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At least 19 recordsLinked to original sources

Hana kai ii: a 17-day dry saturation dive at 18.6 ATA. III. Body fluid balance.

Comprehensive studies on body fluid balance on 5 divers were conducted during the Hana Kai II dive (17 days at 18.6 ATA and 7 days of decompression). Daily urine flow increased from about 2000 ml at 1 ATA to 2600 ml at 18.6 ATA, at 31 degrees C. This diuresis was accompanied by a reduction in urine osmolality (from 650 to 500 mOsm) and a slight increase in osmolal clearance. Endogenous creatinine clearance remained at about 173 ml/min throughout the dive. Despite such a sustained diuresis, neither daily water intake nor total body water volume changed significantly. The plasma renin activity changed little, while both plasma aldosterone concentration and urinary aldosterone excretion increased significantly during the first week at 18.6 ATA. The plasma prolactin concentration showed a significant decrease during the first 3 days at 18.6 ATA. The daily excretion of antidiuretic hormone (ADH) decreased significantly (by 40%) 4 days after compression and remained low throughout the rest of the dive. Insensible waterloss at 18.6 ATA was 35% lower than that at 1 ATA. It is suggested that the observed hyperbaric diuresis is due primarily to suppression of ADH as a result of suppression of insensible water loss.

Aldosterone↗

Monitoring hyperhydration during high-dose chemotherapy: body weight or fluid balance?

Body weight and fluid input/output are usually monitored for checking fluid balance in case of intravenous hyperhydration during nephrotoxic chemotherapy. The reliability of measuring fluid input/output is uncertain. Moreover, this measurement is redundant, complex, labour-intensive and represents an occupational hazard for nurses and other health-care workers handling fluids or body excreta. In a prospective cohort study, we determined the concordance between body weight and fluid intake/output. We also examined the clinical consequences with respect to the safety of selecting only body weight measurement as a parameter for fluid overload. A total of 591 combined observations of fluid balances and body weights were collected. We observed a higher increase in body weight than in fluid balance. The Pearson correlation between fluid balance and body weight was relatively low (r = 0.28). With regard to the safety of measuring body weight only, we found 4 cases (0.6%) who might not have received furosemide if the fluid input/output had not been measured, without clinical consequences, however. After standardization, body weight can safely be used as the only parameter for monitoring fluid retention in case of hyperhydration during chemotherapy.

Adolescent↗

Electric impedance for evaluation of body fluid balance in cardiac surgical patients.

OBJECTIVE: To evaluate whether electric impedance can be used to monitor body fluid balance and fluid distribution in cardiac surgical patients. DESIGN: Prospective clinical study. SETTING: Heart Center, Rigshospital, Copenhagen. PARTICIPANTS: Sixteen consecutive patients scheduled for cardiac surgery. MEASUREMENTS AND MAIN RESULTS: Body weight, fluid balance, central hemodynamics, and total and segmental body impedance were examined perioperatively. During semisupine rest before surgery, changes in impedance indicated relocation of fluid from the legs to the thorax, mostly in the extracellular space. After surgery, weight and fluid balance increased by 3.87 +/- 0.35 kg and 1.86 +/- 0.16 L (mean +/- SE, p < 0.01) and remained elevated through the next 2 days. Impedance decreased by 30% over the thorax, by 24% over the abdomen, by 2% over the leg, and by 4% over the entire body. Changes in total and thoracoabdominal impedances had the highest correlation to the fluid balance (r = -0.86 and r = -0.87). After correction of impedance values by the constant from the regression model, the mean difference in estimation of fluid changes obtained by electric impedance and by fluid balance was 0 +/- 0.1 L at the range of changes of 4.6 L. CONCLUSION: Alterations in electric impedance closely follow changes in fluid balance during the perioperative period. This method can be used in clinical practice to control postoperative body fluid balance in cardiac surgical patients.

Adult↗

Thoracic impedance as an index of body fluid balance during cardiac surgery.

Thoracic impedance at 2.5 (TI2.5) and 100 kHz (TI100), central venous pressure (CVP), and body fluid balance were recorded together with rectal temperature and arterial haematocrit in 15 consecutive patients subjected to coronary artery bypass grafting. I.v. fluid and blood were administered in an excess of 3.18 (1.38-9.35) 1 during the operation. TI2.5 decreased from 51.7 (39.2-66.4) to 34.9 (21.1-45.7) ohm (P = 0.001), while TI100 decreased from 41.9 (31.4-55.0) to 30.3 (18.3-40.8) ohm (P = 0.002). CVP, 6 (3-11) mmHg [0.8 (0.4-1.5) kPa], was the same before and after surgery. Temperature decreased during cardiopulmonary bypass from 35.4 (34.1-36.6) to 26.7 (22.9-31.0) degrees C and haematocrit from 39 (34-46)% to a lowest value of 27 (23-32)% (P = 0.0001). A close linear correlation between TI and body fluid balance was observed (TI2.5: r = -0.96, TI100: r = -0.95, P = 0.0001). Corrections of TI for temperature and/or haematocrit improved the correlation between TI and fluid balance to 0.99 (TI2.5) and 0.98 (TI100). The data indicate that changes in thoracic impedance can be used to monitor body fluid balance during cardiac surgery.

