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PubMedDate not supplied

Inhibition of the firing of vasopressin neurons by atriopeptin.

Atriopeptin, the atrial natriuretic peptide, is a circulating hormone that is released from the atria of mammalian hearts in response to volume expansion and acts upon the kidneys, adrenal glands and vasculature to regulate fluid and electrolyte homeostasis. Atriopeptin is also present in the brain of the rat. Atriopeptin immunoreactive cell bodies and fibres are found in many areas known to be involved in the central regulation of the cardiovascular system, suggesting that it may be a neuromediator in the central control of fluid and electrolyte balance. The paraventricular nucleus of the hypothalamus, which contains the cell bodies of neurons that secrete vasopressin from the posterior pituitary gland, receives a dense innervation from atriopeptin-like immunoreactive fibres. We have studied the effect of atriopeptin on the electrical activity of single neurons in the paraventricular nucleus of anaesthetized rats and found that atriopeptin is a potent inhibitor of putative vasopressin neurons. Atriopeptin, which has systemic actions that oppose those of vasopressin, may act as a neuromodulator in the brain to prevent vasopressin secretion.

Action Potentials↗
PubMed1990

Effects of pulsatile perfusion on plasma catecholamine levels and hemodynamics during and after cardiac operations with cardiopulmonary bypass.

Thirty patients scheduled for elective coronary artery bypass grafting were studied in two groups. Group A had standard cardiopulmonary bypass with nonpulsatile perfusion and group B had pulsatile perfusion. Measurements of plasma epinephrine, norepinephrine, granulocyte elastase, and hemodynamic parameters including mean arterial pressure total peripheral resistance, cardiac index, and pulmonary capillary wedge pressure were made before and after anesthesia induction, after surgical incision, during cardiopulmonary bypass, and 2, 4, and 24 hours after the operation. The venous compliance of the total body venous bed was measured at the end of the operation. In all patients the total net fluid balance was determined during bypass and in the postoperative period. In both groups plasma catecholamine levels increased 5 minutes after institution of bypass (epinephrine 176 +/- 56 to 611 +/- 108 pg/ml and norepinephrine 231 +/- 48 to 518 +/- 100 pg/ml in group A; epinephrine 168 +/- 40 to 444 +/- 100 pg/ml and norepinephrine 162 +/- 44 to 267 +/- 52 pg/ml in group B). The maximum catecholamine level was measured between the end of bypass and 2 hours after the end of bypass (epinephrine 1489 +/- 169 pg/ml and norepinephrine 1542 +/- 108 pg/ml in group A; epinephrine 990 +/- 134 pg/ml and norepinephrine 934 +/- 197 pg/ml in group B). During the same period mean arterial pressure and total peripheral resistance were also significantly higher in group A than in group B mean arterial pressure, 61.4 +/- 3 versus 53.6 +/- 3, p less than 0.06; total peripheral resistance, 1055 +/- 60 versus 899 +/- 45, p less than 0.01). The venous compliance was significantly higher in group A than in group B (2.4 +/- 0.3 versus 1.2 +/- 0.3 ml/mm Hg/kg body weight). The intraoperative and perioperative net fluid balance were significantly higher in group A than in group B (p less than 0.005). The average postoperative tracheal intubation time was also significantly longer in group A than in group B (4.6 +/- 1.2 hours versus 2.7 +/- 0.8 hours, p less than 0.001). No significant difference was detected in either hemoglobin or plasma free hemoglobin content between the two groups postoperatively. The results suggest that pulsatile perfusion, when compared with nonpulsatile perfusion, can attenuate the catecholamine stress response to cardiopulmonary bypass, reduce the fluid overloading of patients, and improve the postoperative recovery period as evaluated by tracheal intubation time.

Cardiopulmonary Bypass↗
PubMed2002

Sodium and body fluid homeostasis in profiling hemodialysis treatment.

