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Extrarenal potassium transport and the beta 2-adrenergic system.

The distribution of a short-term potassium load was quantitated in three groups of acutely nephrectomized rats infused with KCl at 0.75, 1.50, and 2.25 mEq/kg/hr for 90 minutes. The rate of net potassium transfer from the extracellular fluid compartment to the intracellular fluid compartment was stable from 30 to 90 minutes and proportional to the rate of infusion, with no evidence of saturation of transport mechanisms. In the period 60 to 90 minutes, the calculated increments in intracellular potassium concentration over 10-minute intervals were similar to the respective increments in extracellular potassium concentration. The apparent volume of distribution of the infused potassium over this period was similar to total body water. At the termination of the infusions, the net potassium transfer rates rapidly fell to very low levels. Our studies support the view that the extrarenal modulation of short-term potassium load is dependent on changes in plasma potassium concentration that conform to a first-order linear kinetic model. The infusion of the selective beta 2-adrenergic blocker butoxamine without potassium administration to acutely nephrectomized rats resulted in a net efflux of potassium from the intracellular fluid compartment. The addition of butoxamine to three groups of rats receiving KCl at the previous rates resulted in a fixed decrement in net potassium transfer to the intracellular fluid compartment that was not significantly different from the net efflux of potassium seen with butoxamine alone. Despite beta blockade, the net transfer of potassium remained proportional to the infusion rate. Thus, in our studies, beta 2-adrenergic blockade had a relatively fixed influence on decreasing net potassium transfer, both under basal conditions and during short-term potassium administration.

Adrenergic beta-Antagonists↗

Presynaptic vesicles, exocytosis, membrane fusion and basic physical forces.

The theoretical hypothesis is presented trying to explain the vesicle release from presynaptic nerve ending and membrane fusion. This theoretical concept implies only essential physical forces such as electrostatic force and surface tension force. Transmembrane resting potential of approximately -70 to -80 mV means that the intracellular fluid is electronegative in comparison with extracellular one. In this concept it is supposed that the inner and outer lipid layer of the membrane also have different electrostatic charges. Presynaptic vesicles are made from cell membrane by endocytic process through which the vesicle loses the contact with cell membrane. Also, during the endocytic process, the inner lipid layer of the cell membrane becomes the outer lipid layer of presynaptic vesicle and vice versa. During the resting phase, equally charged lipid layers of presynaptic vesicle and cell membrane repel each other, but during the action potential, differently charged lipid layers strongly attract each other, bringing the presynaptic vesicle and cell membrane in close contact. Immediately thereafter, the surface tension forces open the pore and fuse both membranes trying to minimize the area of the contact between water fluids (extra and intracellular fluid) and lipid fluids (lipid membrane bilayer). Since only fundamental physical forces are involved in this process, it could be very fast, effective and almost inexhaustible. Similar mechanisms could be responsible for all exocytic processes and all membrane fusion processes in the cells.

Action Potentials↗

[Dynamics of fluid volumes of body sectors in patients after laparoscopic surgery].

An investigation of the state of volumes of the organism's fluid sectors (general, extra- and intracellular fluid) by a noninvasive method of double-frequency impedancemetry has revealed the influence of preoperative preparing the patients and restriction of the water regimen after operation upon the development of moderate dehydration of the extracellular sector. During the operation lasting about an hour the intravenous administration of 400 ml of crystalloid solutions maintains the volumes of fluid sectors within the due values. These solutions injected in greater volumes result in accumulation of the extra- and intracellular fluid. The antiperistaltic purgation of the intestine before the operation reduces the concentration of calcium in blood by 1 mmol/l at an average.

Adult↗

Direct measurement of Na influx by 23Na NMR during secretion with acetylcholine in perfused rat mandibular gland.

