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PubMed1981

Acupuncture and homeostasis: physiological, physical (postural) and psychological.

When the subject of homeostasis is discussed, one automatically thinks of physiological homeostasis, in particular such things as fluid and electrolyte balance, and the maintenance of body temperature, blood pressure and blood sugar, etc. In fact, two other concepts of homeostasis exist in the literature, namely physical or postural homeostasis, and also psychological homeostasis. The former applies to the situation where the line of gravity of the body in the erect posture passes in the frontal or coronal plane directly through the center of the axis of the atlanto-occipital, shoulder, hip, knee and ankle joints. Only a very small proportion of people attain this ideal balanced posture. Psychological homeostasis refers to emotional control or tranquility. It has been stated that the biological function of human emotion is primarily homeostatic. Repression is a homeostatic mechanism. Evidence is presented to show that a feedback type of relationship probably exists between these forms of homeostasis, and any of the body-mind type of therapies (including acupuncture and T'ai chi ch'uan) thus have a three-fold effect on man, i.e. on his physiology, his posture and his mind.

Acupuncture Therapy↗
PubMedDate not supplied

[Status of water-electrolyte homeostasis and the systems of hormonal regulation during 237-day space flight].

On mission days 216-219 two crewmembers collected urine and recorded their food and water consumption during three days on end. The cosmonaut-physician withdrew blood samples from the vein and finger. In addition, he made venipuncture to himself and drew blood. Urine and blood samples were frozen and returned to the ground for analysis. In spite of individual variations of each cosmonaut, they all showed a trend for water and sodium retention which was provided by adequate hormonal rearrangement, i. e. increased production of ADH and aldosterone. No disorders in calcium and phosphorus metabolism were seen. Immediately postflight the cosmonauts displayed typical changes in fluid-electrolyte balance and renal function that suggested body dehydration and adjustment to Earth's gravity.

11-Hydroxycorticosteroids↗
PubMed1986

A continuous hemofiltration system using sorbents for hemofiltrate regeneration.

Plasma ultrafiltrate obtained by glomerular filtration undergoes tubular modification which leads to the elimination of toxic substances, excess water and electrolytes, and consequently maintains homeostasis. Using normal urine and the substances it contains as a reference, we have developed a wearable device capable of replacing both the renal excretion function and maintaining fluid and electrolyte equilibrium in uremics within acceptable biological limits. Our device includes a hemofilter allowing continuous plasma ultrafiltration and sorbents obtained from a Redy sorbent cartridge to treat 85% of the ultrafiltrate, whereas 15% of this UF is rejected untreated. After calculating the quantity of ultrafiltrate (about 13 l) containing an amount of waste products of metabolism equivalent to 24-h urine elimination, we determined in vitro the amount of sorbent required to eliminate these waste products from the ultrafiltrate (e.g., 20 g of urea/day) and we have evaluated the quantities of other substances which must be replaced using a tailored diet. This extra-corporeal detoxification process was used in a uremic patient who had been on traditional hemodialysis for the past two years. The continuous treatment permitted maintenance of fluid and electrolyte equilibrium at the desired level and allowed rapid improvement of patient clinical status: elimination uf nausea, vomiting, diarrhea and edema, which had previously reappeared during the interdialytic periods, as well as a rapid decrease in heart size as ascites disappeared. In addition, the patient regained sexual drive and the ability to have an erection. In conclusion, traditional hemodialysis and hemofiltration techniques allow intermittent elimination of products retained by the body and reestablish nearly normal fluid and electrolyte balance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adsorption↗
PubMed1996

[Sports and measurement of components in urine--responses of renal blood flow, electrolytes and hormones and of excretion of proteins into urine to exercise].