Acute adverse side-effects of hemodialysis such as hypotension, muscle cramps, osmotic imbalance and thirst are induced by the interference with fluid and electrolyte balance occurring during treatment. Changes in osmolarity due to alterations of plasma sodium concentration during hemodialysis strongly influence fluid distribution between extracellular and intracellular fluid volume. Increased sodium dialysate concentration induces fluid shift from the intracellular to the extracellular compartment. This shift leads to a more efficient ultrafiltration by increasing plasma refilling volume but also to an increased thirst. Treatment of hypotension, cramps and nausea with hypertonic saline solution leads also to a considerable retention of sodium. Profiling hemodialysis consists in deliberately changing ultrafiltration and dialysate. sodium in order to combine an efficient ultrafiltration with a balanced sodium handling and to prevent side-effects during treatment. Continuous measurement and control of blood volume seems to be the best method to prevent hypotensive episodes. Profiling of sodium should not be the cause of a positive sodium balance. The clinical benefits of sodium profiling to the patients have still to be proven.

Biological Transport↗
PubMed1997

Circulating Na+/K+-ATPase inhibitors: effects of neuropeptides, volume expansion and salt loading in conscious rats.

1. In mammalian plasma, many different inhibitors of Na+/K(+)-ATPase are present, but it is not clear whether their net effect on NA+/K(+)-ATPase activity changes during the regulation of electrolyte and fluid balance. We studied Na+/K(+)-ATPase inhibition by plasma extracts in conscious rats during short- and long-term body fluid regulation. 2. Male, adult, conscious, freely moving Wistar rats were subjected to one of the following protocols: (i) intracerebro-ventricular (i.c.v.) injections of angiotension II (AngII; 1, 10 and 100 ng), the AngII receptor antagonist losartan (1 microgram), atrial natriuretic peptide (ANP-III; 1 microgram) or isotonic saline (IS); (ii) intra-arterial (i.a.) injections of IS (6 or 10 mL), hypertonic saline (HS; 1.2% NaCl, 5 mL) or hypertonic plasma expander (HPS; 3.5% hetastarch in HS, 5 mL); or (iii) a low salt-high salt-low salt diet sequence (0.18/1.8/0.18% NaCl chow for 5 days each with controls receiving 0.18% NaCl on all days). Bodyweight, the intake of food and water, urine volume and Na+ concentration and weight of faeces were determined daily. Plasma samples were withdrawn repeatedly throughout the respective protocols, extracted on C18-reversed phase columns and assayed for their effect on the activity of different Na+/K(+)-ATPase preparations. 3. The inhibition of rat brain Na+/K(+)-ATPase by plasma extracts was not significantly changed by i.c.v. injection of AngII, losartan, ANP-III and IS within the observation period (30 min from respective stimuli). Similarly, no significant changes occurred after acute volume expansion by i.a. injection of IS or HS within 120 min; upon HPS, however, Na+/K(+)-ATPase inhibition was decreased by approximately 20% (P < 0.05), probably due to passive dilution. During the high-salt diet, fluid retention was effectively counteracted by an adaptive increase of urinary sodium excretion. Throughout the protocol, inhibition of pig brain Na+/K(+)-ATPase by plasma extracts did not differ significantly between groups. 4. It is concluded from these results that the short- or long-term control of body fluids in conscious rats is not associated with systematic changes in Na+/K(+)-ATPase inhibition by plasma factors.

Angiotensin II↗
PubMed2002

Effect of high and low rates of fluid intake on post-exercise rehydration.

The effect of a high (H) and a low (L) rate of post-exercise fluid consumption on plasma volume and fluid balance restoration was investigated. Eight well-trained cyclists were dehydrated at 3% of body weight (BW) by cycling at 28 degrees C. During the recovery period, they ingested a carbohydrate-electrolyte solution in a volume equivalent to 120% of BW loss. Randomly, they ingested 60%, 40%, and 20% in the 1st, 2nd, and 3rd hours of the recovery period, respectively (H), or 24% x h(-1) during 5 hours (L). BW loss was similar for both trials and resulted in a total drink intake of 2.6 +/- 0.1 kg. Urine output in H exceeded significantly that of L in the 2nd and 3rd hours. This was reversed in the 5th and 6th hours. Plasma volume and fluid balance increased more rapidly in H compared to L. After 6 hours this difference disappeared. It is concluded that H results in a faster rate of plasma volume and fluid balance restoration compared to L, despite a temporary large urine output.

