Increased Fluid Volume Research Articles

Exploring aegle marmelos (bael fruit): understanding its health benefits and potential for therapy

The kidneys play a crucial role in maintaining the body's fluid balance through precise regulation of sodium, chloride, and water levels. They expel sodium and chloride, prompting water release and reducing fluid volume. Conversely, retaining these elements leads to water retention and increased fluid volume. This intricate mechanism ensures internal stability. Kidneys filter these substances into tubules, with most being reabsorbed into the blood and exiting as urine. Complex processes in various tubule segments complicate sodium and chloride reabsorption. Diuretics are valuable in treating edema, congestive heart failure, and hypertension. Bael (A. marmelos), a significant herb in Ayurveda, contains compounds like flavonoids and alkaloids. It's used for diarrhea, diabetes, inflammation, and hyperlipidemia. An alcoholic extract from the mature fruit of Aegle marmelos exhibits diuretic activity, potentially assisting with common kidney ailments. Bael's therapeutic potential arises from its diverse compounds and established use in traditional medicine.

High intraoperative fluid load associated with prolonged length of hospital stay and complications after non-cardiac surgery in neonates

Inappropriate perioperative fluid load can lead to postoperative complications and death. This retrospective study was designed to investigate the association between intraoperative fluid load and outcomes in neonates undergoing non-cardiac surgery. From April 2020 to September 2022, 940 neonates who underwent non-cardiac surgery were retrospectively enrolled and their perioperative data were harvested for further analysis. According to recorded intraoperative fluid volumes defined as ml.kg−1 h−1, patients were mandatorily divided into quintile with fluid load as restrictive (quintile 1, Q1), moderately restrictive (Q2), moderate (Q3), moderately liberal (Q4), and liberal (Q5). The primary outcomes were defined as prolonged length of hospital stay (LOS) (postoperative LOS ≥ 14 days), complications beyond prolonged LOS, and 30-day mortality. Secondary outcomes included postoperative complications within 14 days of hospital stay. The intraoperative fluid load was in Q1 of 6.5 (5.3–7.3) (median and IQR); Q2: 9.2 (8.7–9.9); Q3: 12.2 (11.4–13.2); Q4: 16.5 (15.4–18.0); and Q5: 26.5 (22.3–32.2) ml.kg−1 h−1. The odd of prolonged LOS was positively correlated with an increase fluid volume (Q5 quintile: OR 2.602 [95% CI 1.444–4.690], P = 0.001), as well as complications beyond prolonged LOS (Q5: OR 3.322 [95% CI 1.656–6.275], P = 0.001). The overall 30-day mortality rate was increased with high intraoperative fluid load but did not reach to a statistical significance after adjusted with confounders. Furthermore, the highest quintile of fluid load (26.5 ml.kg−1 h−1, IQR [22.3–32.2]) (Q5 quintile) was significantly associated with longer postoperative mechanical ventilation time compared with Q1 (Q5: OR 2.212 [95% CI 1.101–4.445], P = 0.026). Conclusion: Restrictive intraoperative fluid load had overall better outcomes, whilst high fluid load was significantly associated with prolonged LOS and complications after non-cardiac surgery in neonates. Trial registration: Chictr.org.cn Identifier: ChiCTR2200066823 (December 19, 2022).What is Known:• Inappropriate perioperative fluid load can lead to postoperative complications and even death.What is New:• High perioperative fluid load was significantly associated with an increased length of stay after non-cardiac surgery in neonates, whilst low fluid load was consistently related to better postoperative outcomes.

