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Sodium tonicity volume

Maria-Eleni Roumelioti, Robert H Glew, Zeid J Khitan, Helbert Rondon-Berrios, Christos P Argyropoulos, Deepak Malhotra, Dominic S Raj, Emmanuel I Agaba, Mark Rohrscheib, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas
The regulation of body fluid balance is a key concern in health and disease and comprises three concepts. The first concept pertains to the relationship between total body water (TBW) and total effective solute and is expressed in terms of the tonicity of the body fluids. Disturbances in tonicity are the main factor responsible for changes in cell volume, which can critically affect brain cell function and survival. Solutes distributed almost exclusively in the extracellular compartment (mainly sodium salts) and in the intracellular compartment (mainly potassium salts) contribute to tonicity, while solutes distributed in TBW have no effect on tonicity...
January 6, 2018: World Journal of Nephrology
N Van Regenmortel, T De Weerdt, A H Van Craenenbroeck, E Roelant, W Verbrugghe, K Dams, M L N G Malbrain, T Van den Wyngaert, P G Jorens
Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. fluid solutions supported by limited scientific evidence. In particular, it remains unclear whether fluid tonicity contributes to the recently established detrimental effects of fluid, sodium, and chloride overload. Methods.: This crossover study consisted of two 48 h study periods, during which 12 fasting healthy adults were treated with a frequently prescribed solution (NaCl 0...
June 1, 2017: British Journal of Anaesthesia
Christos Argyropoulos, Helbert Rondon-Berrios, Dominic S Raj, Deepak Malhotra, Emmanuel I Agaba, Mark Rohrscheib, Zeid Khitan, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas
Disturbances in tonicity (effective osmolarity) are the major clinical disorders affecting cell volume. Cell shrinking secondary to hypertonicity causes severe clinical manifestations and even death. Quantitative management of hypertonic disorders is based on formulas computing the volume of hypotonic fluids required to correct a given level of hypertonicity. These formulas have limitations. The major limitation of the predictive formulas is that they represent closed system calculations and have been tested in anuric animals...
May 2, 2016: Curēus
Lívia X S Farah, Vanessa Valentini, Thaissa D Pessoa, Gerhard Malnic, Alicia A McDonough, Adriana C C Girardi
Glucagon like peptide-1 (GLP-1) is an incretin hormone constantly secreted from the intestine at low basal levels in the fasted state; plasma concentrations rise rapidly after nutrient ingestion. Upon release, GLP-1 exerts insulinotropic effects via a G protein-coupled receptor, stimulation of adenylyl cyclase, and cAMP generation. Although primarily involved in glucose homeostasis, GLP-1 can induce diuresis and natriuresis when administered in pharmacological doses in humans and rodents. However, whether endogenous GLP-1 plays a role in regulating renal function remains an open question...
January 15, 2016: American Journal of Physiology. Renal Physiology
Anna E Stanhewicz, W Larry Kenney
Physiological regulation of sodium and water intake and output is required for the maintenance of homeostasis. The behavioral and neuroendocrine mechanisms that govern fluid and salt balance are highly interdependent, with acute and chronic alterations in renal output tightly balanced by appropriate changes in thirst and, to a lesser extent in humans, sodium appetite. In healthy individuals, these tightly coupled mechanisms maintain extracellular fluid volume and body tonicity within a narrow homeostatic range by initiating ingestive behaviors and the release of hormones necessary to conserve water and sodium within the body...
September 2015: Nutrition Reviews
R Kettritz, F C Luft
The maintenance of water and electrolyte homeostasis is of enormous importance for the functioning of cells and tissues. A number of therapeutic procedures intentionally or unintentionally influence important regulatory mechanisms of these interdependent balanced systems. Excessive salt intake doesn't only expand the extracellular volume; it can also cause a considerable increase in tonicity. Owing to its insulin-dependent duality of action, glucose can represent an effective or an ineffective osmolyte. This fact has to be considered in patients with diabetic ketoacidosis...