Adult↗
PubMed1992

Sex-dependence of body fat distribution in patients with obesity and hypertension.

The relationship of body fat distribution with blood pressure, fat cell weight and extracellular fluid volume was studied and compared in 20 obese hypertensive men and 20 obese hypertensive women of similar age, degree of overweight and blood pressure level. Body fat distribution, as reflected by the ratio between waist and hip circumference (W/H ratio), was significantly higher in male than in female obese patients. The W/H ratio was positively and independently correlated with systolic arterial pressure both in males and females. However, for the same W/H ratio, systolic arterial pressure was higher in females. The W/H ratio was positively correlated with gluteal fat cell weight only in males and not in females. Both in males and females, the W/H ratio was positively correlated with extracellular fluid volume, independently of the level of blood pressure level and/or the degree of obesity. The study provided evidence that the relationship between body weight and blood pressure in obese hypertensives is affected by the sex-dependence of body fat distribution with possible interferences on fat cell weight and extracellular fluid volume. Several epidemiological studies have emphasized the positive correlation observed between body weight and blood pressure in many. Many investigations have documented the association of blood pressure with body weight, weight to height, overweight or other indices of fatness such as skinfold thickness. However, the correlation coefficients of these different relationships were found constantly small, indicating that the relationship between overweight and blood pressure is somewhat complex. In patients with hypertension, body weight was shown to be strongly related with the levels of both blood pressure and extracellular fluid volume. On the other hand, patients with overweight and hypertension were found to be principally affected by hypertrophic obesity, as shown by the evaluation of fat cell weight. However these findings were exclusively observed in males. No solid data were reported in females. The relationships between body weight and extracellular fluid on one hand, and between body weight and fat cell weight on the other hand, are certainly different in males and in females. First, in females, extracellular fluid volume is submitted to cyclic changes in sodium balance involving the effect of sex steroid hormones. Second, body fat distribution, a parameter which is weakly correlated to blood pressure, is different in males and females. In males, body fat predominates in the upper part of the body while, in females, adiposity is mainly observed in the lower part of the body.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗
PubMed1992

Effect of leg exercise training on vascular volumes during 30 days of 6 degrees head-down bed rest.

Plasma and red cell volumes, body density, and water balance were measured in 19 men (32-42 yr) confined to bed rest (BR). One group (n = 5) had no exercise training (NOE), another near-maximal variable-intensity isotonic exercise for 60 min/day (ITE; n = 7), and the third near-maximal intermittent isokinetic exercise for 60 min/day (IKE; n = 7). Caloric intake was 2,678-2,840 kcal/day; mean body weight (n = 19) decreased by 0.58 +/- 0.35 (SE) kg during BR due to a negative fluid balance (diuresis) on day 1. Mean energy costs for the NOE, and IKE, and ITE regimens were 83 (3.6 +/- 0.2 ml O2.min-1.kg-1), 214 (8.9 +/- 0.5 ml.min-1.kg-1), and 446 kcal/h (18.8 +/- 1.6 ml.min-1.kg-1), respectively. Body densities within groups and mean urine volumes (1,752-1,846 ml/day) between groups were unchanged during BR. Resting changes in plasma volume (ml/kg) after BR were -1.5 +/- 2.3% (NS) in ITE, -14.7 +/- 2.8% (P less than 0.05) in NOE, and -16.8 +/- 2.9% (P less than 0.05) in IKE, and mean water balances during BR were +295, -106, and +169 ml/24 h, respectively. Changes in red cell volume followed changes in plasma volume. The significant chronic decreases in plasma volume in the IKE and NOE groups and its maintenance in the ITE group could not be accounted for by water balance or by responses of the plasma osmotic, protein, vasopressin, or aldosterone concentrations or plasma renin activity. There was close coupling between resting plasma volume and plasma protein and osmotic content.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

The effects of endurance exercise with and without a reduction of energy intake on fat-free mass and the composition of fat-free mass in obese women.

