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PubMed1992

Effects of head-down tilt and saline loading on body weight, fluid, and electrolyte homeostasis in man.

We studied the effects of head-down tilt bedrest (HDT) on body weight, fluid and sodium homeostasis. A fluid load session with rapid intravenous infusion of 22 ml/kg body weight (BW) isotonic saline was performed before, during and after HDT. During the pre- and post HDT periods the test subjects were given a diet containing 2600 kcal/day. The energy intake was reduced to 2000 kcal/day during HDT. Water intake was kept constant at 40 ml/kg BW, sodium intake was 2.2 mmol/kg BW and protein intake was 1.4 g/kg BW, while the daily fat and carbohydrate intake was reduced during the HDT period. As expected plasma volume and BW changed rapidly in the beginning of HDT and during early recovery. A total body water loss of 0.6 l was observed within the second day after tilting. Plasma volume was reduced by 16% during HDT-bedrest. The time course of the body fluid loss paralleled a decrease in body sodium that then remained fairly constant during the HDT-bedrest period (except for the interference caused by the fluid loading on day S06). A restoration of body fluid and body sodium content occurred early in the recovery period. Fluid loading caused a negative fluid balance of 0.6-0.9 l over a 48 hr period following infusion regardless of the phase of the HDT study. These results demonstrate that under our strictly controlled conditions 1) HDT alters body fluid and sodium balances, 2) a standard fluid loading causes a net negative 3-day fluid balance during all phases of the study.

Adult↗
PubMed1978

[The treatment of acute dehydration (author's transl)].

In infants and children acute dehydration is mainly caused by gastroenteritis with vomiting and diarrhoea, and by feeding failures. Since in the German speaking literature very different therapeutic regimens for rehydration are discussed the principles of oral and parenteral treatment are described. The rational therapy is based on the knowledge of physiology and pathophysiology of water and electrolyte metabolism. Therefore a few basic aspects are described, i.e. compartments of body fluids, turnover rates, the balance, types of dehydration, concentration of electrolytes in body fluids and their relevance to dehydration. Special problems exist in the treatment of hypertonic dehydration. In order to avoid cerebral edema the rehydration should not be attempted quickly with very hypotonic salt solutions, but should be performed with a 1/2--1/3 isotonic Ringer-lactate solution and early begin of potassium substitution over a period of 48 h.

Acute Disease↗