Renal blood flow decreased depending on the increase in exercise intensity. The kidneys may have roles to conserve the electrolytes and body fluid, and maintenance of acid-base balance during and after severe exercise. Increases in plasma hormones involved in the regulation of electrolyte-water balance, and decreases in urine flow, Na, Cl and K excretions into urine were observed following moderate exercise under a warm environment. Inhibition of electrolytes and water excretion into urine following exercise in water was less than that following exercise on land. Exercise in water is good for patients with hypertension, obesity and a mild renal disease who have tendency to conserve sodium and/or water. Increase in urinary albumin excretion, glomerular-type proteinuria was observed after moderate exercise (50 approximately 75%HRmax) in the obese individuals who had higher levels of hematocrit, serum concentrations of triglyceride, total cholesterol, LDL-cho, apoprotein B, CIII, and fasting insulin. The findings suggest that moderate exercise causes a latent abnormality of renal glomerular basement membrane in the obese individuals who had an early disturbance of glucose-fatty metabolism.

Adult↗
PubMed1998

Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis.

OBJECTIVE: To quantify the sequential changes in metabolic response occurring in patients with severe sepsis after the onset of peritonitis. SUMMARY BACKGROUND DATA: Understanding the changes in energy expenditure and body composition is essential for the optimal management of severely septic patients; however, they have not been quantified in the context of modern surgical care. METHODS: Twelve patients with severe sepsis secondary to peritonitis (median APACHE II score = 21.5) had measurements of energy expenditure and body composition as soon as they were hemodynamically stable and 5, 10, and 21 days later. Sequential measurements of acute-phase proteins and cytokine responses were also made. RESULTS: Resting energy expenditure rose to 49% above predicted and remained elevated throughout the study period. Total energy expenditure was 1.25 x resting energy expenditure. Body fat was oxidized when energy intake was insufficient to achieve energy balance. There was a positive fluid balance of 12.5 1 over the first 2 days after onset of sepsis; thereafter, body water changes closely paralleled body weight changes and were largely accounted for by changes in extracellular water. During the 21 -day study period, there was a loss of 1.21 kg (13%) of total body protein. During the first 10 days, 67% of the protein lost came from skeletal muscle, but after this time it was predominantly from viscera. Intracellular potassium levels were low but did not deteriorate further after hemodynamic stability had been reached. There was a reprioritization of hepatic protein synthesis that was obligatory and independent of changes in total body protein. The cytokine responses demonstrated the complexity, redundancy, and overlap of mediators. CONCLUSIONS: The period of hypermetabolism in severely septic patients is similar to that previously described, but the fluid changes are larger and the protein loss is greater. Protein loss early on is predominantly from muscle, thereafter from viscera. Fat loss can be prevented and cell function preserved once hemodynamic stability is achieved.

APACHE↗
PubMed1980

The effect of cold exposure on fluid balance, circulating arginine vasopressin concentration and milk secretion in the goat.

Total body water, water intake, urine output, milk yield, plasma, milk and urine osmolality and plasma arginine vasopressin concentration were measured in goats exposed to thermoneutral (20 degrees C) and cold (0-1.0 degrees C) environments for 24 h. Cold exposure caused the animals to reduce their water intake substantially. This was accompanied by a decrease in total body water and an increase in osmolality of plasma and milk. The output of urine decreased as cold exposure progressed but free water clearance by the kidney was not significantly different in thermoneutral and cold environments and cold exposure had no effect on circulating arginine vasopressin concentration. Milk yield was reduced by cold exposure and it is suggested that the reduced net movement of water from blood to milk is partly a consequence of the dehydration induced by cold exposure and that this, in turn, is due primarily to a decrease in water intake with no effective renal compensation.

Animals↗
PubMed1972

Locomotion of Spirilla.

The hydromechanics of spirilla locomotion is analyzed by considering the balance of both rectilinear and angular momenta of the surrounding viscous fluid which is otherwise at rest. The physical model of Spirillum adopted for the present analysis consists of a rigid helical body with flagella attached to both ends of the helix. The motion is supposed to be activated first by the polar flagella, both rotating in the same sense, thus causing the helical body to rotate in the opposite sense in angular recoil, which in turn pushes the body forward in response to the balance of linear momentum of the surrounding fluid. The sweeping back of the polar flagella during forward motion is ascribed to a certain bending flexibility of the flagella and of their conjunction with the body. Based on this model some quantitative results for Spirillum movement are predicted, and are found to be consistent with existing experimental data.