July 2015: Der Internist
Huai-huai Wang, Li-min Zhang, Zi-gang Zhao, Chun-yu Niu
PURPOSE: To evaluate the changes of contractility and reactivity in isolated lymphatics from hemorrhagic shock rats with resuscitation. METHODS: Six rats in the shock group suffered hypotension for 90 min by hemorrhage, and resuscitation with shed blood and equal ringer's solution. Then, the contractility of lymphatics, obtained from thoracic ducts in rats of the shock and sham groups, were evaluated with an isolated lymphatic perfusion system using the indices of contractile frequency (CF), tonic index (TI), contractile amplitude (CA) and fractional pump flow (FPF)...
March 2015: Acta Cirúrgica Brasileira
Jeremy N Friedman, Carolyn E Beck, Julie DeGroot, Denis F Geary, Daniel J Sklansky, Stephen B Freedman
IMPORTANCE: Use of hypotonic intravenous fluids for maintenance requirements is associated with increased risk of hyponatremia that results in morbidity and mortality in children. Clinical trial data comparing isotonic and hypotonic maintenance fluids in nonsurgical hospitalized pediatric patients outside intensive care units are lacking. OBJECTIVE: To compare isotonic (sodium chloride, 0.9%, and dextrose, 5%) with hypotonic (sodium chloride, 0.45%, and dextrose, 5%) intravenous maintenance fluids in a hospitalized general pediatric population...
May 2015: JAMA Pediatrics
Pieter Martens, Raf Bisschops
Adequate cleansing of the bowel is important for a reliable and diagnostic colonoscopy. Proper bowel preparation is directly correlated to the diagnostic performance of colonoscopy, procedure time, cost price and the complication rate. The ideal bowel preparation agent should be efficient, safe and well tolerated by the patient. Numerous agents have become commercially available overtime. Current agents can be classified according to their tonicity, as being isotonic or hypertonic. Poly-ethylene glycol based solutions balanced with electrolytes are the prototype of isotonic bowel preparations...
June 2014: Acta Gastro-enterologica Belgica
Emma C Hart, B Gunnar Wallin, Jill N Barnes, Michael J Joyner, Nisha Charkoudian
Interindividual variability in sympathetic nerve activity (SNA) has provided insight into integrative mechanisms contributing to blood pressure (BP) regulation in humans. In young people, the influence of high SNA on BP is balanced by lower cardiac output and less adrenergic vasoconstrictor responsiveness. Older people have higher SNA and higher BP. We hypothesized that SNA has a restraining effect on peripheral vasodilator responsiveness in young and older men, such that individuals with higher tonic SNA would show less forearm vasodilatation to exogenous vasodilators...
March 2014: American Journal of Physiology. Heart and Circulatory Physiology
Jonathan P Mochel, Martin Fink, Mathieu Peyrou, Cyril Desevaux, Mark Deurinck, Jérôme M Giraudel, Meindert Danhof
The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and volume homeostasis. Its contribution to the development of cardiovascular diseases has long been recognized. Extensive literature has shown that peptides of the RAAS oscillate with a circadian periodicity in humans, under strong influence of posture, sleep, and age. Although observations of time-variant changes in the renin cascade are available in dogs, no detailed chronobiological investigation has been conducted so far...
November 2013: Chronobiology International
Thomas J Morgan
PURPOSE OF REVIEW: This review explores the contemporary definition of the term 'balanced crystalloid' and outlines optimal design features and their underlying rationale. RECENT FINDINGS: Crystalloid interstitial expansion is unavoidable, but also occurs with colloids when there is endothelial glycocalyx dysfunction. Reduced chloride exposure may lessen kidney dysfunction and injury with a possible mortality benefit. Exact balance from an acid-base perspective is achieved with a crystalloid strong ion difference of 24 mEq/l...
August 2013: Current Opinion in Critical Care
Christian Overgaard-Steensen, Troels Ring
Disturbances in sodium concentration are common in the critically ill patient and associated with increased mortality. The key principle in treatment and prevention is that plasma [Na+] (P-[Na+]) is determined by external water and cation balances. P-[Na+] determines plasma tonicity. An important exception is hyperglycaemia, where P-[Na+] may be reduced despite plasma hypertonicity. The patient is first treated to secure airway, breathing and circulation to diminish secondary organ damage. Symptoms are critical when handling a patient with hyponatraemia...
