a loss in the intracellular fluid compartment (mean -1.3 l, P less than 0.05) with little change in total body water volume. Changes in body weight correlated poorly with body cell mass or fluid volume changes. Change in arm muscle area correlated well with changes in body cell mass (r = 0.61, P less than 0.05) and lean body mass (r = 0.68, P less than 0.05), while that of arm fat area did not reflect its isotope dilution-derived counterpart. Instead, the change in arm fat area was related to shifts in fluid compartments. Prealbumin decreased significantly (mean -9.3 mg/dl, P less than 0.05), while albumin decreased slightly (mean -0.1 mg/dl), and both were related to changes in body cell mass. Nitrogen balance was negative throughout the study and the overall mean was related to the change in body cell mass (r = 0.60, P less than 0.05). Calorie and protein intakes were not associated with the changes in body composition, implying other causal factors.

Adolescent↗

Long-term arterial pressure control: an analysis from animal experiments and computer and graphic models.

Long-term arterial pressure control is very different from acute control, because many of the acute control systems are overridden by a single long-term mechanism that has little to do with short-term control. This is the renal fluid volume mechanism for pressure control. It is based on a simple functional property of the kidney: as the arterial pressure rises, the kidney output of water and electrolytes increases dramatically. When the output rises above the net intake of water and electrolytes, negative body fluid balance occurs, causing both the body fluid volume and the pressure to decrease. This decrease continues until the kidney fluid output exactly balances the net fluid intake. Conversely, if the pressure falls below the exact level for balance, intake becomes greater than output; then fluid builds up in the body and the pressure rises until intake and output again exactly balance each other. This fluid mechanism for pressure control has been known from the beginning of blood pressure research. However, its overpowering importance was not appreciated until a mathematical computer analysis in 1966 demonstrated the renal-fluid feedback mechanism to have infinite feedback gain for long-term pressure control. This is the principal topic of the present review.

Animals↗

Relationship between absolute body-fluid deficits and fluid intake in the rat.

Acute absolute body-fluid deficits were induced in rats by injection of the diuretic drug furosemide, which caused up to 20% reduction of extracellular fluid volume and up to 2% reduction of intracellular fluid volume. Water and .3 M NaCl were subsequently made available to allow the rats to replace their body fluids by drinking. The rats increased their intake of both fluids, but replaced less than half of the total deficit, thereby tolerating larger and larger voluntary body-fluid deficits as the size of the diuretic fluid loss increased. Plasma measures showed that the rats sustained hypovolemia after drinking, while intracellular fluid volume was apparently restored. Fluid-depleted rats drank normally in response to intracellular dehydration induced by a sodium chloride load. Incomplete restoration of body-fluid balance after body-fluid depletion is due to a failure to drink in response to extracellular dehydration.

Animals↗

Thermophilic amylase-digested rice-electrolyte solution in the treatment of acute diarrhea in children.

OBJECTIVE: To compare the efficacy of an oral rehydration solution (ORS) containing short polymers of glucose derived from rice (Amylyte-ORS) and five times the caloric density of current ORS to the standard glucose-ORS (World Health Organization [WHO] = ORS) in the treatment of acute diarrhea in children. METHODS: The rice ORS (Amylyte-ORS) was obtained by adding thermophilic amylase (252,500 MW units) and salts (1.5 g NaCl, 600 mg KCl, and 150 mg CaCl2) to 100 g rice and boiling for 10 minutes in 500 mL water. This yields 250 mL Amylyte-ORS, which contains 92% to 96% short-chain glucose polymers, three to nine molecules in length, and provides 425 kcal/L, compared to 80 kcal/L for the WHO-ORS. One hundred forty-four male children, 4 months to 3 years of age, presenting with acute diarrhea and mild, moderate, or severe dehydration, were assigned by random allocation to receive either WHO-ORS or Amylyte-ORS. Data from 127 children were analyzed (57 received the WHO-ORS and 70 the Amylyte-ORS). Two children given Amylyte-ORS and 15 given the WHO-ORS were not included in the analysis because of improperly collected data or lost urine or fecal specimens. None were given antibiotics during the study. Free water and feeding were allowed after the children were rehydrated. RESULTS: The clinical characteristics of the children in the two treatment groups were comparable. Five children who received the WHO-ORS and three children given Amylyte-ORS were treatment failures. Amylyte-ORS reduced diarrhea duration by 15% (41.4 +/- 2.5 vs 34.7 +/- 1.8 hours; P < .03) compared to the WHO-ORS, regardless of the severity of dehydration. In the Amylyte-treated group, ORS requirements were significantly less (234 +/- 15.2 vs 295 +/- 17.6 mL/kg; P < .01) and weight gain was significantly more (367.7 +/- 45.1 vs 199.2 +/- 38.2 g; P < .01) than in those given the WHO-ORS. The net intestinal fluid balance and total body fluid balance were similar in the two groups. CONCLUSIONS: Amylyte-ORS effectively rehydrates children with acute diarrhea, reduces diarrhea duration, decreases ORS requirements, and improves weight gain compared to the WHO-ORS.

