scholarly journals IMPACT OF RESTRICTIVE REGIMEN OF INFUSION THERAPY ON THE PERIOPERATIVE PERIOD IN PATIENTS WITH URGENT ABDOMINAL PATHOLOGY

2019 ◽  
Vol 19 (2) ◽  
pp. 35-38
Author(s):  
O.V. Kravets
Keyword(s):  
Water Balance ◽  
Plasma Volume ◽  
Extracellular Volume ◽  
Extracellular Fluid ◽  
The Body ◽  
Infusion Therapy ◽  
Emergency Laparotomy ◽  
Volume Depletion ◽  
Therapy Regimen ◽  
Interstitial Volume

One of the leading pathogenetic processes that is specific for emergency abdominal pathology is hypovolemia. The primary method of its treatment is infusion therapy. The purpose of the study is to evaluate the effectiveness of the restrictive regimen of infusion therapy in patients with emergency abdominal pathology. Materials and methods. We examined 50 patients who were performed on emergency laparotomy. Perioperative infusion therapy in all patients was carried out in a restrictive regimen with balanced crystalloid solutions. We studied the indicators of water metabolism: daily and cumulative water balances, the percentage of fluid excess. We determined water sectors of the body by the method of non-invasive bioelectric rheography. Results. The study has found out the presence of the initial depletion of the extracellular fluid volume due to a decrease in both interstitial and intravascular volumes in patients with urgent abdominal pathology. Intravascular deficiency was due to a decrease in plasma volume. Replenishment of extracellular deficiency by restrictive regimen of infusion therapy restored the plasma volume to normal values since one day after surgery; interstitial volume started restoring on the 7th days of observation, compared to the normal intracellular volume on the 3 days of the postoperative period. Conclusions: restrictive infusion therapy regimen enables to completely and safely restore extracellular volume depletion on the 7 days of the preoperative period by correcting plasma deficiency since the 1 day of the post-operative period; to replenish interstitial volume on the 7 days and to prevent the development of oedema during “zero” daily water balance, as well as to slightly increase the cumulative water balance and the percentage of excess fluid.

Fluid and electrolyte shifts during bed rest with isometric and isotonic exercise

1977 ◽  
Vol 42 (1) ◽  
pp. 59-66 ◽  
Author(s):  
J. E. Greenleaf ◽  
E. M. Bernauer ◽  
H. L. Young ◽  
J. T. Morse ◽  
R. W. Staley ◽  
...  
Keyword(s):  
Plasma Volume ◽  
Recovery Period ◽  
Extracellular Volume ◽  
Isometric Exercise ◽  
Bed Rest ◽  
The Other ◽  
Interstitial Volume ◽  
Isotonic Exercise ◽  
Exercise Regimen ◽  
Blood Cell And Plasma

Fluid and electrolyte shifts were measured in seven men (19–21 yr) during three 2-wk bed rest (BR) periods, each of which was separated by a 3-wk ambulatory recovery period. During two of the three BR periods they performed isometric exercise and isotonic exercise. No prescribed exercise was given during the other BR period. On day 4 of BR, plasma volume decreased (P less than 0.05) 441 ml (-12.6%) with no exercise, 396 ml (-11.3%) with isometric, and 262 ml (-7.8%) with isotonic exercise; the decreases (NS) of extracellular volume were -4.4%, -2.6%, and -2.7%, respectively. By day 13 of BR, plasma volume stabilized at the lower level with isometric and isotonic exercise and continued to decline with no exercise; but the extracellular volume returned to or above control levels due to an overshoot of the interstitial volume of +320 to +430 ml (2.0–2.7%) that was about equal to the plasma volume loss. During BR there were isocontent losses from the plasma of protein, albumin, globulin, urea N2, uric acid, creatinine, Na, Cl, osmolarity, P, and glucose that were not influenced by either exercise regimen. However, the blood, red blood cell, and plasma volumes, and the Ca and K contents were stabilized during BR by both exercise regimens. The results suggest that during BR, preservation of the extracellular volume takes precedence over maintenance of the plasma volume, and this mechanism is independent of the effects of isometric or isotonic exercise.

scholarly journals DETERMINATION OF THE VOLUME OF THE EXTRACELLULAR FLUID OF THE BODY WITH RADIOACTIVE SODIUM

1941 ◽  
Vol 74 (6) ◽  
pp. 569-590 ◽  
Author(s):  
Nolan L. Kaltreider ◽  
George R. Meneely ◽  
James R. Allen ◽  
William F. Bale
Keyword(s):  
Body Weight ◽  
Intravenous Injection ◽  
Intravenous Administration ◽  
Plasma Volume ◽  
Radioactive Isotope ◽  
Extracellular Fluid ◽  
Normal Subjects ◽  
Volume Of Fluid ◽  
The Body ◽  
Excess Sodium

