Regulation of body fluids andSalt water balance I

Prof. K.A. Kirsch

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Solids and water distribution Usual daily sources of water intake

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Body Composition and Body Fluid Compartments ECFV = Extracellular Fluid VolumeICFV = Intracellular Fluid Volume

ECFV

ICFV

FATBones

Infant Child Male Female Pregnant Woman

Elderly

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Fluid Balance

• External Balance =

Fluid Input versus Fluid Output

• Internal Balance =

Shifts between the Body Fluid Compartments

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Distribution and Exchange of water and changesin external water balance

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Fluid BalanceFactors to be considered

• Water intake (thirst)

• Water outputKidneysPerspiration

Respiratory water lossTransdermal water loss

• Food intake

• Salt intake Salt output

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Regulation of water and NaCl output

HypervolemiaH2O NaCL

Renin Osmolarity ↑

A II ↓ Quabain ANF ADH ↑AtriumADH ↓

Osmolarity ↓

R H2O ↓ R H2O ↑

Antidiuresis

Aldosterone

Diuresis Natriuresis

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Historical information sought in assessing water

balance

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Ascent to high altitude is associated with a

• Decrease in Body weight

• Decrease in Water intake

• Increase in urine output

(Change in the external balance)

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Factors contributing to the negative water balance in high altitude

• Sensation of thirst is blunted

• Increased water loss via the lungs cold → low humidity

• Solar radiation

• Low food intake

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

Cumulative water balanceunder a exposure

at 4.300 m

Joluson H. et al. Fed. Proc. 1969; 28: 1195 - 98

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Regulation of body fluids and Salt water balance I K.A. Kirsch April 2005

The change in levels of serum proteins, hematocrit, and

hemoglobin three hours after the arrival at the altitude of 2,390 m

Effect of altitude exposure on

the plasma volume

Hannou et al. J Appl. Physiol. 1969; 26: 540-47Hutardo et. al. J. Appl. Physiol. 1932; 100: 487-505

Regulation of body fluids andSalt water balance II

Prof. K.A. Kirsch

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Mean changes in hematoglobin, red cell volume, plasma volume, total blood volume during a Himalayan Expedition

Pugle L. et. al.Brit. Med. J. 1962; 2: 621-27

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Calculated changes inbody fluid volumes

during several days ofhill walking at sea level

Williams E. Proc. Royal Soc. 1966; 165: 266 - 80

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

ANP in acute mountain sickness

Bärtsch P. et. al. J. Appl, Physiol. 1988; 65(5): 1929-1937

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Hematocrit and circulation

Bärtsch P. et. al. J. Appl, Physiol. 1988; 65(5): 1929-1937

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Regulation of water and NaCl output

HypervolemiaH2O NaCL

Renin Osmolarity ↑

A II ↓ Quabain ANF ADH ↑AtriumADH ↓

Osmolarity ↓

R H2O ↓ R H2O ↑

Antidiuresis

Aldosterone

Diuresis Natriuresis

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

The influence of AMS on the Renin - Angiotensin - System

Bärtsch P. et. al. J. Appl, Physiol. 1988; 65(5): 1929-1937

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Changes in potassium at high altitude

Janoshi W. Fed. Proc. 1969; 28: 1185-1189

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Influence of volume depletion on acute response of plasma ADH to osmotic stimulation

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Regulation of body fluids and Salt water balance II K. Kirsch April 2005

Disorders Associated with Chronic Sodium Depletation