Intracellular Na content (Nain) in the perfused rat mandibular gland was measured by using a 23Na NMR spectroscopy at 24 degrees C. An aqueous chemical shift reagent, dysprosium triethylenetetramine-N,N,N',N",N"'N"'-hexaacetic acid [Dy(TTHA)] was used in order to discriminate between the intracellular and the extracellular Na signal. The mandibular gland of rat was perfused arterially with a modified Krebs solution containing 10 mM Dy(TTHA). At rest, Nain was not changed by blocking the Na+/K+ ATPase with ouabain (1 mM) and atropine (3 microM), implying that, in the absence of stimulation, the spontaneous Na influx across the plasma membrane must have been negligibly small. Following onset of stimulation with acetylcholine (1 microM), Nain increased by 9.1 +/- 1.5 mmol/l intracellular fluid (mean +/- SEM, n = 13), and remained at this level during stimulation. In the initial phase of secretion (0-5 min), about 50 mmol/min/l intracellular fluid of Na was secreted into the luminal space (estimated from the secretory rate by assuming an isotonic primary secretion) but, in spite of the higher secretion rate, Nain increased only at an initial rate of 4.1 mmol/min/l intracellular fluid. During the steady phase of secretion (15-30 min) evoked by acetylcholine (1 microM), ouabain (1 mM) caused an increment of Nain of 44 +/- 8 mmol/l intracellular fluid (mean +/- SEM, n = 4). From the rate of Nain increment, the Na influx rate at the steady phase was estimated as 4.5 mmol/min/l intracellular fluid. These results suggest that the influx of Na is caused by stimulation with acetylcholine.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗

Fluid distribution measurement between body compartments in primates in disclosing fluid retention during prolonged hypokinesia.

Body fluid homeostasis undergoes significant changes during hypokinesia (diminished movement). Understanding of fluid transfer between body fluid compartments and its regulating mechanisms was the aim of this study for disclosing impaired fluid retention during hypokinesia (HK). Studies were done on 12 male Macaca mulatta (rhesus monkeys) aged three to five years (5.15 to 6.56 kg) during 90 days period of pre-HK and 90 days period of HK. All primates were divided equally into two groups: vivarium control primates (VCP) and hypokinetic primates (HKP). Hypokinetic primates were kept for 90 days in small individual cages that restricted their movements in all directions without hindering food and fluid intakes. Control primates were housed in individual cages without their movements being restricted. Total body fluid (TBF), intracellular fluid volume (IFV) and circulating plasma volume (CPV) decreased significantly (p < 0.05), while extracellular fluid volume (EFV) and interstitial fluid volume (IsFV) decreased significantly (p < 0.05) at the initial seven days of the HK period and after the 7th day increase progressively in HKP compared with their pre-HK values and their respective control values in VCP. Fluid excretion, urinary and plasma sodium (Na) and potassium (K) levels increased significantly (p < 0.05), while fluid intake and fluid retention decreased significantly (p < 0.05) in HKP compared with their pre-HK values and their respective controls in VCP. The measured parameters did not change in VCP compared with their pre-HK values. It was concluded that decreased IFV and CPV may demonstrate fluid depletion, while marked increase of fluid loss despite of fluid depletion may demonstrate impair fluid retention during HK. Dissociation between fluid loss and fluid depletion may demonstrate the presence of reduced fluid retention as the mechanism of development of fluid depletion during HK.

Animals↗

Modeling a hydropic recipient twin in twin-twin transfusion syndrome.

We developed a mathematical model of twin-twin transfusion syndrome (TTTS) that includes a hydropic recipient twin, adding interstitial and intracellular fluid compartments, fetal congestive cardiac failure, and the dynamics of renin-angiotensin system (RAS) mediators to our previous TTTS model. Ten differential equations for each twin, coupled by the net fetofetal transfusion of blood and blood components, i.e., colloids, osmoles, and RAS mediators, describe the development of fetal arterial and venous blood volumes, blood osmolality and colloid osmotic pressure (COP), interstitial fluid volume and COP, intracellular fluid volume, amniotic fluid volume and osmolality, and RAS mediator concentration. We included varying placental anastomoses, placental sharing, and amnionicity. The 20 differential equations were solved numerically from 0 to 40 wk with a 0.6-s time step. Consistent with clinical experience, model predictions are as follows. Unidirectional arteriovenous anastomoses and arteriovenous anastomoses inadequately compensated by oppositely directed anastomoses cause severe TTTS that includes a hydropic recipient. Adequately compensated arteriovenous anastomoses simulated TTTS without hydrops. The probability that oppositely directed anastomoses prevent onset of a hydropic recipient after TTTS onset, i.e., the largest interval between onset of TTTS and onset of hydrops in the recipient, was best for a venovenous anastomosis, closely followed by an arterioarterial and finally an oppositely directed arteriovenous anastomosis. Hydropic recipients have decreased amniotic fluid volume. Unequal placental sharing and amnionicity modify hydrops onset. In conclusion, our model simulates a sequence of events that results in a hydropic recipient twin in severe TTTS. The model may allow an assessment of the efficacy of current therapeutic interventions for TTTS cases that include a hydropic recipient twin.

