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PubMedDate not supplied

Fluid and electrolyte balance in the pediatric patient.

Maintaining adequate fluid and electrolyte balance is an important aspect of all patient care. The intravenous nurse's skill and expertise in starting and maintaining i.v. access is extremely vital to providing adequate fluids and electrolytes. Children and infants present unique problems in the management of fluid and electrolyte balance. Differences in rate of metabolism and body surface area are just two examples of special circumstances that affect diagnosis and management. An awareness of predisposing factors, early recognition of signs and symptoms that may be indicative of a developing problem, and knowledge of medical and nursing interventions help provide safe patient care. This article presents unique aspects of caring for infants and children, reviews important electrolytes, and discusses dehydration.

Child↗
PubMed2001

Importance of amino-acid and electrolyte balance in experimental diets used to determine the apparent metabolisable energy (AME) value of wheat.

1. An experiment was done with male, Ross broiler chicks to study the effect of diet composition and electrolyte balance on the measurement of diet AME and performance parameters in diets containing high levels of wheat inclusion. 2. The control diet (G) was based on wheat (667 g/kg) with full-fat soya, soyabean meal, Extrupro and herring meal providing the protein supplements. The experimental treatments were based on 2 diets, one based on wheat (790 g/kg) with casein as the protein supplement and the other containing 667 g/kg wheat plus casein, cellulose and starch. Each of these was formulated to contain one of three concentrations of sodium and potassium bicarbonate giving final values for dietary electrolyte balance of approximately 90, 180 and 280 meq/kg diet. 3. DM intake was numerically lower with the lower level of wheat inclusion and LWG (P < 0.05) and gain:food (P < 0.001) were reduced. ME:GE was similar for the two levels of wheat/casein but higher (P < 0.001) than for the control diet. 4. The two higher electrolyte balances improved DM intake (P < 0.01), LWG and gain:food (P < 0.01) compared with the diets containing no added bicarbonate. ME:GE was unaffected by electrolyte inclusion. 5. Viscosity of ileal digesta supernatant fell (P < 0.01) with increasing bicarbonate inclusion but the value for the highest electrolyte level was still higher than for the control diet. 6. It is concluded that addition of both arginine and electrolyte is needed with a wheat/casein diet to improve performance to levels seen with a more commercial diet but that the determination of diet AME, with the type of fat addition used in this study, is unaffected by electrolyte balance. The interaction between electrolyte balance and in vivo viscosity requires further study.

Amino Acids↗
PubMedDate not supplied

Short-term effects of human orthotopic heart transplantation on hormones regulating fluid and electrolyte balance.

Hormonal regulation of fluid and electrolyte homeostasis and blood pressure is under the auspices of three organs: the heart, the brain, and the kidneys. Their regulatory roles are fulfilled by the actions of atrial natriuretic peptide (ANP), vasopressin, and the renin-angiotensin-aldosterone system (RAAS), respectively. The aim of this study was to appreciate the short-term effects of orthotopic human heart transplantation on the release of these hormones. Alpha-ANP, renin, aldosterone, and vasopressin serum levels were assessed by radioimmunoassay before and during the 10 days after grafting in a series of 10 patients. On day 1, alpha-ANP levels dropped from 42.4 +/- 6.5 to 25.1 +/- 2.2 fmol/ml before returning to levels comparable with those found before transplantation. This decrease in alpha-ANP levels was associated with a peak in vasopressin and aldosterone levels. With the exception of the peak in vasopressin levels seen on day 1, preoperative and postoperative levels of this hormone were near normal. Increased preoperative renin levels dropped significantly as of day 5 (from 268 +/- 99 to 122 +/- 66 ng/L). This decrease was related to improved patient hemodynamic status. No significant correlation was found between the changes in alpha-ANP levels, RAAS or vasopressin levels, patient hemodynamic status, or administered drugs. In conclusion, grafted heart tissue was capable of high alpha-ANP release early on. The drop in alpha-ANP serum levels, compared with the peaks in vasopressin and aldosterone on day 1, might have been caused by the ability of the graft to play a role in the hormonal regulation of fluid and electrolyte balance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMedDate not supplied

[The effect of GABA-ergic agents on the electrolyte balance under hypokinesia].

The effect of hypokinesia on the blood electrolyte balance was studied. In restricted motor activity marked deviations of the type of hypokalemia and hypercalcemia were encountered, which could promote the development of various pathological processes, including disorder of central and regional hemodynamics. GABA and piracetam had no effect on the blood serum electrolyte content in the early periods of hypokinesia. In later periods of hypokinesia both drugs under examination corrected the disorders of blood electrolyte balance induced by prolonged restriction of motor activity.

