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PubMedDate not supplied

[Changes in electrolyte and water balance in old age].

The involutive restriction of renal function, of thirst, and loss of body fluid reduce the adaptability of the electrolyte- and fluid metabolism in the geriatric patient. The causes of hydromineral emergencies involving the elderly are discussed. It is explained how, in the geriatric patient, the rapid disturbance of fluid metabolism can frequently pose a more serious threat to life than the underlying pathology, and how awareness of this problem and its rapid resolution can often save the geriatric patient's life.

Adaptation, Biological↗
PubMed1968

[Burns].

Explore the source record for details and available documents.

Acute Kidney Injury↗
PubMed1982

Surgery in the diabetic patient.

The condition of the diabetic patient--reduced availability of insulin and an enhanced reaction to the counter-regulatory hormones elicited during major surgical stress--necessitates the administration of insulin to prevent hyperglycemia, fat mobilization and ketosis, and wastage of body protein. Crucial items in management are the maintenance of fluid and electrolyte balance and prevention of infection. The recognition of diabetes-related complications, particularly those involving the cardiovascular system, will forestall problems related to these conditions during the perioperative period. For both type I and type II diabetes the use of intravenous glucose-insulin infusion provides a safe and effective method for management during surgery. During surgery, monitoring of blood glucose concentration determines the adequacy of insulin dosage, which can be adjusted to maintain glucose concentrations within the desired range. With this system, the hazards of hyperglycemia are avoided and significant hypoglycemia is rarely encountered. For elective operations as well as for emergency surgical procedures, this method can provide a simple and effective regimen for use in most hospitals.

Anesthesia↗
PubMed1981

Malignant hyperthermia: current perspectives.

The incidence, etiology, clinical manifestations, and management of malignant hyperthermia (MH) are reviewed. The syndrome of MH is recognized as one of the causes of anesthesia-related deaths. It is considered pharmacogenetic because both an abnormal gene and precipitating environmental factors are necessary to produce an acute reaction. Metabolic defects, involving a derangement of calcium dynamics, appear to be the common characteristic of susceptible individuals. Calcium release and uptake from the sarcoplasmic reticulum is altered when an individual with MH is exposed to certain anesthetic agents or triggering physical and emotional stresses. Muscle rigidity, tachycardia, tachypnea, and high fever can lead to other complications and death. Management of an acute reaction of MH includes cooling methods to lower body temperature, hyperventilation, sodium bicarbonate control of acidosis, maintenance of fluid and electrolyte balance, and the administration of dantrolene sodium. A thorough family history, baseline CPKs, caffeine-halothane contracture tests, and ultramicroscopic examination of muscle biopsy specimens are recommended as screening techniques. The early administration of dantrolene sodium in acute reaction of MH has been shown to rapidly alleviate the symptoms and ensuing severe complications. Individuals with a strong family history of MH or previous episodes may be treated with oral dantrolene sodium before surgery to effectively prevent a crisis, and after surgery to prevent recurrence.

Creatine Kinase↗
PubMed2004

Unorthodox sites and modes of aldosterone action.

Aldosterone controls electrolyte balance by acting on the renal epithelium. However, there is strong evidence that vascular endothelium is another target for mineralocorticoids. Endothelial cells gain sensitivity to diuretics when exposed to aldosterone. Atomic force microscopy detects such phenomena. It is speculated that endothelium and kidney join forces in the regulation of body fluids.

Aldosterone↗
PubMedDate not supplied

Comparison of cellular recovery rates and morphologic detail obtained using membrane filter and cytocentrifuge techniques.

Two methods commonly used for collecting cells from a large volume of fluid-membrane filters (Millipore, Gelman, and Nuclepore) and cytocentrifugation-were compared for percentage of cell recovery and degree of cell preservation. Twenty samples of body cavity fluid were centrifuged, and the buffy coat of each was resuspended in a balanced electrolyte solution. The cellularity of each suspension was determined using both Coulter Counter and hemocytometer. Exact aliquots of each sample were collected on Millipore, Gelman, and Nuclepore filters and on slides by cytocentrifugation (Shandon). The resultant material was fixed in alcohol (95% ethanol), stained by the Papanicolaou method, mounted, and then evaluated with respect to the number of cells present and the diagnostically significant morphologic detail of the cells. Cell recovery was estimated by counting cells in known areas of each preparation and then ascertaining the total area. The Millipore filter technique consistently recovered the highest percentage of cells and preserved the best morphologic detail.

Body Fluids↗
PubMed1980

[Furosemide and metolazone: a highly effective diuretic combination].

The natriuretic and diuretic effects of combined treatment with furosemide and metolazone have been studied quantitatively. 15 hospitalized patients with severe fluid retention who showed no reduction of body weight despite treatment with furosemide received metolazone in addition for 3 days. 11 patients had biventricular heart failure with edema, and 4 had cirrhosis of the liver with ascites. Following the addition of metolazone at a starting dose of 2.5 mg/d, a highly significant increase in diuresis and natriuresis, with a corresponding reduction in body weight, was seen in all patients pretreated with a daily dose of 40-370 mg furosemide (mean 122 mg/d). On the first day of this combined treatment the mean sodium excretion increased from 131 to 303 mval/d (2 p less than 0.01) and the mean urine volume increased from 1677 to 2940 ml/d (2 p less than 0.01). The mean reduction in body weight was 6.1 kg (2 p less than 0.001) within 7 days of continuous treatment. Even at low doses metolazone significantly potentiates the diuretic effects of furosemide and therefore simplifies the treatment of fluid retention. High doses of furosemide can be avoided in many cases, a factor of particular advantage in ambulatory long term therapy and in patients with decreased kidney function. It may also lower the cost of the therapy. In 3 patients the furosemide dose had to be lowered after metolazone was started, to avoid an excessive negative fluid balance. These cases clearly demonstrate the importance of daily checks on the patient's body weight after starting combined therapy with furosemide and metolazone.

