Fluid Deficit

2021 ◽  
pp. 1891-1891
Keyword(s):  
Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 361
Author(s):  
Louise Ekman ◽  
Peter Johnson ◽  
Robert G. Hahn

Background and Objectives: Dehydration might be an issue after hip fracture surgery, but the optimal tools to identify the dehydrated condition have not been determined. The aim of the present study was to compare the characteristics of elderly postoperative patients who were classified as dehydrated according to the methods used in the clinic. Materials and Methods: Thirty-eight patients aged between 65 and 97 (mean, 82) years were studied after being admitted to a geriatric department for rehabilitation after hip fracture surgery. Each patient underwent blood analyses, urine sampling, and clinical examinations. Results: Patients ingested a mean of 1,008 mL (standard deviation, 309 mL) of fluid during their first day at the clinic. Serum osmolality increased significantly with the plasma concentrations of sodium, creatinine, and urea. Seven patients had high serum osmolality (≥300 mosmol/kg) that correlated with the presence of tongue furrows (p < 0.04), poor skin turgor (p < 0.03), and pronounced albuminuria (p < 0.03). Eight patients had concentrated urine (urine-specific gravity ≥ 1.025) that correlated with a low intake of liquid and with a decrease in body weight during the past month of −3.0 kg (25–75 th percentiles, −5.1 to −0.9) versus +0.2 (−1.9 to +2.7) kg (p < 0.04). Conclusions: Renal fluid conservation of water, either in the form of hyperosmolality or concentrated urine, was found in 40% of the patients after hip fracture surgery. Hyperosmolality might not indicate a more severe fluid deficit than is indicated by concentrated urine but suggests an impaired ability to concentrate the urine.


1991 ◽  
Vol 70 (1) ◽  
pp. 342-348 ◽  
Author(s):  
R. A. Irving ◽  
T. D. Noakes ◽  
R. Buck ◽  
R. van Zyl Smit ◽  
E. Raine ◽  
...  

Renal function including fluid and electrolyte balance was studied during recovery in eight subjects who developed symptomatic hyponatremia (HN; plasma sodium concentration less than 130 mM) during an 88-km ultramarathon footrace and compared with results for normonatremic runners [NN; n = 18, mean postrace plasma sodium concentration, 138.2 +/- 1.2 (SE) mM]. Estimated fluid intake during the race for HN was 12.5 +/- 1.6 (SE) liters over 9 h 41 min (+/- 28 min). HN excreted a net fluid excess of 2.95 +/- 0.56 (range 1.2–5.9) liters compared with a fluid deficit of 2.7 +/- 0.3% body weight in NN. The sodium deficit was 153 +/- 35 mmol in HN and 187 +/- 37 mmol in NN. Despite the fluid overload, plasma volume was decreased by 24.1 +/- 5.0% in HN compared with 8.2 +/- 2.6% in NN. Serum renin activity (5.1 +/- 2.0 ng.ml-1.h-1), aldosterone concentrations (410 +/- 34 ng/l), creatinine clearances (174.8 +/- 28.2 ml/min), and urine output (6.4 +/- 1.0 ml/min) were markedly elevated in HN during recovery. Thus the hyponatremia of exercise results from fluid retention in subjects who ingest abnormally large fluid volumes during prolonged exercise.


2019 ◽  
Vol 156 (6) ◽  
pp. S-545-S-546
Author(s):  
Rahul Sethia ◽  
Soumya Jagannath ◽  
Saransh Jain ◽  
Swatantra Gupta ◽  
Varun teja ◽  
...  