Adult↗

Lactate distribution and metabolism during and after anoxia in the turtle, Chrysemys picta bellii.

To determine the fate of lactate during and after prolonged anoxia, 14C-labeled lactate was injected into turtles after 2 h of a 6-h submergence at 20 degrees C. 14C activities of plasma and chamber water were tested at intervals during anoxia and also in expired air during 39 h of recovery. Partitioning of label in major body compartments [extracellular fluid (ECF), intracellular fluid (ICF), and shell] and 14C activity and glycogen in selected tissues (heart, liver, and muscle) were measured after anoxia (n = 7) and after recovery (n = 6). Shell 14C and [lactate] were extensively measured on six anoxic turtles. During anoxia all 14C remained in the animal indicating no urine production. At 6 h of anoxia 47% of recovered 14C, presumably still as lactate, was in the ECF, 27% in the ICF, and 30% in the shell. During recovery, plasma [lactate] fell from 35 to 5 meq, but surrounding water and expired air accounted for only 9 and 8%, respectively, of recovered label. The ICF portion grew to 41%, associated with a recovery in tissue glycogen. The shell still had 22% of total label. We conclude that, during recovery from anoxia, lactate is predominantly resynthesized to glycogen, and only a small fraction is directly oxidized. During anoxia, however, lactate is widely distributed in the body, and a surprisingly large and functionally significant fraction resides in the shell.

Animals↗

The benefits and side effects of ramped hypertonic sodium dialysis.

The effectiveness of ramped hypertonic sodium dialysis (RHSD) is controversial because of the prevalence of side effects (weight gain and hypertension). Standard dialysis (SD) was therefore compared with RHSD in a double-blind controlled crossover trial. Eleven patients who suffered from symptoms attributable to water shifts from extracellular fluid to intracellular fluid (headaches or hangover) or extracellular-fluid volume contraction (cramps or lightheadedness) and five asymptomatic patients were enrolled in the study. RHSD was individually tailored to each patient (to minimize thirst) during a 2-wk run-in period. Patients then received RHSD and SD for a period of 3 wk in randomized sequence. Outcome measures were both objective and subjective ratings on questionnaires. Significant differences were found between the two treatments, with RHSD improving specific problems (70% of lightheadedness/cramps, 100% of headaches/hangover) versus SD. Weight gain and hypertension were not different between the two treatments despite increased thirst sensation reported by 14/16.94% of patients preferred RHSD. Long-term studies in 20 different patients demonstrated the lack of increase in blood pressure or weight gain after 3 and 6 months of therapy.

Blood Pressure↗

Lymphodynamics in the fetus and newborn.

Body fluid is distributed among three major fluid spaces: plasma, interstitial fluid, and intracellular fluid. The distribution of fluid in each of these compartments is dramatically different in the fetus and newborn compared to the adult. In addition, the amniotic fluid that surrounds the fetus may also be considered an extension of the extracellular space of the fetus. The purpose of this review is to discuss the complex mechanism that regulates volume in the fetus and newborn as well as the regulation of fluid distribution between the plasma and interstitial fluid, while placing special emphasis on the role the lymphatic system plays in mediating and maintaining this distribution.

