[Use of a balanced electrolytic solution in heart surgery with extracorporeal circulation].
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Blood Proteins↗
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[Studies on the pathogenesis and therapy of experimental hypertension in rats. I. Blood pressure, water balance, electrolyte excretion].
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Animals↗
The influence of tryptophan and its metabolites upon rabbit lens electrolyte balance.
The effect of tryptophan and three major metabolites of tryptophan on the rabbit lens electrolyte balance was examined. Even at 3 x 10(-3) M tryptophan, tryptamine and xanthurenic acid had no effect on lens sodium, potassium and calcium content after a 20 hr incubation. Small but significant changes in lens sodium and potassium content were induced by 20 hr incubation in 2 x 10(-3) M 3-hydroxy-DL-kynurenine and 10(-3) M hydroxyanthranilic acid. Lens Na, K-ATPase activity was unaffected by 3 x 10(-3) M tryptophan. Tryptamine reduced, to a small extent, Na,K-ATPase activity at 3 x 10(-3) M, but was without effect at 10(-3) M. 3-hydroxy-DL-kynurenine (2 x 10(-3) M) and 3-hydroxyanthranilic acid (10(-3) M) inhibited Na,K-ATPase activity by 27% and 30% respectively. Only 3-hydroxy-DL-kynurenine had a demonstrable effect on 86Rb uptake. It is concluded that, in contrast to findings in the amphibian lens, metabolites of tryptophan have minimal or no detrimental effects upon rabbit lens electrolyte balance under the in vitro conditions of these experiments. However, this does not rule out a long term effect of these compounds should they accumulate in the lens.
Adenosine Triphosphatases↗
Acid-base and electrolyte balance in urinary intestinal orthotopic reservoir: ileocecal neobladder compared with ileal neobladder.
OBJECTIVES: To compare acid-base and electrolyte balance in ileocecal and ileal neobladders. METHODS: Acid-base and electrolyte balance were studied in 45 patients with an ileocecourethrostomy and 18 patients with an ileal reservoir. The mean follow-up was 51 months. Results were compared with regard to both the type of operation and the time since surgery. RESULTS: No significant differences were found with regard to either the type of operation or the length of follow-up. A preserved renal function is important in maintaining a healthy status. CONCLUSIONS: The use of 35 to 40 cm of ileum or 10 cm of cecum with the ileocecal junction seems to be safe even after a long follow-up. The length rather than the kind of bowel used for bladder replacement appears to be important in safeguarding hydroelectrolyte and acid-base homeostasis. This is particularly true in the presence of preserved renal function.
Acid-Base Equilibrium↗
Mesenteric microcirculatory changes in nonlethal hemorrhagic shock: the role of resuscitation with balanced electrolyte or hypertonic saline/dextran.
Class I and II hemorrhage has been routinely treated clinically with 2-2.5 times the volume of shed blood as balanced electrolyte solution. Although this regimen has been shown to adequately restore arterial pressure in trauma patients, it is not clear that it uniformly restores regional perfusion. Since it is becoming apparent that the gut plays a major role in the development of the posttraumatic septic state, we studied the effects of graded doses of balanced electrolyte resuscitation on the mesenteric microcirculation. Regimens consisting of one (1 x LR), two (2 x LR), or three (3 x LR) times the volume of shed blood as lactated Ringer's (LR) solution or 7.5% hypertonic saline and 6% dextran (HSD) equal to one seventh the volume of shed blood were given to groups of anesthetized (urethane-chloralose) male Sprague-Dawley rats after 30 minutes of hemorrhage to 50% of baseline mean arterial blood pressure. The microcirculation of the distal ileum was observed using an in vivo video microscope. Mean arterial pressure and ileal A1 diameters returned to baseline values with HSD within 20 minutes following this moderate hemorrhage. Additionally, A1 diameters returned to baseline in the 2 x LR and 3 x LR groups. A1 vessels remained significantly constricted in the 1 x LR group. Mean arterial pressure remained significantly lower than the baseline value in all of the LR groups. We conclude that in this model, HSD is superior to LR for restoration of blood pressure. In restoring A1 diameters, LR is equivalent to HSD only when volumes of balanced electrolyte two and three times shed blood volume are given.
Animals↗
Treatment of alternated water-electrolyte balance and endocrine status after removal of craniopharyngioma in adults.