Spinal column and midbrain integration for long duration space missions

Background: Deep space missions produce atrophied postural muscles and cognitive and proprioception losses. Lumbar and hip injury as well as limbic system dysregulation may result. In microgravity, the Neutral Body Position is the spinal baseline for the prone-position cycle, where the astronaut’s lumbar muscles and audio and visual-spatial centers can be informed through a virtual reality interface. Methods: The exercise can be reproduced as a low-fidelity space simulation in a epsom-salt float tank. MRI and ultrasound imaging of the spine at the start of the 4-week program can be compared to the imaged results upon program completion. Any contractile tightening would be evident in shortened IVD (intervertebral distances) in post-procedure MRI results. The terrestrial gravity cycling instrument establishes an effective baseline for determining anthropomorphic tolerances, the necessary workout duration and resistance levels in zero gravity. Results: An exercise regimen performed on an ergonomically-designed cycle can limit the stresses to demineralized postural bones thus reducing the risk of in-flight and post-flight fractures. The redistribution of spinal fluids is a specific focus of this exercise instrument. It's postulated that the secondary effect of reduced spinal fluid shifts are lower optic nerve and cranial pressures and the tertiary effect is the reduction of neuro-cognitive and cardio-vascular stresses brought on by weightlessness. Conclusions: The biomechanism of spinal fluid’s dynamic flow across a lower pressure gradient may be the cause of increased fluid volume in the spinal canal. This cycling exercise lessens the physical impact to areas of BMD depletion such as the hip socket. The exercise can maintain spinal flexibility, fluid stasis and posture. Human body systems affected by microgravity could be assisted with Virtual Reality (VR) inputs. The limbic system receives comprehensive, targeted sensory information that enables reorganization of neuronal networks that may serve to change dysregulated human immune, spatio-temporal, and cognitive systems.

Physical activity for obstructive sleep apnea after stroke? A pilot study assessing the contribution of body fluids.

Obstructive sleep apnea (OSA) and physical inactivity are common after stroke. Physical inactivity can lead to/or exacerbate edema following stroke, and the resultant overnight fluid shift may increase the risk of OSA. We aimed to investigate the effect of physical activity on nocturnal rostral fluid shift, sleep pattern, and edematous state of hemiparetic patients. Neck circumference (tape measured) and arms, legs, and trunk fluid volume (bioelectrical impedance spectrum analyzer) were measured before and after 2 polysomnography (PSG) examinations. In the lab, a whole night PSG was performed after the intervention. The intervention consisted of inactivity (lying down and sitting) or activity (standing, performing calf muscle contractions while standing, walking, and climbing stairs) between 13 and 21 h, after therandomization of the participants. With a 7-day interval, participants crossed over to the other group. From 126 eligible participants, 8 with hemiparetic post-first-ever ischemic stroke at the subacute phase were recruited (age: 53.2 ± 16.2; 6 women). Physical activity reduced AHI from 19 to 13n°/h and wake after sleep onset from 76.5 to 60.3 min and increased fluid volume of paretic and non-paretic arms and trunk before sleep compared to inactivity. An acute bout of physical activity reduced OSA classification based on AHI (from moderate to mild) and sleep fragmentation. Our results provide preliminary evidence of a possible link between physical activity in patients after stroke as an intervention to counteract OSA severity and improve sleep.

RELATIONSHIP MOTIVATION WITH INTERDIALITYC WEIGHT GAIN (IDWG) CHANGES IN CHRONIC KIDNEY DISEASE PATIENTS

Chronic kidney disease is a failure of kidney function to maintain metabolism, and balance of fluid and electrolytes due to the progressive destruction of kidney structure. Increased fluid volume must be limited. If there is excess can cause edema, tightness and decreased consciousness. Therefore, patient motivation is needed to control changes of Interdialytic Weight Gain (IDWG). The aim of this study is to prove the relationship of patient motivation with changes of IDWG in CKD patients. The design of this study was correlational analysis with a cross-sectional approach. The sampling technique used non-probability sampling type purposive sampling, 40 CKD patients undergoing hemodialysis therapy at the RSUD Bangil were enrolled in this study. Data collection was using a questionnaire. Data analysis was using Spearman rho statistical test, which showed a significance value of 0,000 that was smaller than alpha (0.05), so it can be concluded that there was a significant relationship between patient motivation and IDWG changes of CKD patients undergoing hemodialysis therapy. Strong motivation to undergo hemodialysis is important because hemodialysis has become a necessity for him, a treatment must be undertaken by patients with chronic kidney disease.