Amniotic Fluid↗

Kaluresis and diuresis after administration of antidiuretic hormone to hyperkalemic dogs.

Dogs infused with 2 meq KCl/kg per h exhibit electrocardiographic evidence of prelethal cardiotoxicity in about 3 h when serum potassium reaches a level between 10.2-10.5 meq/liter. During this time, their urine output of 30 ml/h is equal to the volume of KCl infused. Studies of the potassium distribution in these animals indicate that 20 percent of the infused ion is added to the extracellular fluid and red blood cell mass, 20 percent is excreted in the urine, while the remaining 60 percent is unaccounted for and presumably transferred to intracellular fluid. Dogs treated with moderately large doses of antidiuretic hormone intramuscularly before and during KCl infusion delay development of prelethal cardiotoxicity for about 5 h, with serum potassium levels comparable to those of untreated dogs. In addition, treated animals display a considerable diuresis and kaluresis with urine volumes nearly 4 times that of the volume infused. The potassium ion distribution in animals given antidiuretic hormone is much different from that of untreated dogs, with 55 percent of the infused ion found in the urine, about 15 percent in extracellular fluid and red blood cell mass, and only 30 percent presumably transferred to intracellular fluid. Transfer of potassium to intracellular fluid was calculated to be 3.1 plus or minus 0.7 meq/kg in antidiuretic-hormone-treated animals and 3.8 plus or minus 0.7 meq/kg in untreated (control) animals. Since these values are, within experimental error, quite comparable, it is possible that antidiuretic-hormone-induced kaluresis and diuresis are involved in protecting some animals from the effects of hyperkalemia by delaying the attainment of cardiotoxic blood levels.

Animals↗

Body fluid volumes in rats with mestranol-induced hypertension.

Because estrogens have been reported to produce sodium retention, this study investigated the possibility that hypertension in rats resulting from the ingestion of an estrogen used as an oral contraceptive could be due to increases in body fluid volumes. Female rats were given feed containing mestranol for 1, 3, and 6 mo; control rats were given the feed without mestranol. The mestranol-treated rats had higher arterial pressures than the controls only after 6 mo of treatment. Plasma volume, extracellular fluid volume, and total body water were measured in each rat by the distribution volumes of radioiodinated serum albumin, 35SO4, and tritiated water, respectively. Values for blood volume, interstitial fluid volume, and intracellular fluid volume were derived from these measurements. These body fluid volumes, expressed per 100 g of body weight, were not different between the mestranol-treated rats and their controls at any of the three treatment times. Due to differences in body weight and lean body mass between the mestranol-treated and the control rats, these volumes also were expressed per 100 g of lean body mass. Again, no differences were observed between the mestranol-treated rats and the control rats for any of these body fluid compartments at any of the treatment times. These studies, therefore, were unable to provide evidence that increases in body fluid volumes contributed to the elevated arterial pressure in this rat model of oral contraceptive hypertension.

Animals↗

Evaluation of body fluid status after cardiac surgery using bioelectrical impedance analysis.

BACKGROUND: In the assessment of fluid status after cardiac surgery, we applied bioelectrical impedance analysis (BIA) to measure the total body water (TBW), extracellular fluid (ECF), and intracellular fluid (ICF), and evaluated its validity. METHODS: Thirty patients who underwent cardiopulmonary bypass (CPB group) and 19 surgical patients not receiving CPB (non-CPB group). RESULTS: The change of BIA values (deltaTBW, deltaECF, deltaICF), body weight and cumulative fluid balance were determined for 120 postoperative hours, and the relationship between BIA values and body weight and fluid balance were evaluated. Postoperative changes in BIA values in the CPB group were compared with those in the non-CPB group. Finally the ECF/ICF ratio and hemodynamic parameters were compared. deltaTBW and deltaECF correlated with changes in body weight and fluid balance, respectively. Especially there was a high correlation in each case although large deviations in the slope of the regression lines were observed. TBW and ECF increased from immediately after operation up to 96 hours (the maximum value was at day 2). On the other hand, ICF decreased from 48 to 72 hours after operation. There were significant high ECF/ICF in the CPB group compared with the non-CPB group from 12 to 72 postoperative hours. We found that ECF/ICF correlated inversely with mean blood pressure, mixed venous oxygen saturation and colloid osmotic pressure, and positively with central venous pressure and pulmonary artery wedge pressure. CONCLUSIONS: It was considered that BIA was useful for evaluating the relative changes in TBW and fluid distribution, and ECF/ICF might be a new parameter for abnormal water metabolism after cardiac surgery.