Cell Movement↗
PubMed2002

Perioperative risk factors in elective pneumonectomy: the impact of excess fluid balance.

BACKGROUND AND OBJECTIVE: This study was performed to identify risk factors for complications and in-hospital mortality associated with pneumonectomy. METHODS: The influence of fluid balance during anaesthesia was evaluated, taking into account the patient's age, gender and body mass index, smoking habits, history of pulmonary or cardiac disorders, the site of pneumonectomy and duration of anaesthesia. One-hundred-and-seven patients undergoing elective pneumonectomy were included in the study. RESULTS: A total of 31 patients (29%) suffered from one or more postoperative complications, seven (22.4%) of these had severe dysrhythmias, six (19.6%) had pulmonary complications and three (9.3%) had cardiovascular complications. The overall mortality rate was 10.3%. CONCLUSIONS: Based on logistic regression analysis, our data indicate the following risk factors for postoperative complications: positive fluid balance exceeding 4000 mL during anaesthesia (pulmonary complications and mortality), body mass index < 17 or > 25 kg m(-2) (severe dysrhythmias), or history of chronic heart disease (pulmonary complications). Thirteen patients (12.4%) suffered from a fluid balance > 4000 mL during anaesthesia. Regression analysis indicated that fluid balance exceeding 4000 mL was associated with a higher risk of postoperative complications than blood loss exceeding 1000 mL and to be the strongest risk factor for postoperative pulmonary complications and in-hospital mortality. Further trials estimating the effect of restrictive fluid regimens and the use of vasopressors for blood pressure control during anaesthesia must be carried out.

Adult↗
PubMed2000

Body fluid regulation in micro-gravity differs from that on Earth: an overview.

Similar to the response to central hypervolemic conditions on Earth, the shift of blood volume from the legs to the upper part of the body in astronauts entering micro-gravity should, in accordance with the Henry-Gauer mechanism, mediate diuresis and natriuresis. However, fluid balance and kidney function experiments during various space missions resulted in the surprising observation that the responses qualitatively differ from those observed during simulations of hypervolemia on Earth. There is some evidence that the attenuated responses of the kidney while entering weightlessness, and also later during space flight, may be caused by augmented fluid distribution to extravascular compartments compared to conditions on Earth. A functional decoupling of the kidney may also contribute to the observation that renal responses during exposure to micro-gravity are consistently weaker than those during simulation experiments before space flight. Deficits in body mass after landing have always been interpreted as an indication of absolute fluid loss early during space missions. However, recent data suggest that body mass changes during space flight are rather the consequences of hypocaloric nutrition and can be overcome by improved nutrition schemes. Finally, sodium-retaining humoral systems are activated during space flight and may contribute to a new steady-state of metabolic balances with a pronounced increase in body sodium compared to respective conditions on Earth. A revision of the classical "micro-gravity fluid shift" scheme is required.

Body Fluids↗
PubMed1991

Fluid balance during pulmonary edema. Is fluid gain a marker or a cause of poor outcome?