Acute Disease↗

Changes in body fluids during endurance rowing training.

The aim of this study was to investigate the influence of long-lasting, extensive rowing training on body fluids in 12 experienced rowers (23.3 +/- 6.3 years, 188.7 +/- 5.9 cm, 82.0 +/- 10.8 kg, body mass index [BMI] 23.7 +/- 2.1). All rowers had a light traditional breakfast about 3 h before the training. The subjects rowed 2 h 17 min and covered 22.6 +/- 2.5 km. Before and immediately after the training session and after 30, 60, and 120 min of recovery, body fluid balance was measured using a multiple-frequency impedance device (Multiscan 5000, Bodystat Ltd., UK). Body resistance was measured at the right side of the body. Extracellular (ECW), intracellular (ICW), and total (TBW) body water were measured at 5, 200, and 50 kHz, respectively. Blood hemoglobin (Hgb) and hemotocrit (Hct) were measured, and changes in blood volume (BV), plasma volume (PV), and cell volume (CV) were measured according to Dill and Costill (1974). The body weight of the rowers decreased significantly (p < 0.05) from 82.0 +/- 10.8 kg to 80.6 +/- 11.2 kg during the endurance training. There were no significant changes in TBW immediately after the training session. Significant changes in the content of TBW occurred during the first 30 min of recovery (48.7 +/- 4.4 to 47.9 +/- 4.1; p < 0.05). The amount of ECW also decreased significantly during the first 30 min of recovery (23.3 +/- 2.0 to 22.7 +/- 1.91; p < 0.05). There were no significant changes in the balance of ECW. BV decreased during the training session by 2.5 +/- 5.2% (p < 0.05). There were significant relationships (p < 0.05) between the covered distance and the following parameters after the training session: body weight (r = -0.75), TBW (r = -0.75), and ECW (r = -0.83). Changes in the blood parameters did not correlate significantly with changes in body fluids and training volume. It was concluded that extensive rowing training significantly changed the balance of body fluids in rowers.

Adult↗

In vitro sensitivity of median preoptic neurons to angiotensin II, osmotic pressure, and temperature.

In vivo experiments suggest an interaction of the mechanisms involved in the regulation of body fluid balance and body temperature. Increases in plasma osmolality initiate drinking and increase the thermal set point for sweating. The median preoptic nucleus (MnPO) has anatomical connections with brain areas important in fluid balance and cardiovascular regulation and, with the preoptic-anterior hypothalamus, a thermoregulatory region. The present experiments employed in vitro single-unit recordings to determine the sensitivity of MnPO neurons to angiotensin II (ANG II), changes in osmotic pressure, and changes in temperature. One-fifth (11 of 55) of the MnPO neurons responded with changes in firing rate during the ANG II treatment, one-fourth (19 of 75) responded to changes in perfusate osmolality, and there was a significant effect of osmolality and ANG II on the thermosensitivity of 25% of the neurons tested.

Angiotensin II↗