February 27, 2013: Critical Care: the Official Journal of the Critical Care Forum
Amy E Burchell, Paul A Sobotka, Emma C Hart, Angus K Nightingale, Mark E Dunlap
Heart failure is increasing in prevalence around the world, with hospitalization and re-hospitalization as a result of acute decompensated heart failure (ADHF) presenting a huge social and economic burden. The mechanism for this decompensation is not clear. Whilst in some cases it is due to volume expansion, over half of patients with an acute admission for ADHF did not experience an increase in total body weight. This calls into question the current treatment strategy of targeting salt and water retention in ADHF...
June 2013: Current Heart Failure Reports
Giancarlo Vanini, Helen A Baghdoyan
STUDY OBJECTIVES: Gamma-aminobutyric acid (GABA) causes phasic inhibition via synaptic GABAA receptors and tonic inhibition via extrasynaptic GABAA receptors. GABA levels in the extracellular space regulate arousal state and cognition by volume transmission via extrasynaptic GABAA receptors. GABAergic transmission in the pontine reticular formation promotes wakefulness. No previous studies have determined whether an agonist at extrasynaptic GABAA receptors administered into the pontine reticular formation alters sleep and wakefulness...
March 2013: Sleep
Alice Huang, Satish Govindaraj
PURPOSE OF REVIEW: A comprehensive literature review was conducted to evaluate the efficacy of various topical therapies of chronic rhinosinusitis (CRS): saline, antibiotics, corticosteroids, and antifungals. Emerging new studies can provide the necessary amendments to improve the treatment for CRS. RECENT FINDINGS: Saline was more effective in treating CRS when administered with increased tonicity or through large volume, low positive pressure devices. Contamination rates of irrigation bottles were insufficient to outweigh the benefits of saline...
February 2013: Current Opinion in Otolaryngology & Head and Neck Surgery
Thierry Petitclerc
Water balance control is aimed at normalizing cellular hydration, and sodium balance control at normalizing extracellular volume. Water balance control is based on the regulation of body fluid tonicity, while the control of sodium balance is based on the regulation of effective arterial volume. Disorders of water balance act on cellular hydration: primary disorders induce a proportional change in tonicity; secondary disorders are induced by a change in tonicity or effective arterial volume. Disorders of sodium balance act on extracellular volume: primary disorders of sodium balance induce a change in effective arterial volume; secondary disorders are induced by a change in effective arterial volume...
February 2013: Néphrologie & Thérapeutique
Michael Bennett, Gerry Fitzpatrick, Maria Donnelly
A 41-year-old white male with a history of alcoholism and depression was brought from prison into the emergency department (ED) after having had a witnessed tonic-clonic seizure lasting approximately 5 min. During the 24 h prior to admission, the patient's cell mate reported that he was restless and had consumed 11 litres of water. The patient had also been taking regular escitalopram for his depression. On arrival to the ED, the patient was found to have a sodium level of 112 mmol/l. After correction of his hyponatraemia the patient developed rhabdomyolisis with a creatine kinase level of 65 064 IU/l...
October 4, 2011: BMJ Case Reports
Pierre-Alexandre Boucher, Béla Joós, Catherine E Morris
Injury to neural tissue renders voltage-gated Na⁺ (Nav) channels leaky. Even mild axonal trauma initiates Na⁺-loading, leading to secondary Ca²⁺-loading and white matter degeneration. The nodal isoform is Nav1.6 and for Nav1.6-expressing HEK-cells, traumatic whole cell stretch causes an immediate tetrodotoxin-sensitive Na⁺-leak. In stretch-damaged oocyte patches, Nav1.6 current undergoes damage-intensity dependent hyperpolarizing- (left-) shifts, but whether left-shift underlies injured-axon Nav-leak is uncertain...
October 2012: Journal of Computational Neuroscience
Chris Thompson, Tomas Berl, Alberto Tejedor, Gudmundur Johannsson
The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist's view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process...
March 2012: Best Practice & Research. Clinical Endocrinology & Metabolism
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