OBJECTIVE: The objective of this study was to evaluate the effects of endurance exercise on fat-free mass and nitrogen balance, with energy restriction or with energy intake to meet non-exercise needs in obese women. DESIGN: The study was a 14-week metabolic control study with a 2-week baseline period for dietary stabilization followed by a 12-week period of exercise (E) with or without energy restriction (D), E or D+E. SETTING: Metabolic research unit of the Western Human Nutrition Research Center. SUBJECTS: Ten obese women between the ages of 19 and 37 years volunteered as subjects. Body weight ranged from 19% to 41% IBW and body fat was 31-40% of body weight. INTERVENTION: Women were assigned to either an energy-restricted or energy-'adequate' group so that group means for weight, body fat, FFM, predicted VO2max and RMR were similar. Data were polled for the 2-week baseline period and in 3-week intervals during the intervention period. RESULTS: The data indicated that E had a slower rate of weight loss and a lower loss of FFM than D+E. Nitrogen balance was more positive in E than D+E. Negative N balance occurred in the D+E group when blood was drawn. There was no decrease in N excretion to compensate for blood losses. N balance for E was positive throughout the study. CONCLUSION: Changes in FFM, assessed by total body electrical conductivity, were different from the results obtained by classic nitrogen balance. This suggests that losses were due to fluid losses, which were confirmed by deuterium dilution procedures. This study demonstrated that body protein stores remained intact during periods of increased energy expenditure and dietary restriction in obese women.

Adipose Tissue↗
PubMed1971

Effect of extracellular fluid volume expansion on maximum glucose reabsorption rate and glomerular tubular balance in single rat nephrons.

Extracellular fluid volume expansion with isotonic saline (7.5% of body weight) decreased maximum glucose reabsorption rate by rat kidneys at plasma glucose concentrations greater than 30 mM. Glucose reabsorption rate was 30.2 +/-1.6 (SE) mumoles/min.g kidney in nonexpanded rats; it was 18.4 +/-1.5 mumoles/min.g in volume-expanded rats. Glucose reabsorption determined by micropuncture was 92% complete at the end of accessible superficial proximal convolutions. Volume expansion resulted in a slight but statistically insignificant reduction of maximal glucose reabsorption rate in superficial nephrons from 786 +/-35 mumumoles/min.g kidney in nonexpanded rats to 720 +/-30 mumumoles/min.g in volume-expanded rats. Superficial nephron filtration rate was increased by volume expansion from 28.8 +/-1.2 nl/min.g to 36.6 +/-1.5 nl/min.g kidney. In nonexpanded rats, the ratio of glucose reabsorption to glomerular filtration (tmg/sgfr) was similar in superficial and juxtamedullary nephrons. In volume-expanded rats superficial nephron tmg/sgfr was greater than juxtamedullary nephron tmg/sgfr. Juxtamedullary nephron function was measured by puncturing loops of Henle in the exposed papillae of small rats. Volume expansion increased sgfr without much effect on tmg in superficial nephrons while it decreased tmg without much effect on sgfr in deep nephrons. Physical changes produced by volume expansion seem to exert their greatest effect on proximal tubular function in the inner cortex. The increase in heterogeneity of glomerular-tubular balance could account for increased splay of glucose titration curves previously reported to accompany volume expansion.

Absorption↗
PubMed1999

Early initiation of peritoneal dialysis after surgical repair of congenital heart disease.