Animals↗
PubMed1991

Feasibility of outpatient electrolyte balance studies.

Clinical studies requiring controlled electrolyte balance have traditionally been conducted in an inpatient (IP), metabolic ward setting. The purpose of this study was to test the feasibility of performing such studies in an outpatient (OP) clinical research setting. Focusing on sodium (Na) and potassium (K) balance, we retrospectively compared 28 subjects studied as OP vs 25 studied as IP on our metabolic ward. We assessed their adherence to our metabolic diets and their compliance with serial 24-hr urine collections. Dietary compliance was assessed by checksheet and urinary Na excretion; urine collection accuracy was determined by serial 24-hr creatinine excretion. The diets for both studies contained a low Na phase (10 mEq) and a high Na phase (200 mEq for IP and 250 mEq for OP), each lasting 1 week. When in balance on the low Na diet, 24-hr Na excretion was 4.6 +/- 0.7 mEq for OP and 13.4 +/- 2.2 mEq for IP, indicating excellent compliance with the low salt diet. Na excretion on the high Na diet was 184.5 +/- 7.4 mEq for OP and 195.3 +/- 9.6 mEq for IP. These values were not significantly different from each other; however, the OP were significantly less than their diet of 250 mEq Na (p less than 0.05). This difference may have been due to dermal Na losses. K excretion was also similar in the two groups. There was no significant difference in the reproducibility of individual multiple urinary creatinine measurements in OP vs IP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Water and electrolyte balance after ileoanal anastomosis.

Water and electrolyte balance was studied in 30 patients with ileoanal anastomosis and J pouch, 10 patients with conventional ileostomy, and nine nonoperated patients with quiescent ulcerative colitis. Serum electrolyte concentrations, daily urinary volume, and daily losses of sodium, potassium, and chloride were measured in all patients. Daily fecal weight and daily losses of sodium and potassium were analyzed in patients with ileoanal anastomosis or conventional ileostomy. Serum chloride in patients with ileoanal anastomosis was significantly lower (P less than 0.05) than in those with conventional ileostomy or in nonoperated patients. Daily urinary loss of sodium in nonoperated patients was significantly higher than in patients with ileoanal anastomosis (P less than 0.01) or conventional ileostomy (P less than 0.05). Daily urinary loss of chloride in patients with ileoanal anastomosis was significantly lower (P less than 0.05) than in nonoperated patients. Daily fecal loss of potassium in patients with ileoanal anastomosis was significantly higher (P less than 0.05) than in those with conventional ileostomy. Daily urinary volume and fecal weight did not differ significantly in patients with ileoanal anastomosis or conventional ileostomy. The present study indicates that changes in water and sodium balance after ileoanal anastomosis are similar to those after conventional ileostomy but chloride balance is more altered after ileoanal anastomosis.

Adult↗
PubMed1988

Influence of dietary electrolyte balance, source of added potassium and anticoccidial agents on the performance of male broilers.

1. The performance of 1680 male broiler chickens was measured from one to 42 d of age. They were given diets with three (125, 165 and 205 mEq/kg) electrolyte balances (sodium + potassium - chloride), two sources of added potassium (carbonate or sulphate) and two anticoccidial agents (90 mg/kg of either monensin or lasalocid). 2. The dietary treatments had no significant effects on the growth performance of broiler chickens in the starter phase. 3. In the finisher phase, the chickens given the diets containing lasalocid utilised food less efficiently that those given the diets containing monensin. 4. There were significant interactions between dietary electrolyte balance and source of added potassium on body weight gains and food:gain ratios in the finisher phase. In diets with an electrolyte balance of 205 mEq/kg, the inclusion of potassium sulphate instead of potassium carbonate increased body weight gains by 3.4% and reduced food:gain ratios by 4.6%. 5. The body weight gains of chickens given the finisher diets containing lasalocid and added potassium carbonate were reduced by 2.6% compared to those of chickens given the diets containing monensin or added potassium sulphate. 6. The litter moisture content was higher in pens with chickens on the diets with an electrolyte balance of 205 mEq/kg than on the diets with either 125 or 165 mEq/kg. Both lasalocid and potassium sulphate tended to increase the litter moisture content. 7. It may be concluded that the inclusion of 90 mg/kg of either monensin or lasalocid in broiler diets does not alter the balance of electrolytes required for optimum growth performance of broiler chickens.

Animals↗
PubMed1990

Disturbance of the water and electrolyte balance during high-dose interferon treatment.