Author(s):  
Ruowu Ma ◽  
Shuying Feng ◽  
Meiqing Xie

Objective: To estimate the incidence of excessive distension absorption in the patient went through hysteroscopic surgery distended with 5% mannitol solution, to evaluate the use of 5% mannitol solution for hysteroscopic surgical procedure specifically and to testify the safe threshold for distension absorption. Design: Retrospective. Setting: Academic medical center. Patients: 10693 patients went through inpatient hysteroscopic surgery distended with 5% mannitol solution using monopolar electrosurgical instrument from Jan. 2015 to Sep. 2020. Intervention(s): None. This study has been approved by the Ethics Committee of Sun Yat-sen Memorial Hospital. Measurements and Main Results: Fluid deficit more than 1000mL is defined as excessive distension absorption. Incidence of excessive distension absorption in all the inpatient hysteroscopic surgeries is 0.46% (49/10693). It is 2.57% (16/623) in transcervical resection of fibroid (TCRF), 2.36% (9/381) in retained products of conception (RPOC) removal, 1.20% (6/501) in hysteroscopic uterine septum resection (HSR), 0.53% (14/2621) in transcervical resections of adhesion (TCRA) while in the severe cases it was 2.34% (14/598), 0.48% (4/828) in transcervical resection of the endometrium (TCRE). Excessive distension absorption developed within ten minutes in two cases. Twelve of thirty nine patients with fluid deficit under 2500mL presented with clinical consequences related to circulation overload. Conclusion: Incidence of excessive distension absorption could be low generally however it would be five times higher in TCRP, RPOC removal and TCRA. Resection by needle electrode may contribute to the excessive distension absorption developed within short time. 30.77% of the patients could not tolerate the less than 2500mL distension absorption.


Author(s):  
Anthea Hatfield

This chapter will tell you how surgery affects fluid balance and how the body controls fluids. Fluid compartments in the body and the nature of fluids are described. Disorders of fluid balance, the use of fluids to restore blood volume, and extra cellular fluid volume are all discussed. Management of fluid deficit, fluid overload, and pulmonary oedema and how to correct electrolyte balance are all clearly set out. Recommendations for fluids after different types of surgery and fluids for patients with renal and cardiac failure are given.


Author(s):  
Louise M. Burke ◽  
Asker E. Jeukendrup ◽  
Andrew M. Jones ◽  
Martin Mooses

Distance events in Athletics include cross country, 10,000-m track race, half-marathon and marathon road races, and 20- and 50-km race walking events over different terrain and environmental conditions. Race times for elite performers span ∼26 min to >4 hr, with key factors for success being a high aerobic power, the ability to exercise at a large fraction of this power, and high running/walking economy. Nutrition-related contributors include body mass and anthropometry, capacity to use fuels, particularly carbohydrate (CHO) to produce adenosine triphosphate economically over the duration of the event, and maintenance of reasonable hydration status in the face of sweat losses induced by exercise intensity and the environment. Race nutrition strategies include CHO-rich eating in the hours per days prior to the event to store glycogen in amounts sufficient for event fuel needs, and in some cases, in-race consumption of CHO and fluid to offset event losses. Beneficial CHO intakes range from small amounts, including mouth rinsing, in the case of shorter events to high rates of intake (75–90 g/hr) in the longest races. A personalized and practiced race nutrition plan should balance the benefits of fluid and CHO consumed within practical opportunities, against the time, cost, and risk of gut discomfort. In hot environments, prerace hyperhydration or cooling strategies may provide a small but useful offset to the accrued thermal challenge and fluid deficit. Sports foods (drinks, gels, etc.) may assist in meeting training/race nutrition plans, with caffeine, and, perhaps nitrate being used as evidence-based performance supplements.


2005 ◽  
Vol 15 (6) ◽  
pp. 641-652 ◽  
Author(s):  
John R. Stofan ◽  
Jeffrey J. Zachwieja ◽  
Craig A. Horswill ◽  
Robert Murray ◽  
Scott A. Anderson ◽  
...  