A method for measuring the volume of fluid available for the distribution of sodium (sodium space) by the use of its radioactive isotope (Na24) has been described and the accuracy of the method has been discussed. Simultaneous determinations of the plasma volume by means of the blue dye T-1824 and the volume of the extracellular fluid by employing radiosodium and sodium thiocyanate have been made in normal subjects. Repeated measurements were made at varying periods of time in the same individuals. In order to establish the rate of diffusion equilibrium for the radioactive isotope of sodium and thiocyanate between serum and serous effusions, simultaneous samples of both were obtained at varying intervals after the intravenous injection of these substances. Since evidence in the literature indicates that there is an excess of sodium mainly limited to bone, which cannot be attributed to the extracellular phase, experiments on dogs and man were so devised that the ratio of tissue concentration to plasma concentration for radiosodium and chemically determined chloride could be calculated. The following conclusions may be drawn from the results of this investigation: 1. Radiosodium after intravenous administration spreads rapidly during the first 3 hours from the plasma into a volume of fluid which represents approximately 25 per cent of the body weight of man. Thereafter for 6 hours it diffuses more slowly into certain tissue spaces—the central nervous system and probably the skeleton. The plasma volume and interstitial fluid represent 15 and 85 per cent of the sodium space respectively. 2. Diffusion equilibrium for both radiosodium and thiocyanate is not established between serum and transudates in edematous patients until from 9 to 12 hours after the intravenous injection of these substances. 3. Until more complete information is available, it is concluded that unless the difference between repeated observations on the same individual exceeds ±1.38 liters there is no significant change in the sodium space providing that the activity of the standard and serum samples are in the range of 40 counts per minute per milliliter with the counting apparatus used. As the activity of the samples increases, the error becomes less because there is no correlation between the magnitude of the error and the magnitude of the activity. 4. Climatic conditions produce no significant changes in the volume of the blood or extracellular fluid. 5. In the dog, following the intravenous injection of radiosodium, the concentration of the isotope in bone reaches its maximum rapidly (3 hours). The extra sodium in the skeleton of dog is equal to about ¼ of the total counts in the body, assuming that the chloride space of bone represents its extracellular volume. Similar amounts of excess sodium are found in the skeleton of man 12 hours after the administration of Na24. 6. Correction of the sodium space of man for the excess sodium reduced the average value by 3.7 liters or 18.9 per cent. The average corrected volume for the normal subjects 6 hours after the injection is 15.9 liters or 21.1 per cent of the body weight compared with the thiocyanate space of 17.7 liters, representing 23.5 per cent of the body weight. 7. The most useful method for calculating the sodium space from the data obtained after intravenous administration of radiosodium is as follows: See PDF for Equation This space exceeds the volume of extracellular fluid by the amount of excess sodium in the body that cannot be attributed to the extracellular phase. 8. While neither the thiocyanate method nor the radiosodium method gives precise estimates of the extracellular fluid, the error is of the same order of magnitude in both. For clinical use, the thiocyanate method is superior because of the ready availability of the substance, and the apparatus required.

Influence of adrenal cortex on body water distribution in rats

1965 ◽  
Vol 208 (4) ◽  
pp. 662-665 ◽  
Author(s):  
Arnold M. Moses
Keyword(s):  
Plasma Volume ◽  
Water Distribution ◽  
Plasma Osmolality ◽  
Body Water ◽  
The Body ◽  
Interstitial Volume ◽  
Intracellular Compartments ◽  
Intracellular Volume ◽  
The Relationship ◽  
Adrenalectomized Rats

Body water distribution was determined in rats by the dilution of serum albumin-I131 and Br82 and by desiccation. Methylprednisolone (MP) increased the plasma and intracellular compartments and decreased the interstitial volume in intact hydrated rats. The body water moved in the opposite direction in the adrenalectomized, salt-maintained rats, and MP prevented this movement in terms of intracellular and interstitial volumes. Adrenalectomized rats which were salt depleted had an increased intracellular volume with water coming from both extracellular compartments, and MP had no effect in this group. The effect of deoxycorticosterone acetate was to increase plasma volume in the intact hydrated and in both adrenalectomized groups. The relationship between these changes in body water distribution, hematocrit, and plasma osmolality and sodium concentrations has been discussed.