The mortality rate of infants who require renal replacement therapy after surgical repair of congenital heart disease has been reported to be 30%-79%. We report our experience with early initiation of continuous manual peritoneal dialysis (CPD) to treat fluid overload in 20 consecutive critically ill children who underwent CPD post cardiotomy. CPD catheters were inserted at the discretion of the cardiothoracic surgeon. CPD was started for evidence of total body fluid overload with inadequate urine output, and stopped when negative fluid balance was achieved and urine output improved. Median age was 10 days (range 3-186 days), mean time to start CPD post-operatively was 22 h (range 5-40 h), and mean duration of CPD was 50 h (range 13-92 h). CPD resulted in mean ultrafiltration of 93 ml/kg per day (range 43-233 ml/kg per day). Net negative fluid balance was 106 ml/kg per day (range 49-273 ml/kg per day). During CPD, the mean number of inotropes decreased from 2.2 to 1.6 (P<0.05) and urine output increased from 2.2 to 3.9 ml/kg per hour (P<0.01). No patient died during CPD or had CPD discontinued due to adverse hemodynamic effects. The overall mortality rate was 20%. We conclude that early initiation of CPD can safely and effectively promote fluid removal in infants after repair of congenital heart disease, with a lower mortality rate than has previously been reported.

Adolescent↗
PubMed2005

Steroid supplementation: a legitimate pharmacotherapy after neonatal open heart surgery.

BACKGROUND: An inflammatory response together with multiple organ failure subsequent to cardiopulmonary bypass is especially prominent in neonates. The behavior of glucocorticoids during this period in these patients is not known. If adrenal insufficiency should exist, it could considerably compromise postoperative recovery. METHODS: Twenty neonates undergoing biventricular repair were enrolled. Ten patients were assigned to receive hydrocortisone treatment and the other 10 to receive placebo. The treatment group received stress-dose hydrocortisone sodium succinate after discontinuation of cardiopulmonary bypass: 0.18 mg.kg(-1).hr(-1) for 3 days, 0.09 mg.kg(-1).hr(-1) for 2 days, and 0.045 mg.kg(-1).hr(-1) for 2 days. The placebo was 5% glucose solution. RESULTS: Patients had adrenal insufficiency (cortisol < 5 microg/dL) from 24 to 72 hours in the placebo group. This was associated with a simultaneous reduction of left ventricular shortening fraction (p < 0.0001, analysis of variance; p = 0.0203, Student's t test), the necessity to increase inotropic agents (p = 0.043, analysis of variance), and an increase in serum lactate level (p = 0.049, Student's t test). During this period, serum cortisol level was maintained above the normal level (> 23 microg/dL) in the hydrocortisone group. The placebo group had a greater positive fluid balance (p = 0.027, Student's t test) and greater total body edema in the immediate postoperative period (p = 0.065, Student's t test). Blood oxygenation constantly improved, and the duration on mechanical ventilation was shorter (83.5 +/- 42.1 versus 138.2 +/- 89.7 hours; p = 0.098) in the hydrocortisone group. CONCLUSIONS: Adrenal insufficiency may occur after neonatal open heart surgery. Stress-dose hydrocortisone supplementation blunts other organ dysfunction and can be considered a legitimate pharmacotherapy in this cohort.

Cardiopulmonary Bypass↗
PubMed1996

Body fluid metabolism at actual and simulated microgravity.

Recent observations from space missions indicate that weightlessness does not induce an increase in diuresis and natriuresis in astronauts. Rather, both oral fluid and sodium intake as well as renal fluid and sodium output appear reduced compared with the preflight condition. In addition, influences of reduced energy intake may be more important for total body fluid content inflight than generally assumed. Decreases in plasma volume and observations of upper body edema formation inflight indicate, in addition, an increased extravasation as a result of the headward fluid shift in weightlessness. Current simulations models of microgravity for body fluid metabolism are valid for simulations of the central fluid shift occurring in microgravity. Since weightlessness appears to decrease central venous pressure and does not induce an increased renal fluid and sodium excretion, while simulations models have opposite effects, additional models to simulate adaptation of body fluid metabolism to weightlessness might be necessary.

Adaptation, Physiological↗