Aged↗

Effects of caffeine ingestion on body fluid balance and thermoregulation during exercise.

This study investigated the effects of caffeine supplementation on thermoregulation and body fluid balance during prolonged exercise in a thermoneutral environment (25 degrees C, 50% RH). Seven trained male subjects exercised on a treadmill at an intensity of 70-75% of maximal oxygen consumption to self-determined exhaustion. Subjects exercised once after caffeine and once after placebo ingestion, given in a double-blind crossover design. Five milligrams per kilogram body weight of caffeine followed by 2.5 mg.kg-1 of caffeine were given 2 and 0.5 h before exercise, respectively. Rectal temperature was recorded and venous blood samples were withdrawn every 15 min. Water loss and sweat rate were calculated from the difference between pre- and post-exercise body weight, corrected for liquid intake. Following caffeine ingestion, when compared with placebo, no significant difference in final temperature or in percent change in plasma volume were found. No significant differences were observed in total water loss (1376 +/- 154 vs. 1141 +/- 158 mL, respectively), sweat rate (12.4 +/- 1.1 vs. 10.9 +/- 0.7 g.m-2.min-1, respectively), rise in rectal temperature (2.1 +/- 0.3 vs. 1.5 +/- 0.4 degrees C, respectively), nor in the calculated rate of heat storage during exercise (134.4 +/- 17.7 vs. 93.5 +/- 22.5 W, respectively). Thus, in spite of the expected rise in oxygen uptake, caffeine ingestion under the conditions of this study does not seem to disturb body fluid balance or affect thermoregulation during exercise performance.

Adult↗

Thermal responses and body fluid balance of competitive male swimmers during a training session.

Thermoregulatory and body fluid balance (BFB) responses of competitive swimmers were studied during a typical interval training session under natural field conditions. Subjects were 9 males (18.0 +/- 1.7 years; VO(2)max = 3.8 +/- 0.9 L x min(-1)) who covered 9,000 m in 180 minutes in an outdoor pool (mean water temperature = 26.8 +/- 0.3 degrees C; mean wet bulb globe temperature = 29.8 +/- 2.8 degrees C). Mean body weight (BWt) decreased by 1.8 +/- 0.5 kg (P < 0.05), and rectal temperature increased by 1.0 +/- 1.0 degrees C (P < 0.05). Volitional water intake (WI) (0.1 +/- 0.2 kg) did not maintain BFB (-0.5 kg per hour) and plasma volume decreased 10.7 +/- 5.4%. During a typical training session, swimmers experienced significant body fluid losses, and WI was not enough to prevent involuntary dehydration. The magnitude of the fluid losses (2.5% of BWt) was sufficient to compromise convective thermoregulation because of the decreased plasma volume. Hence, to prevent involuntary dehydration, swimmers should be encouraged to consume an amount of fluids that equals losses throughout the training sessions.

Acclimatization↗

Atrial natriuretic peptide secretion and body fluid balance after bilateral atrial appendectomy by the maze procedure.

OBJECTIVES: One of the earliest recognized postoperative complications of the maze procedure was the fluid retention in the immediate postoperative period. Routine postoperative administration of diuretics markedly reduces the frequency and severity of the fluid retention. However, the cause of the abnormal fluid balance is still uncertain. METHODS: We evaluated 24 patients: 15 patients underwent the maze procedure (maze group) and 9 patients did not (nonmaze group). Blood samples were obtained before and in the time course after operation for atrial natriuretic peptide measurement. To evaluate the influence of atrial natriuretic peptide on the body fluid balance, we also measured the amount of body fluid balance and the total doses of furosemide and dopamine administered after operation. To examine the effect of the maze procedure on atrial natriuretic peptide secretion in chronic phase, we measured plasma atrial natriuretic peptide levels during dynamic exercise in 21 patients who had undergone cardiac operations 2 years before. RESULTS: Plasma atrial natriuretic peptide levels in the nonmaze group significantly increased after operation. In contrast, plasma atrial natriuretic peptide levels in the maze group did not increase, and these levels were significantly lower than in the nonmaze group. Although significantly greater doses of furosemide and dopamine were administered to the maze group than to the nonmaze group, the body fluid balance in the maze group was comparable with that in the nonmaze group in the early postoperative period. The response of atrial natriuretic peptide secretion by exercise was significantly attenuated in the maze group (n = 12) compared with the nonmaze group (n = 9) even 2 years after surgery, although there were no significant differences in heart rate or blood pressure during exercise between two groups. CONCLUSIONS: These results suggest that the maze procedure attenuates atrial natriuretic peptide secretion in the early postoperative period and persists in chronic phase. This attenuated atrial natriuretic peptide secretion may reduce the ability of the kidneys to handle fluid load early after surgery.