Ascites↗
PubMed2004

Fluid and electrolyte intake and loss in elite soccer players during training.

This study measured fluid balance during a 90-min preseason training session in the first team squad (24 players) of an English Premier League football team. Sweat loss was assessed from changes in body mass after correction for ingested fluids and urine passed. Sweat composition was measured by collection from patches attached to the skin at 4 sites. The weather was warm (24-29 degrees C), with moderate humidity (46-64%). The mean +/- SD body mass loss over the training session was 1.10+/- 0.43 kg, equivalent to a level of dehydration of 1.37 +/- 0.54% of the pre-training body mass. Mean fluid intake was 971 +/- 303 ml. Estimated total mean sweat loss was 2033 +/- 413 ml. Mean sweat electrolyte concentrations (mmol/L) were: sodium, 49 +/- 12; potassium, 6.0 +/- 1.3; chloride, 43 +/- 10. Total sweat sodium loss of 99+/- 24 mmol corresponds to a salt (sodium chloride) loss of 5.8 +/- 1.4 g. Mean urine osmolality measured on pre-training samples provided by the players was 666 +/- 311 mosmol/kg (n = 21). These data indicate that sweat losses of water and solute in football players in training can be substantial but vary greatly between players even with the same exercise and environmental conditions. Voluntary fluid intake also shows wide inter-individual variability and is generally insufficient to match fluid losses.

Adult↗
PubMed2004

Influence of differences in body weight and volume management on experimental results in porcine models.

BACKGROUND: In contrast to humans, young pigs naturally have a low COPpl (12-16 mmHg versus 22-26 mmHg in young humans). Thus, behavior occurring when volume management is performed similar to human medicine might be different. Potentially underestimated intra- to extravascular fluid and solute shifts could influence time course of variables investigated. That is why we studied whether differences in the basic protocol for infusion therapy and different levels of COP according to age or body weight, respectively - impair reproducibility and reliability of experimental results. METHODS: Group A [n=6, lower body weight (LBW < 22 kg)] was treated with unrestricted infusion rates (UIR) adjusted to maintain a constant blood pressure; group B [n=6, higher body weight (HBW > 28 kg)] was treated with a restricted continuous infusion rate for fluid balance (RIR); group C (n=6) combined HBW and UIR protocol. Blood pressure, plasma solutes, diuresis, and peritoneal fluid were analysed. Statistical analysis was performed using Kruskal-Wallis test and Wilcoxon test. RESULTS: UIR-treated pigs with LBW (group A) developed ascites and demonstrated time dependent decreases of plasma solute concentrations whereas in pigs of group C mainly diuresis was increased and subcutaneous edema occurred. None of the protocols enabled constant blood pressure. DISCUSSION: In young pigs (LBW), an adaptive volume substitution using crystalloids to standardize blood pressure may induce fluid extravasation; in turn data may not show statistical significance, stable hemodynamics may not be achieved and changes in plasma solute concentrations may lead to false interpretations. RIR-strategy provided reproducible, plausible results and thus should be recommended in combination with pigs >29 kg BW for the use of porcine models.

Acute Kidney Injury↗
PubMed1982

Cholesterol transport between cells and body fluids. Role of plasma lipoproteins and the plasma cholesterol esterification system.

The manner in which cells retain their sterol content is reviewed. Although most of what is known at the molecular level has been defived from studies in continuous cell culture, the findings appear to be broadly applicable to conditions in vivo. The main impetus to this research has come from the potential direct relevance of cell sterol balance to lipid disorders.

Animals↗
PubMed2000

Liquid versus solid carbohydrate: effects on food intake and body weight.

BACKGROUND: Beverages are contributing an increased proportion of energy to the diet. Because they elicit a weak compensatory dietary response, they may increase risk of positive energy balance. OBJECTIVES: This study aimed to document the differential effects of matched liquid and solid carbohydrate loads on diet and body weight. DESIGN: In a cross-over design, seven males and eight females consumed dietary carbohydrate loads of 1880 kJ/day as a liquid (soda) or solid (jelly beans) during two 4 week periods separated by a 4 week washout. Subjects were permitted to consume the loads however they chose. In addition to baseline measurements, diet records were obtained on random days throughout the study, body composition was measured weekly, physical activity was assessed before and after treatments and hunger was assessed during washout and midway through each treatment. RESULTS: Free-feeding energy intake during the solid period was significantly lower than intake prior to this period. Dietary energy compensation was precise (118%). No decrease in free-feeding energy intake occurred during the liquid period. Total daily energy intake increased by an amount equal to the load resulting in dietary compensation of -17%. Consequently, body weight and BMI increased significantly only during the liquid period. Physical activity and hunger were unchanged. CONCLUSIONS: This study indicates that liquid carbohydrate promotes positive energy balance, whereas a comparable solid carbohydrate elicits precise dietary compensation. Increased consumption of energy-yielding fluids may promote positive energy balance.

Adult↗