Aged↗

Bioimpedance spectroscopy technique: intra-, extracellular, and total body water.

The purpose of this study was to test the validity of a multiple frequency bioimpedance spectroscopy (BIS) technique that estimates extracellular fluid volume (ECV), intracellular fluid volume (ICV), and total body water (TBW). Thirteen healthy males (mean +/- SD: age, 23 +/- 3 yr; body mass, 80.6 +/- 14.7 kg) had their TBW and ECV measured by ingesting dilution tracers (7.27 g deuterium oxide, 1.70 g sodium bromide; blood samples at 0 and 4 h). ICV was calculated as TBW minus ECV. Impedance was measured (50-500 kHz) at rest, on a nonconducting surface, with a BIS analyzer. Electrode placement, posture, exercise, food/fluid intake, and ambient temperature were controlled. Dilution measures (TBW, 51.00 +/- 9.30; ECV, 19.88 +/- 3.14; ICV, 31.12 +/- 6.80 L) and BIS volumes (TBW, 50.03 +/- 7.67; ECV, 20.95 +/- 3.33; ICV, 29.04 +/- 4.51 L) were significantly different for ECV (P < 0.01) and ICV (P < 0.05); some individual differences were large. The correlation coefficients of dilution versus BIS volumes (r = 0.93 to 0.96) were significant at P < 0.0001; SEEs were: TBW, 2.23 L; ECV, 1.26 L; and ICV, 1.71 L. We concluded that BIS is valid for between-subject comparisons of body fluid compartments, is appropriate in clinical settings where change in ECV/ICV ratio is important, and should be used by comparing the required level of accuracy to the inherent technique error/variance.

Adult↗

Comparison of segmental and global bioimpedance spectroscopy errors using generalizability theory.

The generalizability theory, an expansion of classic true-score reliability theory, was used to investigate the generalizability of observed segmental extracellular fluid (ECF) and intracellular fluid (ICF) distribution measurements. The test instrument was a Xitron Hydra ECF/ICF bioimpedance analysis system model 4200, Xitron Technologies, San Diego, CA. Fifty American healthy men (17-72 years) and 50 American healthy women (17-76 years) volunteered as participants. Xitron continuous segmental ECF-ICF procedures for testing leg segmental data were followed for testing participants in both the standing erect and lying supine postures. A two-facet, person-by-trial, completely crossed design was used. All facets were treated as random. During a one-day session each subject was tested involving 20 trials for the standing erect posture and 20 trials for the lying supine posture. Data on each fluid measurement, each body posture and each sex group were independently analysed. The analyses revealed that the trial factor accounted for less than 0.2% of the total variance for ECF and ICF scores. ECF and ICF generalizability coefficients for the segmental method were 0.99 or greater. In comparing ECF segmental to ECF global, results showed generalizability coefficients were similar. However, ICF segmental coefficients were larger than the coefficients produced by the global method. In conclusion, the segmental method appeared more reliable than the global method, under the conditions of this study.

Adolescent↗

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↗

Fluid shifts following 7% hypertonic saline (2400 mosmol/L) infusion.