Pregnancy - A Challenge to Water Balance

Physiology ◽  
1986 ◽  
Vol 1 (4) ◽  
pp. 131-134 ◽  
Author(s):  
K Olsson
Keyword(s):  
Blood Loss ◽  
Water Balance ◽  
Blood Plasma ◽  
Diabetes Insipidus ◽  
Plasma Volume ◽  
Plasma Osmolality ◽  
The Body ◽  
Regulatory Mechanisms ◽  
Set Point ◽  
Homeostatic Mechanisms

Pregnancy involves severe challenges to the homeostatic mechanisms of the body, including the control of water balance. Blood plasma volume increases, but pregnant animals react to blood loss as if plasma volume were not expanded. In some species plasma osmolality falls to a new set point, but plasma osmolality still appears accurately regulated. Transient diabetes insipidus or primary polydipsia may occur, suggesting that water regulatory mechanisms become more vulnerable during pregnancy.

Physiology of body fluids

2016 ◽  
Author(s):  
Anthony Delaney
Keyword(s):  
Interstitial Fluid ◽  
Extracellular Volume ◽  
Extracellular Fluid ◽  
Body Fluids ◽  
The Body ◽  
Fluid Replacement ◽  
Fluid Status ◽  
Healthy Humans ◽  
Fluid Compartment ◽  
The Difference

An understanding of the physiology of body fluids is essential when considering appropriate fluid resuscitation and fluid replacement therapy in critically-ill patients. In healthy humans, the body is composed of approximately 60% water, distributed between intracellular and an extracellular compartments. The extracellular compartment is divided into intravascular, interstitial and transcellular compartments. The movement of fluids between the intravascular and interstitial compartments, is classically described as being governed by Starling forces, leading to a small net efflux of fluid from the intravascular to the interstitial compartment. More recent evidence suggests that a model incorporating the effect of the endothelial glycoclayx layer, a web of glycoproteins and proteoglycans that are bound on the luminal side of the vascular endothelium, better explains the observed distribution of fluids. The movement of fluid to and from the intracellular compartment and the interstitial fluid compartment, is governed by the relative osmolarities of the two compartments. Body fluid status is governed by the difference between fluid inputs and outputs; fluid input is regulated by the thirst mechanism, with fluid outputs consisting of gastrointestinal, renal, and insensible losses. The regulation of intracellular fluid status is largely governed by the regulation of the interstitial fluid osmolarity, which is regulated by the secretion of antidiuretic hormone from the posterior pituitary gland. The regulation of extracellular volume status is regulated by a complex neuro-endocrine mechanism, designed to regulate sodium in the extracellular fluid.

Preoptic recess lesions, body fluid compartments, and the renin-aldosterone system

1983 ◽  
Vol 245 (6) ◽  
pp. R901-R905 ◽  
Author(s):  
S. L. Bealer ◽  
E. G. Schneider
Keyword(s):  
Plasma Volume ◽  
Sodium Excretion ◽  
Total Body Water ◽  
Body Fluid ◽  
Third Ventricle ◽  
Extracellular Fluid ◽  
Body Water ◽  
Fluid Distribution ◽  
Volume Depletion ◽  
Total Body

The effects of electrolytic ablation of the periventricular tissue surrounding the anteroventral third ventricle (AV3V) of the rat brain on body fluid distribution and the renin-aldosterone system were determined. Rats underwent either ablation of AV3V periventricular tissue or control surgeries. After recovery, animals were implanted with femoral arterial and jugular venous catheters, and sodium space and plasma volume were measured by calculating the dilution of intravenous injections of 22Na- and 125I-labeled serum albumin, respectively. Total body water was determined in separate groups of rats by desiccation. Other animals with AV3V lesions and control rats were used to measure urinary sodium excretion and plasma renin (Prenin) and aldosterone (Paldo) concentrations while volume replete and after volume depletion. Animals with AV3V lesions had expanded extracellular fluid volume and decreased plasma volume, but total body water was comparable with control-operated rats. Volume-replete and volume-depleted rats with AV3V lesions had significantly higher Prenin than control animals in similar volume states. Although Paldo was not different between groups in the volume-replete state, it was significantly greater in rats with AV3V lesions than in control animals after volume depletion. These data demonstrate that AV3V periventricular ablation results in chronic alterations in the normal body fluid distribution but does not diminish the rats' ability to increase Prenin and Paldo or decrease sodium excretion during volume depletion.