BACKGROUND: Water-electrolyte disturbance and endocrine alterations are common complications of adult patients with craniopharygioma in the postoperative period and may affect their recovery and prognosis. Some of these complications even lead to death. Appropriate remedy based upon the status of water-electrolyte balance and the endocrine system is essential to good therapeutic results of adult patients with craniopharyngioma. METHODS: The alterations in water-electrolyte balance (117 patients) and endocrine status (42) of adult patients with craniopharyngioma after surgery were analyzed retrospectively. RESULTS: Most patients with craniopharyngioma experienced postoperative water-electrolyte disturbances and hypotonic dehydration. Moreover, the incidences of hypothyroidism and hypoadrenocorticism were relatively high. CONCLUSION: It is critical to deal with dehydration and endocrine disorders for a sound outcome of craniopharyngioma surgery.
Adolescent↗
Effect of large volume replacement with balanced electrolyte solutions on extravascular lung water in surgical patients with sepsis syndrome.
We investigated the effect of large volume replacement with balanced electrolyte solutions on extravascular lung water (EVLW) in 16 adult surgical patients with sepsis syndrome. Patients entered the study within the 24 h period following surgical interventions for acute necrotizing pancreatitis, intra-abdominal abscesses, and/or peritonitis. Sequential measurements (n = 108) were made at intervals of 6-12 h over a 48 h period. There were no significant differences between initial and final values of thermal-dye EVLW (5.0 +/- 1.1 vs. 5.7 +/- 1.1 ml/kg), plasma colloid osmotic pressure (COP, 13.3 +/- 2.5 vs. 13.2 +/- 2.9 mmHg), pulmonary artery wedge pressure (PAWP, 9.2 +/- 3.0 vs. 10.8 +/- 3.0 mmHg), and COP-PAWP gradient (4.0 +/- 3.5 vs. 2.4 +/- 3.9 mmHg). All results expressed as (mean +/- SD). The EVLW did not correlate with plasma COP, PAWP, or COP-PAWP gradient. We conclude that large volume replacement with balanced electrolyte solutions with the secondary decrease in plasma COP and COP-PAWP gradient do not necessarily contribute to a substantial increase in EVLW. This study fails to show any causal relationship between decrease in plasma COP or COP-PAWP gradient and oedema formation in the lung.
Adult↗
Acid-base and electrolyte balance in infants of diabetic mothers. Vaginal delivery versus caesarean section.
The acid-base and electrolyte balance of 30 women studied at delivery and in their infants during the first 48 h. 18 women were diabetics, 10 of these were delivered vaginally (DMvag) and 8 by elective caesarean section (DMcs). 12 healthy women were vaginally delivered (HMvag). The infants of diabetic mothers (IDM) received active infusion therapy. At birth the DMvag and their infants (IDMvag) had a more pronounced metabolic acidosis than the DMcs and their babies (IDMcs). The largest metabolic acidosis occurred, however, in the group of HMvag and their infants (IHMvag). After birth no significant differences were obtained in the acid-base and electrolyte balance between IDMvag and IDMcs. The plasma potassium level remained lower in IDM than in IHM. The study stress the importance of adequate management of diabetes in pregnancy in combination with active intravenous therapy during delivery and to the infant in the immediate neonatal period. The slightly larger metabolic acidosis seen in combination with vaginal delivery suggests that this mode of delivery should not be attempted uncritically in diabetic women.
Acid-Base Equilibrium↗
Water and electrolyte balance after ileal J pouch-anal anastomosis in ulcerative colitis and familial adenomatous polyposis.
The water and electrolyte balance was studied in 31 patients with ulcerative colitis (UC) and 22 with familial adenomatous polyposis (FAP) who underwent staged surgery involving colectomy and ileal J pouch-anal anastomosis (IAA), preoperatively, after terminal ileostomy, after high ileostomy, and after ileostomy closure. Serum electrolytes did not differ between each surgical stage. After terminal or high ileostomy, daily urine volume and urinary sodium loss was significantly lower, and daily fecal weight and fecal sodium loss was significantly higher than preoperatively. After ileostomy closure, urinary and fecal sodium loss became closer to preoperative value. Daily urinary potassium loss was significantly higher and fecal loss was lower after terminal and high ileostomy than preoperatively and did not show a significant change after ileostomy closure. The urinary sodium to potassium ratio after ileostomy closure was lower than preoperatively, but was higher than that after terminal and high ileostomy. Plasma aldosterone and renin levels were only significantly increased after high ileostomy. These findings indicate that high or terminal ileostomy caused chronic dehydration, which was compensated for by activation of the renin-aldosterone axis, while the water and electrolyte balance became closer to normal after ileostomy closure following ileoanal anastomosis.