Small volumes of hyperosmolar saline solutions may rapidly improve MAP and CO in hemorrhagic shock. In the present study, the effects of infusion of 7% NaCl on interstitial fluid volume and intracellular fluid volume were determined. In anesthetized, normovolemic rats either 7% NaCl (1.1 mL/100 g, intravenously), acetated Ringer's solution (10 mL/100 g), or no fluid (controls) were infused and extracellular volume (ECV) and plasma volume were determined in samples from skin, skeletal muscle, small intestine, liver, and lung. Intracellular volume was determined as local tissue water content minus ECV. Extracellular fluid volumes were 21.1 +/- .6 mL/ 100 g(mean +/- SEM; n = 6) (control animals), 26.1 +/- .4 mL/100 g (following 7% NaCl) (p < .05), and 32.8 +/- .5 mL/100 g (following Ringer's) (p < .05). Following 7% NaCl ECV increased by four to five times the infused volume. With 7% NaCl ECV in skin, muscle and intestine increased significantly, whereas cell volume was reduced by 10% in muscle and liver. Skeletal muscle, constituting > 40% of body mass with a large cell volume, was the main source for fluid mobilized by administration of 7% NaCl.

Animals↗

Reduced oncotic pressure after shock: a proposed mechanism.

Hemorrhagic shock plus resuscitation leads to expansion of both interstitial fluid space (IFS) and intracellular fluid (ICF). THe IFS expansion is thought to reflect reduced serum colloid oncotic pressure (COP) from capillary leak of serum albumin (SA). This hypothesis was analyzed in 138 injured patients who received an average of 13.6 units of blood and 10.7 L of saline solution for correction of shock. Plasma volume (PV), extracellular fluid (ECF) by inulin space technique, SA level, percent albumin leak (PAL), total intravascular albumin content (TIAC), COP, IFS, weight gain, and time of injury were analyzed. Patients studied during the postoperative fluid sequestration phase had a low to normal PV (2.9 L) with a high IFS (15.2 L) and a low PV-ECF ratio (0.15). Although the SA level (2.8 g/dL), TIAC (81 g), and COP (11.9 mOsm/L) were low, the PAL was also low (6.0%/hr; normal, 7%/hr). Patients studied during the fluid mobilization phase had a high PV (3.2 L) and normal PV-ECF ratio (0.21), whereas the SA level (3.0 g/dL), TIAC (103 g), and COP (14.1 mOsm/L) remained low. Despite these findings, the PAL was high (8.0%/hr). The fall in the PV-ECF ratio during the postresuscitation fluid sequestration phas is associated with but not due to reduced TIAC and COP, both of which remained low after the PV-ECF ratio has normalized during the mobilization phase. Contrary to prior reports, albumin leak is not responsible for reduced COP, TIAC, and postresuscitation weight gain. Presumably, the low COP results from decreased reentry of albumin into the plasma volume due to entrapment within the IFS matrix.

Body Fluids↗

Role of muscle in regulating extracellular [K+].

There is a positive association between diets rich in potassium, control of blood pressure, and prevention of stroke. Extracellular [K+] is regulated closely to maintain normal membrane excitability by the concerted regulatory responses of muscle and kidney. Although kidney is responsible for ultimately matching K+ output to K+ intake each day, muscle contains more than 90% of the body's K+ and can buffer changes in extracellular fluid [K+] by either acutely taking up extracellular fluid K+ or releasing intracellular fluid K+ from muscle. It long has been assumed that the changes in muscle K+ transport are a function of sodium pump (Na,K-adenosine triphosphatase [Na, K-ATPasel]) abundance, especially that of the alpha2 isoform, which predominates in skeletal muscle. To test the physiologic significance of changes in muscle Na,K-ATPase expression, we developed the K+ clamp, which measures insulin-stimulated cellular K+ uptake in vivo in the conscious rat. By using the K+ clamp we discovered that significant insulin resistance to cell K+ uptake occurs as follows: (1) early in K+ deprivation before a decrease in muscle sodium pump pool size, and (2) during glucocorticoid treatment, which increases muscle Na,K-ATPase alpha2 levels greater than 50%. We also discovered that adaptation of renal and extrarenal K+ handling to altered K+ balance often occurs without changes in plasma [K+], supporting a feedforward mechanism involving K+ sensing in the splanchnic bed and adjustment of K+ handling. These findings establish the advantage of combining molecular analyses of Na,K-ATPase expression and activity with systems analyses of cellular K+ uptake and excretion in vivo to reveal regulatory mechanisms operating to control K+ homeostasis.

Animals↗