This observational study was designed to determine whether football players with a history of heat cramps have elevated fluid and sodium losses during training. During a “two-a-day” training camp, five Division I collegiate football players (20.2 ± 1.6 y, 113 ± 20 kg) with history of heat cramps (C) were matched (weight, age, race and position) with a cohort of teammates (19.6 ± 0.6 y, 110 ± 20 kg) who had never cramped (NC). Change in body weight (adjusted by fluid intake) determined gross sweat loss. Sweat samples (forearm patch) were analyzed for sodium and potassium concentrations. Adlibitum fluid intake was measured by recording pre- and post-practice bottle weights. Average sweat sodium loss for a 2.5-h practice was projected at 5.1 ± 2.3 g (C) vs. 2.2 ± 1.7 g (NC). When averaged across two practices within the day, fluid intake was similar between groups (C: 2.6 ± 0.8 L vs. NC: 2.8 ± 0.7 L), as was gross sweat loss (C: 4.0 ± 1.1 L vs. NC: 3.5 ± 1.6 L). There was wide variability in the fluid deficit incurred for both C and NC (1.3 ± 0.9 vs. 0.7 ± 1.2%) due to fluid intake. Sweat potassium was similar between groups, but sweat sodium was two times higher in C versus NC (54.6 ± 16.2 vs. 25.3 ± 10.0 mmol/L). These data indicate that sweat sodium losses were comparatively larger in cramp-prone football players than in NC. Although both groups consumed sodium-containing fluids (on-field) and food (off-field), both appeared to experience an acute sodium deficit at the end of practices based on sweat sodium losses. Large acute sodium and fluid losses (in sweat) may be characteristic of football players with a history of heat cramping.


1985 ◽  
Vol 202 (1) ◽  
pp. 1-8 ◽  
Author(s):  
JOHN PAUL ROBERTS ◽  
JOHN D. ROBERTS ◽  
CHRISTOPHER SKINNER ◽  
G. TOM SHIRES ◽  
HANA ILLNER ◽  
...  

1979 ◽  
Vol 47 (1) ◽  
pp. 197-200 ◽  
Author(s):  
S. A. Nunneley ◽  
R. F. Stribley

Though heat and dehydration each impair acceleration tolerance, interactions among these stresses have not previously been studied. Seven men were dehydrated in heat by 0, 1, and 3% of body weight before a series of +Gz, gradual-onset centrifuge runs with the capsule first 38 degrees C, then 20 degrees C. Heat alone raised heart rate by 6.5 beats/min independent of other stresses. Dehydration and acceleration appeared to act synergistically in raising HR. Heat lowered relaxed G tolerance by 0.3 G; dehydration tended to lower G tolerance and increased the variability of response to heat. A high-tolerance subgroup (n = 4) could normally sustain +7 Gz for 60 s with anti-G suit and straining, but 3% dehydration reduced mean time to 35 s. Dehydration was associated with a decrease in the loss of plasma volume at 7 G. Heat-induced tolerance loss appears similar for both gradual- and rapid-onset centrifuge profiles. In contrast, dehydration effects are greater in rapid-onset runs, evidence that normal anti-G protective mechanisms can partly counteract the effect of fluid deficit. The results are relevant for crew members of high-performance aircraft, where unexpected diminution of their normally high G tolerance can have disastrous consequences.


1991 ◽  
Vol 128 (3) ◽  
pp. 333-337 ◽  
Author(s):  
A. B. Anwana ◽  
H. O. Garland

ABSTRACT Metabolic and isotopic dilution techniques were used to investigate fluid balance and fluid volumes in rats made diabetic with streptozotocin before and after infusion. Uninfused diabetic rats had significantly (P < 0·01) lower total body water than controls (57·7±2·2 vs 65·7±1·4% (s.e.m.) fat free mass). This was due exclusively to a significantly (P < 0·001) reduced intracellular fluid volume (38·2±1·5 vs 45·4±1·4% fat free mass). Metabolic studies over the preceding 2 weeks showed that the fluid deficit in the diabetic group had resulted from a failure of the rats to increase their fluid intake to the same extent as their combined fluid losses. A 4-h saline infusion halved the fluid deficit in diabetic animals. The retained fluid was used to restore intracellular fluid volume which became comparable in diabetic and control rats (47·2±2·0 vs 46·4±1·0% fat free mass). The retention of infusate by diabetic animals to counteract their intracellular dehydration may partly explain the reduced urine output reported elsewhere in infused anaesthetized diabetic rats. Journal of Endocrinology (1991) 128, 333–337


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