Atrial Fibrillation↗

Effects of altered body fluid balance and high blood pressure on the plasma brain natriuretic peptide in rats.

The present study was aimed to investigate the regulatory mechanisms of BNP release. Effects of acute and chronic perturbations in body fluid balance, changes in BP, and regulatory roles of NO and endothelin systems on BNP release were examined in rats. Although acute extracellular volume expansion did not have significant effects on plasma BNP, prolonged high-salt intake increased plasma BNP levels. Plasma BNP levels were also higher in 2K1C rats compared with the control. Although infusion of L-NAME increased the plasma BNP in control, it did not further affect the plasma BNP in rats with high-salt intake. Although L-arginine (20 mg.kg-1 per min) per se did not have significant effects on plasma BNP, it blocked the stimulatory effect of L-NAME (200 micrograms.kg-1 per min). Plasma BNP was severalfold increased following a single injection of endothelin (0.3 micrograms/kg) in normal and high-salt intake groups, the magnitude of which was not significantly affected by the high-salt intake. Although indomethacin did not have significant effects on plasma BNP in normal rats, it blocked the stimulatory effect of 2K1C hypertension. It is concluded that BNP is regulated by chronic changes in body fluid balance and blood pressure. It is also suggested that endothelin and NO systems may directly regulate the secretion of BNP in vivo. An endogenous prostaglandin synthesis may be involved in the stimulated release of BNP in hypertension.

Animals↗

Salt consumption and body fluid balance during cold exposure in rats.

We investigated the effect of exposure to cold on salt consumption and the role of salt consumption on the maintenance of body fluid balance in male Wistar rats. The rats were provided with both tap water and NaCl solution ad lib during 16-h exposure to cold (10 degrees C) and normal (25 degrees C) air temperature conditions. The concentration of the NaCl solution was 0.9% for one group (0.9% NaCl group; n = 7) and 1.8% for the other (1.8% NaCl group; n = 6). At 10 degrees C, weight loss was greater than that at 25 degrees C, and fluid and Na balance were negative in the 0.9% NaCl group. However, the calculated Na concentration of the fluid consumed in the 0.9% NaCl group was about 135 mEq/l Na (0.8% NaCl) at both 10 degrees C and 25 degrees C. In the 1.8% NaCl group, the values indicating fluid and Na balance under both temperature conditions were similar, while the calculated concentration of Na in fluid consumed at 10 degrees C (187 mEq/l Na: 1.1% NaCl) was higher than that at 25 degrees C (153 mEq/l Na: 0.9% NaCl). These results suggest that the consumption of hypertonic NaCl solution indicating increased salt appetite during exposure to cold counteracts the loss of body fluid and Na via urine.

Acclimatization↗

Disorders of body fluid balance: a new look into the mechanisms of disease.

OBJECTIVE: To review the mechanisms of disease on the basis of dysfunction in body fluid distribution secondary to abnormalities in capillary permeability and plasma membrane transport disorders, leading to quantitative and qualitative alterations of the interstitial space, a mainly strategic compartment positioned between the microcirculation and cell mass. DATA SOURCES: The recent literature on the mechanisms involved in the control of body fluid balance, with special reference to microcirculation and interstitial compartment physiology, as well as published and unpublished original data from the authors laboratory. DATA EXTRACTION AND SYNTHESIS: To illustrate the importance of capillary permeability dysfunction in the development of disease, animal (rat and dog) models of chronic renal failure, acute diuretic-induced fluid depletion, diabetes mellitus, arterial hypertension and ischemia-reperfusion of the kidney were used in an attempt to show that in all these experimental models, basic capillary permeability dysfunction (measured by the extravasation of Evans blue, a marker of albumin leakage) develops in specific microcirculation beds. As a consequence, tissue edema (interstitial and/or cellular) develops and likely impairs the traffic of nutrients and waste products to and from the cellular mass, and/or challenges the microcirculation, leading to organ damage. Kidney dysfunction is measured by conventional clearance methods (renal hemodynamics and tubular function). In some models, the eventual mediators of vascular abnormality are examined by use of pharmacological tools. CONCLUSIONS: The critical role of microcirculation dysfunctions, in particular capillary permeability, resulting in interstitial compositional changes is presented as the basis of disease. The apparent specificity of target organ damage may represent the nonspecific result of physicochemical alteration in the strategic interstitial fluid compartment.

Angiotensin-Converting Enzyme Inhibitors↗