수중 폭발에 의한 함체의 비탄성 휘핑 응답에 관한 연구

The primary effect of the far-field underwater explosion (UNDEX) is the whipping of the ship hull girder. This paper aims to verify why inelastic effects should be considered in the whipping response estimations from the UNDEX simulations. A navy ship was modeled using Timoshenko beam elements over the ship length uniformly keeping the constant midship section modulus. The transient UNDEX pressure was produced using two types of the Geers-Hunter doubly-asymptotic models: compressible and incompressible fluids. Because the UNDEX model based on incompressible fluid assumption provided more increased fluid volume acceleration in the bubble phase, the incompressible fluid-based UNDEX model was adopted for the inelastic whipping response analyses. The non-linear hull girder bending moment-curvature curve was used to embed inelastic effects in the UNDEX analyses where the Smith method was applied to derive the non-linear stiffness. We assumed two stand-off distances to see more apparent inelastic effects: 40.5 m and 35.5 m. In the case of the 35.5 m stand-off distance, there was a statistically significant inelastic effect in terms of the average of peak moments and the average exceeding proportional limit moments. For the conservative design of a naval ship under UNDEX, it is recommended to use incompressible fluid. In the viewpoint of cost-effective naval ship design, the inelastic effects should be taken into account.

The Increase in Paraoxonase 1 Is Associated With Decrease in Left Ventricular Volume in Kidney Transplant Recipients.

Background: Patients on dialysis have impaired cardiac function, in part due to increased fluid volume and ventricular stress. Restored kidney function through transplantation reduces left ventricular volume in both systole and diastole. We previously reported that the decrease in NT-proB-type natriuretic peptide (NT-proBNP) was associated with a decrease in adiponectin. Paraoxonase 1 (PON1) has been inversely associated with cardiovascular outcomes. We now report the association of changes in PON1 with changes in left ventricular volume and left ventricular mass after kidney transplantation.Design: Patients on dialysis were assessed at baseline and 12 months after kidney transplantation (n = 38). A comparison group of patients on dialysis who were not expected to receive a transplant in the next 24 months were studied (n = 43) to determine if the change of PON1 with kidney transplantation achieved a significance greater than that due to biologic variation. Left ventricular volume and mass were determined by cardiac magnetic resonance imaging. PON1 was measured by arylesterase activity and by mass.Results: PON1 mass and activity were not different between the groups at baseline. Both PON1 mass and activity were increased post-kidney transplantation (p < 0.0001 for change). The change in PON1 mass (p = 0.0062) and PON1 arylesterase activity (p = 0.0254) were inversely correlated with the change in NT-proBNP for patients receiving a kidney transplant. However, only the change in the PON1 mass, and not the change in PON1 arylesterase, was inversely correlated with the change in left ventricular volume (ml/m2.7) (p = 0.0146 and 0.0114 for diastolic and systolic, respectively) and with the change in hemoglobin (p = 0.0042).Conclusion: Both PON1 mass and arylesterase activity are increased by kidney transplantation. The increase in PON1 mass is consistent with a novel relationship to the increase in hemoglobin and decrease in left ventricular volume and NT-proBNP seen when kidney function is restored.

Similarities and Differences Between Vestibular and Cochlear Systems - A Review of Clinical and Physiological Evidence.

The evoked response to repeated brief stimuli, such as clicks or short tone bursts, is used for clinical evaluation of the function of both the auditory and vestibular systems. One auditory response is a neural potential — the Auditory Brainstem Response (ABR) — recorded by surface electrodes on the head. The clinical analogue for testing the otolithic response to abrupt sounds and vibration is the myogenic potential recorded from tensed muscles — the vestibular evoked myogenic potential (VEMP). VEMPs have provided clinicians with a long sought-after tool — a simple, clinically realistic indicator of the function of each of the 4 otolithic sensory regions. We review the basic neural evidence for VEMPs and discuss the similarities and differences between otolithic and cochlear receptors and afferents. VEMPs are probably initiated by sound or vibration selectively activating afferent neurons with irregular resting discharge originating from the unique type I receptors at a specialized region of the otolithic maculae (the striola). We review how changes in VEMP responses indicate the functional state of peripheral vestibular function and the likely transduction mechanisms allowing otolithic receptors and afferents to trigger such very short latency responses. In section “ELECTROPHYSIOLOGY” we show how cochlear and vestibular receptors and afferents have many similar electrophysiological characteristics [e.g., both generate microphonics, summating potentials, and compound action potentials (the vestibular evoked potential, VsEP)]. Recent electrophysiological evidence shows that the hydrodynamic changes in the labyrinth caused by increased fluid volume (endolymphatic hydrops), change the responses of utricular receptors and afferents in a way which mimics the changes in vestibular function attributed to endolymphatic hydrops in human patients. In section “MECHANICS OF OTOLITHS IN VEMPS TESTING” we show how the major VEMP results (latency and frequency response) follow from modeling the physical characteristics of the macula (dimensions, stiffness etc.). In particular, the structure and mechanical operation of the utricular macula explains the very fast response of the type I receptors and irregular afferents which is the very basis of VEMPs and these structural changes of the macula in Menière’s Disease (MD) predict the upward shift of VEMP tuning in these patients.

