scholarly journals Effect of sodium administration on fluid balance and sodium balance in health and the perioperative setting. Extended summary with additional insights from the MIHMoSA and TOPMAST studies

2022 ◽  
Vol 67 ◽  
pp. 157-165
Author(s):  
Niels Van Regenmortel ◽  
Thomas Langer ◽  
Tim De Weerdt ◽  
Ella Roelant ◽  
Manu Malbrain ◽  
...  
Keyword(s):  
Fluid Balance ◽  
Sodium Balance

Volume repletion after exercise-induced volume depletion in humans: replacement of water and sodium losses

1998 ◽  
Vol 274 (5) ◽  
pp. F868-F875 ◽  
Author(s):  
Susan M. Shirreffs ◽  
Ronald J. Maughan
Keyword(s):  
Body Mass ◽  
Fluid Balance ◽  
Intermittent Exercise ◽  
Sodium Intake ◽  
Recovery Period ◽  
Whole Body ◽  
Sodium Balance ◽  
Volume Depletion ◽  
Urine Production ◽  
Exercise Induced

Sodium and water loss during, and replacement after, exercise-induced volume depletion was investigated in six volunteers volume depleted by 1.89 ± 0.17% (SD) of body mass by intermittent exercise in a warm, humid environment. Subjects exercised in a large, open plastic bag, allowing collection of all sweat secreted during exercise. For over 60 min beginning 40 min after the end of exercise, subjects ingested drinks containing 0, 25, 50, or 100 mmol/l sodium ( trials 0, 25, 50, and 100) in a volume (ml) equivalent to 150% of the mass lost (g) by volume depletion. Body mass loss and sweat electrolyte (Na+, K+, and Cl−) loss were the same on each trial. The measured sweat sodium concentration was 49.2 ± 18.5 mmol/l, and the total loss (63.9 ± 38.7 mmol) was greater than that ingested on trials 0 and 25. Urine production over the 6-h recovery period was inversely related to the amount of sodium ingested. Subjects were in whole body negative sodium balance on trials 0 (−104 ± 48 mmol) and 25 (−65 ± 30 mmol) and essentially in balance on trial 50(−13 ± 29 mmol) but were in positive sodium balance on trial 100 (75 ± 40 mmol). Only on trial 100 were subjects in positive fluid balance at the end of the study. There was a large urinary loss of potassium over the recovery period on trial 100, despite a negligible intake during volume repletion. These results confirm the importance of replacement of sodium as well as water for volume repletion after sweat loss. The sodium intake on trial 100 was appropriate for acute fluid balance restoration, but its consequences for potassium levels must be considered to be undesirable in terms of whole body electrolyte homeostasis for anything other than the short term.

Fluids and electrolytes

2017 ◽  
Author(s):  
Grenville Fox ◽  
Nicholas Hoque ◽  
Timothy Watts
Keyword(s):  
Metabolic Acidosis ◽  
Fluid Balance ◽  
Base Excess ◽  
Blood Gases ◽  
Sodium Balance ◽  
Fluid Loss ◽  
Acid Base Balance ◽  
Acid Base ◽  
Newborn Period ◽  
Base Balance

This chapter provides an overview of the background of fluid balance in the neonate, including the need to compensate for fluid loss (output), and the requirement to provide energy and nutrition. It also covers the management of common issues in fluid, electrolyte, and acid-base balance in the newborn period, including dehydration, sodium balance (hyponatraemia and hypernatraemia), hyperkalaemia, interpretation of blood gases (including pH, base excess, and anion gap), respiratory and metabolic acidosis, and hydrops fetalis.

Ultra long-term sodium balance studies during the Mars500 campaign

2012 ◽  
Vol 37 (03) ◽  
Author(s):  
N Rakova ◽  
K Jüttner ◽  
M Rauh ◽  
A Dahlmann ◽  
U Goller ◽  
...  
Keyword(s):  
Sodium Balance

VARIATIONS IN PLASMA RENIN ACTIVITY AND URINARY ALDOSTERONE EXCRETION IN NORMAL SUBJECTS AFTER SALT RESTRICTION AND ACUTE PITUITARY INHIBITION WITH 6-DEHYDRO-16-METHYLENE HYDROCORTISONE

1971 ◽  
Vol 67 (1) ◽  
pp. 159-173
Author(s):  
A. Peytremann ◽  
R. Veyrat ◽  
A. F. Muller
Keyword(s):  
Plasma Renin Activity ◽  
Salt Intake ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Inhibitory Effect ◽  
Renin Activity ◽  
Sodium Balance ◽  
Experimental Conditions ◽  
Salt Restriction ◽  
Aldosterone Production

ABSTRACT Variations in plasma renin activity and urinary aldosterone excretion were studied in normal subjects submitted to salt restriction and simultaneous inhibition of ACTH production with a new synthetic steroid, 6-dehydro-16-methylene hydrocortisone (STC 407). At a dose of 10 mg t. i. d. this preparation exerts an inhibitory effect on the pituitary comparable to that of 2 mg of dexamethasone. In subjects maintained on a restricted salt intake, STC 407 does not delay the establishment of an equilibrium in sodium balance. The increases in endogenous aldosterone production and in plasma renin activity are also similar to those seen in the control subjects. A possible mineralocorticoid effect of STC 407 can be excluded. Under identical experimental conditions, the administration of dexamethasone yielded results comparable to those obtained with STC 407.

Management of Intraoperative Fluid Balance and Blood Conservation Techniques in Adult Cardiac Surgery

2011 ◽  
Vol 14 (1) ◽  
pp. 28 ◽  
Author(s):  
George Vretzakis ◽  
Athina Kleitsaki ◽  
Diamanto Aretha ◽  
Menelaos Karanikolas
Keyword(s):  
Cardiac Surgery ◽  
Blood Cell ◽  
Fluid Balance ◽  
Blood Product ◽  
Blood Donation ◽  
Autologous Blood ◽  
Small Body ◽  
Risk Indicators ◽  
Blood Transfusions ◽  
Blood Conservation

Blood transfusions are associated with adverse physiologic effects and increased cost, and therefore reduction of blood product use during surgery is a desirable goal for all patients. Cardiac surgery is a major consumer of donor blood products, especially when cardiopulmonary bypass (CPB) is used, because hematocrit drops precipitously during CPB due to blood loss and blood cell dilution. Advanced age, low preoperative red blood cell volume (preoperative anemia or small body size), preoperative antiplatelet or antithrombotic drugs, complex or re-operative procedures or emergency operations, and patient comorbidities were identified as important transfusion risk indicators in a report recently published by the Society of Cardiovascular Anesthesiologists. This report also identified several pre- and intraoperative interventions that may help reduce blood transfusions, including off-pump procedures, preoperative autologous blood donation, normovolemic hemodilution, and routine cell saver use.A multimodal approach to blood conservation, with highrisk patients receiving all available interventions, may help preserve vital organ perfusion and reduce blood product utilization. In addition, because positive intravenous fluid balance is a significant factor affecting hemodilution during cardiac surgery, especially when CPB is used, strategies aimed at limiting intraoperative fluid balance positiveness may also lead to reduced blood product utilization.This review discusses currently available techniques that can be used intraoperatively in an attempt to avoid or minimize fluid balance positiveness, to preserve the patient's own red blood cells, and to decrease blood product utilization during cardiac surgery.

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