STUDY OBJECTIVE: To evaluate the importance of fluid balance and changes in extravascular lung water (EVLW) on survival in the ICU and short-term outcome in patients with pulmonary edema. DESIGN: Retrospective analysis of data (sorting by survival and "treatment received") from a recent randomized controlled trial of fluid restriction in this population. SETTING: Medical ICU of a university-affiliated, tertiary-care medical center. PATIENTS: Eighty-nine patients (from the previously mentioned study) requiring pulmonary artery catheterization with abnormally high EVLW (greater than 7 ml/kg). MEASUREMENTS AND RESULTS: When analyzed by survival, the survivors had no significant fluid gain or change in EVLW but decreased wedge pressure and body weight, compared to nonsurvivors. When analyzed by fluid balance, patients who gained less than 1 L of fluid by 36 hours into the study had a better rate of survival (74 percent) than the rest (50 percent; p less than 0.05). Also, the median duration of days on the ventilator, ICU days, and days of hospitalization was approximately half as long for each variable in the group with less than 1 L of fluid gain. Even accounting for baseline differences in the severity of illness, fluid balance was an independent predictor of survival (p less than 0.05). When analyzed by whether or not EVLW decreased by more than 15 percent between the first and last measurement, only patients with ARDS or sepsis had decreased days on the ventilator and ICU days. CONCLUSIONS: These data support the concept that positive fluid balance per se is at least partially responsible for poor outcome in patients with pulmonary edema and defend the strategy of attempting to achieve a negative fluid balance if tolerated hemodynamically.

Extravascular Lung Water↗
PubMedDate not supplied

Oxygen transport and consumption during experimental cardiopulmonary bypass using oxyfluor.

To evaluate a perfluorocarbon based oxygen carrier (Oxyfluor), a porcine model of cardiopulmonary bypass (CPB) was implemented. Swine (30 kg) were subjected to 2 h of normothermic CPB using Oxyfluor (OF group, n = 8) or Ringer's lactate (RL group, n = 13) as the prime. Mean arterial pressure (MAP) was kept at 50 mm Hg, flow rate at 80 ml x min(-1) x kg(-1), and PaCO2 at 35 mm Hg. Hemodynamic, hematologic, fluid balance, and blood gasimetry variables were measured. Total body oxygen delivery (DO2), consumption (VO2), and the fractional contribution to delivery (FCD) and to consumption (FCC) of the red blood cells (RBC), PFC, and plasma phases were calculated. Mixed venous PO2 (PvO2) was significantly higher at 30 min and 1 h on CPB in the OF group than in the RL group. FCCRBC was significantly lower at 30 min, 1 h, and 90 min on CPB in the OF group than in the RL group. PvjO2, Ca-vO2, Ca-vj O2, and VO2 were slightly higher in the OF group than in the RL group. Tissue fluid accumulation was not alleviated with Oxyfluor, and tissue and brain acidosis were significantly increased in the OF group. This study presented evidence that Oxyfluor improved tissue oxygenation and total body oxygen consumption during experimental CPB. In addition, Oxyfluor reduced FCCRBC, increasing oxygen transport reserve of the RBC phase, which can be useful to reduce hypoxic events during CPB. Further research should be conducted to optimize PFC-OCs for use in CPB and to reduce secondary effects.

Animals↗
PubMed1976

Interstitial fluid and transcapillary fluid balance in the lung.

Alterations in extravascular lung water content when capillary pressure or plasma colloid osmotic pressure is increased have been evaluated in isolated, continuously weighed, plasma-perfused pairs of rabbit lungs. After modest increases in left atrial pressure, most preparations rapidly reached a new stable weight, and thus a new transcapillary fluid balance, but no significant increase in extravascular lung water content could be detected. In preparations where there was still a steady, slow gain in weight and thus still some transvascular filtration of fluid 15 min after the increase in pressure, a moderate but significant increase in extravascular water could be detected. It is concluded that only very small transvascular shifts of fluid occur in the lungs when capillary pressure changes, as long as this change is kept below the level that causes oedema. This limitation of pressure-induced transvascular shifts of fluid in the lung could be explained by the existence, close to the capillaries, of a small interstitial space containing fluid with a high protein concentration. Alterations in the colloid osmotic pressure exerted by this fluid would then contribute markedly towards continuous readjustment of the transcapillary fluid balance in the lung. Experiments by other workers indicate that alveolar pressure can markedly affect the transcapillary fluid balance of the isolated perfused lung.

Animals↗