Ten patients with amyotrophic lateral sclerosis were treated during 5 consecutive days with intravenous infusion of high-dose human leukocyte interferon-alpha (IFN-alpha) or placebo in a single-blinded randomized trial. To assess the effect of IFN on the water and electrolyte balance, serum electrolytes, creatinine, and antidiuretic hormone as well as urine excretion of electrolytes, aldosterone, and cortisol were measured before the trial and during the fourth day of IFN infusion. Compared with placebo the results showed a significant reduction of the mean serum calcium level (from 2.28 +/- 0.03 mmole/liter to 2.01 +/- 0.06 mmole/liter; p less than 0.01), that of the mean serum osmolality (from 296 +/- 9.9 mosm/kgH2O to 281 +/- 2.5 mosm/kgH2O; p less than 0.05) and that of the mean urinary excretion of magnesium (from 5.32 +/- 2.04 mmoles/liter to 2.65 +/- 1.68 mmoles/liter; p less than 0.05). Careful observation of water and electrolyte balance is emphasized during high-dose IFN treatment.

Amyotrophic Lateral Sclerosis↗
PubMed1986

Effect of dietary phosphorus concentration and electrolyte balance on the growth performance of broiler chickens.

The performance of 1680 male and female broiler chickens given diets with either a low (4.7-4.3 g/kg) or high (8.9-8.2 g/kg) content of inorganic phosphorus and four (150, 200, 250 and 300 mEq/kg) electrolyte balances (Na+K-Cl) was measured from 1-d-old to 49 d of age. Diets with the higher concentration of inorganic phosphorus reduced body weight gains in the starter (P less than 0.01) and finisher (P less than 0.05) phases but the efficiency of food utilisation was reduced only in the starter phase (P less than 0.05). The reduction in body weight gain was greater in males than in females. The growth depression caused by the higher concentration of inorganic phosphorus in the finisher diets was partially alleviated by increasing the electrolyte balance to either 250 or 300 mEq/kg diet. The higher concentration of inorganic phosphorus significantly reduced the dressing percentage and increased the abdominal fat pad weight and litter moisture content. Electrolyte balance had no significant effects on efficiency of food utilisation, abdominal fat pad weights or litter moisture content. Neither the dietary concentration of phosphorus nor the electrolyte balance had a significant effect on mortality or ash content of the tibia.

Animal Nutritional Physiological Phenomena↗
PubMed2002

The effects of prolonged physical exercise on renal function, electrolyte balance and muscle cell breakdown.

BACKGROUND: Postexercise proteinuria, hematuria and changes in serum electrolyte balance as well as increased levels of plasma indicators for muscle leakage are believed to be transient and of benign character. METHODS: A group of 51 healthy athletes took part in a 100 km race over 14.25 hours. All of them had to reach the finish together. Urine and blood samples were collected before (a) and immediately after running (b) as well as 6 hours after the race (c). RESULTS: The serum concentrations of potassium (4.8 +/- 0.5 (a) vs. 4.0 +/- 0.3 (c) mmol/l), protein (73.1 +/- 5.2 (a) vs. 71.1 +/- 3.9 (c) g/l) and albumin (44.0 +/- 2.85 (a) vs. 42.9 +/- 2.8 (c) g/l) decreased significantly (p < 0.0001, p < 0.05, p < 0.05, respectively) but remained within physiological ranges. The serum sodium concentration decreased immediately after the race (136.9 +/- 4.5 (a) vs. 131.1 +/- 2.4 (b) micromol/l, p < 0.0001). The fractional sodium excretion decreased 6 hours, but not immediately after the race (0.78 +/- 0.59 (a) vs. 0.48 +/- 0.82 (c), p < 0.05). Myoglobin (31.8 +/- 6.9 (a), 291.5 +/- 197.2 (b) and 182.2 +/- 135.3 (c) microg/l, p < 0.0001) and creatine kinase (1.13 +/- 0.45 (a), 10.76 +/- 6.9 (b) and 9.46 +/- 15.5 (c) pmol/l, p < 0.0001) increased dramatically. Troponin I was also significantly increased at finish (0.0186 +/- 0.0121 (a) vs. 0.0213 +/- 0.0165 (b) ng/ml, p < 0.05) and positively correlated with myoglobin and creatine kinase, but remained far below the pathologic range. Serum creatinine and urea remained almost unchanged. Glucosuria and hematuria occurred 6 hours after the run in 9.1% and 6.8%, respectively. The erythrocytes examined by phase-contrast microscopy were not damaged in terms of dysmorphic cells. Glomerular-type proteinuria was found in 11.4% of the participants 6 hours after the race. CONCLUSIONS: We conclude that long lasting, mild exertion is harmless for renal function, electrolyte balance and skeletal muscle as well as myocardial metabolism in healthy persons.

Adult↗