Variations of Water and Electrolyte Composition of Muscle and Skin in Infants Suffering Acute Dehydration

Abstract

Extract: Variations in the composition of muscle tissue have been studied by neutron activation analysis of microbiopsies in 66 children dehydrated as a result of diarrhea. In the great majority of cases (53 children) no significant potassium depletion was found in muscle. In 23 cases of hypertonic dehydration, muscle tissue showed an important loss of water in 20 cases and a significant increase of sodium content in 20 cases and of chloride content in 15 cases. Hypertonicity of tissular water was observed. In hypotonic dehydration (21 cases), muscle tissue remained normally hydrated and in one-third of all cases, a low sodium and chloride content was found. Hypo-tonicity of tissular water was observed. Analysis of skin tissue, performed in 21 of these children, showed essential differences; in the majority of cases, including those with hypotonic dehydration, there was an important reduction of the water content of skin without any detectable changes in the amount of electrolytes. The differences in behavior of muscle and skin tissues in acute dehydration were confirmed by the study of seven children with hypotonic dehydration at the time of admission and after complete recovery. In those cases, the increase of cutaneous hydration during treatment was not accompanied by any significant variations in the amount of muscle water. The absence of any significant correlation between variations of plasma chloride concentration and the concentration of chloride in skin water confirms the experimental data showing that, in contrast to other tissues, i.e., muscle, the movement of water between plasma and skin is not accompanied by parallel movement of chloride ions. Speculation: The data presented in this study suggest that skin may be considered as a mobile depot for water which acts as an emergency regulator for the maintenance of water content of tissues that are richer in cells, such as muscle. Hypotonic dehydration represents a good illustration of this statement. Since only 14 of the 66 dehydrated children studied presented a significantly decreased value of muscle potassium, it seems likely that there exists no systematic cellular depletion of potassium in acute dehydration consecutive to diarrhea of short duration.