Adenomatous Polyposis Coli↗
Pediatric fluid and electrolyte balance: critical care case studies.
The care of the critically ill infant or child often is complicated further by disruptions in fluid or electrolyte balance. Prompt recognition of these disruptions is essential to the care of these patients. This article provides an overview of the principles of fluid and electrolyte balance in the critically ill infant and child. Imbalances in fluid homeostasis and imbalances in sodium, potassium, and calcium homeostasis are presented in a case study format.
Adolescent↗
Electrolyte balance in gastrointestinal disease.
Even small losses of gastrointestinal secretions when combined with reduced intake of electrolytes may seriously disturb electrolyte balance. Knowledge of the ionic composition of secretions lost is essential in planning therapy. Loss of gastric contents usually results in excessive loss of chloride; in achlorhydria this is not the case. Loss of sodium and potassium may be large in either case and is often underestimated. Small bowel obstruction results in a more balanced loss of electrolyte which may not affect acidbase balance greatly. In diarrhea loss of base predominates, and may result in a large potassium deficit. Steatorrhea due to nontropical sprue results in large fecal losses of sodium, potassium and chloride, in addition to the large calcium and phosphorus loss. In chronic peptic ulcer excessive ingestion of milk and absorbable alkalies may result in hypercalcemia, azotemia and alkalosis, without hypercalciuria. Since renal function is usually adequate in the milder gastrointestinal disturbances, electrolyte and fluid replacement should be started early, and can be guided by generally available laboratory tests, the carbon dioxide combining power and serum chloride levels, provided the predominate ionic loss is known and potassium deficiency remedied. If this is done, development of serious fluid and electrolyte deficits can usually be prevented.
Alkalosis↗
The effect of various diet nutrient densities and electrolyte balances on sow and litter performance during two seasons of the year.
An experiment involving 289 farrowings during a 2-yr period was conducted to determine the effect of increasing dietary nutrient concentration, electrolyte balance, and season of the year on the lactational performance of sows. Experimental diets were corn-soybean meal-based. The basal diet was formulated to meet or exceed the NRC requirements and the high-nutrient diet was formulated to contain approximately 20% higher levels of the nutrients than the basal diet, with or without adjustment of the electrolyte balance (Na+K-Cl) to 250 mEq/kg. Experimental diets were fed in both the warm (May through October) and cool (November through April) seasons of the year, resulting in a 2 x 2 x 2 factorial arrangement of treatments. There were no season x treatment interactions for any of the indices measured. During the first 21 d of lactation, sows farrowing in the cool season consumed more feed (P < .001) and produced heavier (P < .001) pig weights and litter weight gains than sows farrowing in the warm season. Increasing nutrient density from 100 to 120% of the NRC requirements resulted in decreased (P < .05) daily feed consumption, but it increased (P < .001) daily CP and GE intake, 21-d pig weights, and litter weight gains. Adjusting the dietary electrolyte balance from normal (130 mEq/kg) to 250 mEq/kg tended to increase (P < .07) 21-d pig weights, but it had no effect on other indices measured. These data indicate that under the environmental and management conditions of this experiment, the nutrient requirements of the lactating sow are higher than the current NRC standards.
Animal Feed↗
Water and electrolyte balance in subjects with a permanent ileostomy.
Water and electrolyte balance has been studied in 39 patients with a permanent ileostomy, who had had a proctocolectomy for ulcerative colitis. The findings have been compared with those in 39 healthy subjects who were matched for age and sex. The ileostomists were found to lose excessive quantities of water and sodium in the ileostomy effluent compared with the corresponding losses in normal faeces. The mean plasma total protein and albumin concentrations were increased in the ileostomists suggesting a state of chronic dehydration. The daily urinary output of sodium was low and the output of potassium was high. The urinary pH was low. The ileostomists had raised mean concentration of aldosterone in the plasma (p less than 0.001) and it is suggested that this is responsible for the body's partial compensation for the depletion of sodium and water, including the so-called ileostomy adaptation.
