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PubMed1993

The effects of acute altitude exposure in Swiss highlanders and lowlanders.

The functional characteristics at rest in responding to stepwise acute exposure to simulated altitude (6000 m) were compared in 10 acclimatized mountaineers (highlanders), residents of Zermatt (1616 m) working at an altitude up to about 4000 m, and in 11 nonacclimatized control subjects (lowlanders) living and working in Zurich (450 m). In comparison with the lowlanders, the highlanders showed at altitude significantly greater hyperventilation, lower heart rate and systolic blood pressure, smaller haemoconcentration, lower urodilatin secretion and natriuresis, and a preserved neuropsychological ability (attentiveness) and vasomotor tone (diastolic blood pressure); the critical altitude at which hypoxic short-term adaptation became insufficient was 6000 m. The lowlanders, however, manifested reduced tolerance of hypoxia, i.e. insufficient short-term adjustment with subjective and objective distress coinciding with the first signs of hypoxia of the central nervous system, already apparent at and above 4000 m. It was concluded that the functional differences between highlanders and lowlanders in responding to acute gradual hypoxia indicated factors contributing to altitude acclimatization.

Acclimatization↗
PubMed1980

[Evaluation and treatment of hyponatremia (author's transl)].

In all patients with hyponatremia, an etiologic diagnosis must be made. A diagnostic classification of hyponatremic states is proposed, which is based on extracellular fluid volume status. A spot urinary sodium concentration will be helpful in confirming the diagnosis. Treatment should concentrate on correction of etiologic factors and fluid restriction after any extracellular fluid volume depletion is treated. A regimen of rapid correction of hyponatremia is outlined for serious, symptomatic cases. It consists of diuretic induced diuresis, accompanied by hypertonic sodium replacement of urinary losses. Finally, the usefulness of demeclocycline hydrochloride is characterized.

Furosemide↗
PubMed1992

Constant K+/Na+ excretion ratio during peak diuresis after piretanide but insignificant K+ loss during 24 hours.

The effect of piretanide on Na+ and K+ excretion and on renal haemodynamics has been studied in 14 subjects with a GFR (Inulin clearance) ranging from 140 to 2 ml.min-1. After a two day fluid and salt balance control period, oral piretanide 6 mg induced a natriuresis and kaliuresis, which was proportional to the GFR of the patients. The ratio of drug-induced K+ to Na+ excretion was always 0.13, independent of individual GFR. This was only true for the duration of the action of piretanide, tau, which was 6 h in subjects with normal GFR and 5 h in patients with impaired kidney function. Surprisingly, after tau, i.e. for 24 h after drug administration, less potassium was lost than in the pretreatment period. Neither the GFR nor the renal blood flow (PAH clearance) of the patients were affected by piretanide. In conclusion, piretanide given once a day was an effective natriuretic agent, even in end-stage renal disease, and it produced relatively little K(+)-loss when given once daily.

Adult↗