FEATURES OF FLUID REDISTRIBUTION DURING GOAL-DIRECTED INFUSION THERAPY OF HIGH SURGICAL RISK PATIENTS IN URGENT SURGERY

2020 ◽  
pp. 29-32
Author(s):  
Olha Viktorivna Kravets
Keyword(s):  
Infusion Therapy ◽  
Volume Depletion ◽  
Surgical Risk ◽  
Mild Degree ◽  
Urgent Surgery ◽  
Post Surgery ◽  
Fluid Redistribution ◽  
High Surgical Risk ◽  
Moderate Volume ◽  
Risk Patients

One of the basic components of intensive treatment of patients with an urgent abdominal pathology is perioperative infusion therapy. To analyze the perioperative dynamics of the water sectors of a body in the patients with a high surgical risk with acute abdominal pathology, a targeted regimen of infusion therapy was used to examine 35 patients. Perioperative targeted infusion therapy was carried out with balanced crystalloid solutions. With the non−invasive bioelectric rheography, the indices of water sectors of a body were studied. On the first day, the extracellular sector volume overflow was established due to an increase in interstitial volume. From the second day, the excess volumes of intravascular fluid and plasma were determined. On the third day there was a deficit of all the studied indices. On the fifth day of the post−surgery period, volumetric depletion of mild degree was noted. From the seventh to the tenth days, all the studied parameters to normal were reliably restored. A targeted regimen of infusion therapy in such patients was concluded to correct a moderate volume depletion on the tenth day after surgery by an excessive increase in plasma volume after six hours of treatment, the development of interstitial edema in the first two days, and the formation of mild volumetric depletion from third to seventh day. Key words: water sectors, goal−direct infusion therapy, depletion, urgent surgery, high surgical risk.

scholarly journals Reduction of estimated fluid volumes following initiation of empagliflozin in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the placebo-controlled, randomized EMBLEM trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Michio Shimabukuro ◽  
Hiroki Teragawa ◽  
Yosuke Okada ◽  
Toshinari Takamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Repeated Measures ◽  
Medical Information ◽  
Controlled Trial ◽  
Extracellular Volume ◽  
Cardiovascular Outcomes ◽  
Fluid Volume ◽  
The Body

Abstract Backgrounds/Aim Sodium glucose co-transporter 2 inhibitors promote osmotic/natriuretic diuresis and reduce excess fluid volume, and this improves cardiovascular outcomes, including hospitalization for heart failure. We sought to assess the effect of empagliflozin on estimated fluid volumes in patients with type 2 diabetes and cardiovascular disease (CVD). Methods The study was a post-hoc analysis of the EMBLEM trial (UMIN000024502), an investigator-initiated, multi-center, placebo-controlled, double-blinded, randomized-controlled trial designed primarily to evaluate the effect of 24 weeks of empagliflozin treatment on vascular endothelial function in patients with type 2 diabetes and established CVD. The analysis compared serial changes between empagliflozin (10 mg once daily, n = 52) and placebo (n = 53) in estimated plasma volume (ePV), calculated by the Straus formula and estimated the extracellular volume (eEV), determined by the body surface area, measured at baseline and 4, 12, and 24 weeks after initiation of treatment. Correlations were examined between the changes from baseline to week 24 in each estimated fluid volume parameter and several clinical variables of interest, including N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Results In an analysis using mixed-effects models for repeated measures, relative to placebo empagliflozin reduced ePV by − 2.23% (95% CI − 5.72 to 1.25) at week 4, − 8.07% (− 12.76 to − 3.37) at week 12, and − 5.60% (− 9.87 to − 1.32) at week 24; eEV by − 70.3 mL (95% CI − 136.8 to − 3.8) at week 4, − 135.9 mL (− 209.6 to − 62.3) at week 12, and − 144.4 mL (− 226.3 to − 62.4) at week 24. The effect of empagliflozin on these parameters was mostly consistent across various patient clinical characteristics. The change in log-transformed NT-proBNP was positively correlated with change in ePV (r = 0.351, p = 0.015), but not with change in eEV. Conclusions Our data demonstrated that initiation of empagliflozin treatment substantially reduced estimated fluid volume parameters in patients with type 2 diabetes and CVD, and that this effect was maintained for 24 weeks. Given the early beneficial effect of empagliflozin on cardiovascular outcomes seen in similar patient populations, our findings provide an important insight into the key mechanisms underlying the clinical benefit of the drug. Trial registration University Medical Information Network Clinical Trial Registry, number 000024502

scholarly journals Effects of nonsteroidal anti-inflammatory drugs on plasma volume and extracellular fluid volume in rats

1978 ◽  
Vol 28 ◽  
pp. 179
Author(s):  
Toshiaki Kadokawa ◽  
Kanno Hosoki ◽  
Kunihiko Takeyama ◽  
Hisao Minato ◽  
Masanao Shimizu
Keyword(s):  
Plasma Volume ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Inflammatory Drugs ◽  
Anti Inflammatory
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