Albumins↗
[Effect of ebrantil, a new antihypertensive agent, on lipid metabolism and electrolyte balance].
The influence of Ebrantil on serum electrolytes, lipids, and lipoproteins was studied in 8 normotensives and 10 hypertensives. For this purpose, Ebrantil sustained-release capsules were administered after a 7-10 day diet phase concomitantly with the diet for a period of 2 weeks. Before and after the diet phase, as well as subsequent to the treatment period, laboratory parameters were determined in fasting blood. The serum levels of sodium, potassium, calcium, and magnesium were identical at all measuring times. The concentrations of triglycerides, phospholipids, total cholesterol, VLDL-, LDL-, HDL-cholesterol, and of the apolipoproteins AI, AII and B measured in all patients at the end of the treatment period deviated only slightly from those determined in the diet phase. The mean value for the arteriosclerosis index LDL/HDL decreases significantly during treatment. The results reveal that Ebrantil has no negative influence on electrolyte balance and lipometabolism.
Adult↗
[Acid-base state and the electrolyte balance of young infants in the immediate postoperative period after radical correction of an interventricular septal defect under artificial circulation].
Acid-base equilibrium and electrolyte balance were studied in 80 infants in the immediate postoperative period after surgery for ventricular septal defect under conditions of extracorporeal circulation. Decompensated metabolic alkalosis was the most characteristic disorder of acid-base equillibrium in patients with an uncomplicated postoperative period, whereas decompensated respiratory alkalosis and metabolic acidosis were characteristic of patients with compensated and decompensated forms of cardiac insufficiency. Plasma hypokaliemia and hypochloremia attended by intracellular retention of sodium were typical disorders of the electrolyte balance in all forms of changes in the acid-base equilibrium.
Acid-Base Equilibrium↗
Fluid-electrolyte balance during labor and exercise: concepts and misconceptions.
Body water and electrolyte balance are essential to optimal physiological function and health. During exercise, work, or high temperatures, a significant level of dehydration can develop, and the ratio of extracellular to intracellular fluid can change, despite an ample supply of water. Physical and cognitive performance are impaired at 1-2% dehydration, and the body can collapse when water loss approaches 7%. Because fluid needs and intakes vary, formulating one general guideline for fluid replacement is difficult. Knowing the amount of water lost in sweat may enable predicting fluid needs via mathematical models for industrial, athletic, and military scenarios. Sodium imbalance might result from excessive Na+ loss or from gross overhydration. In most work or exercise lasting < 3-4 hr, the major concern is that fluid be available to prevent heat-related illnesses, which can be prevented if fluid and electrolyte losses are balanced with intake, using the recommendations presented.
Adult↗
Metabolic acidosis and changes in water and electrolyte balance after maximal exercise.
The purpose of this investigation was to study lactate production and the consequent changes in acid-base status, and in water and electrolyte balance, in response to 1 min of maximal exercise in sprint- and endurance-trained subjects. So far, the results from only two subjects (one sprinter and one marathon runner) have been analysed. The rate of lactate production was higher in the sprinter than in the marathon runner, as shown by peak blood lactate concentrations of 20.8 and 13.3 mM for the two subjects, respectively. Arterial blood pH fell from 7.43 to 7.14 in the sprinter and from 7.44 to 7.23 for the marathon runner. The metabolic acidosis was partly compensated for by a lowering of arterial CO2 tension by 0.0775 kPa per 1 mM drop in base excess. In each subject large changes in water and electrolyte balance occurred. Haematocrit increased dramatically in both subjects, and the calculated decrease in plasma volume was 20% for the marathon runner and 30% for the sprinter. In each subject sodium was removed from the circulation in amounts sufficient to keep the plasma sodium concentration constant. Plasma potassium concentration was unrelated to the state of acidosis, being 2.5 mM above the resting concentration immediately after maximal exercise, and dropping by 3 mM in the subsequent 2-3 min of recovery during prevailing acidosis. The degree of lactic acidosis was large in both subjects, although more severe in the sprinter than in the endurance runner. However, buffer capacity and compensatory mechanisms were largely similar in both subjects.
Acidosis↗