Higher plasma NT-proBNP levels correlate with syndrome of inappropriate antidiuretic hormone and poor prognosis in neurological patients.

BackgroundHyponatremia induced by syndrome of inappropriate antidiuretic hormone secretion (SIADH) was common electrolyte disturbance encountered in critically ill neurological diseases, which has normal or increased fluid volume. Brain natriuretic peptide (BNP), which is released in equal proportion to N-terminal pro-brain natriuretic peptide (NT-proBNP), plays vital roles in regulation of volume status. The relationship between SIADH and NT-proBNP levels in neurological diseases has rarely been reported.MethodsA retrospective cross-sectional study was conducted to analyze plasma NT-proBNP levels in 33 patients with SIADH and 23 controlled eunatremic patients with neurological diseases.ResultsBaseline NT-proBNP levels were compared between two groups [SIADH group: median 311 pg/mL, interquartile range (IQR) 110–768 pg/mL] vs. eunatremic group: median 46 pg/mL, IQR, 12–96 pg/mL) (P<0.05). Plasma NT-proBNP levels were markedly increased in hyponatremic patients who had two or more complications than those who had less complication (P<0.05). In SIADH patients, NT-proBNP levels in remission phase were lower to levels at baseline. Furthermore, no death was seen in eunatremic patients, while five SIADH patients died from complications.ConclusionsSIADH had higher plasma NT-proBNP levels and poorer prognosis compared to eunatremic neurological patients. NT-proBNP serves as a biomarker of disease severity while not extracellular volume (ECV) status in critically ill neurological patients.

Fluid Response Evaluation in Sepsis Hypotension and Shock

Patients in septic shock routinely receive large volumes of intravenous fluids as part of their initial resuscitation. However, hypervolemia secondary to aggressive fluid administration is associated with increased morbidity and mortality including renal failure, respiratory failure, or death. Dynamic approaches to hemodynamic monitoring for fluid responsiveness (FR) including measurement of stroke volume (SV) following increased fluid volume through IV fluids during passive leg raise (PLR) may have a role in guiding resuscitative efforts, although the benefits in an emergency department or ICU setting are unclear.

Effect of Exposure to E-Cigarette Smoke on Lung Histology of Balb/c Male Mice (Mus musculus L.)

Background: Electric cigarette is a type of cigarette that change the liquid containing nicotine and other ingredients in the form of steam. This research aimed to identify the effect of exposure to e-cigarette smoke towards the thickness of bronchioles mucosa and the alveolar septa on male Balb'C mice (M. musculus). Methods: This research was an experimental design used 24 male divided into four groups, i.e., control dan three treatment groups. Treatment groups were given different volume of e-cigarettes liquid, i.e., 1 ml; 2 ml; and 4 ml. The exposure of e-cigarette was done in 4 weeks, respectively. Results: Electric cigarette exposure with different fluid volumes leads to an increase in the bronchioles mucosa's thickness and the alveoli septa. Increasing the volume of fluid used results in an increase in bronchioles mucosal thickness, but decreases the alveoli septa's thickness, resulting in destruction and dilatation of the alveoli. Conclusion: Exposure to e-cigarette smoke with a liquid volume of 1 ml affects the increase in the average thickness of the bronchial mucosa and alveoli septa. An increase in the average thickness of the bronchioles mucosa occurs along with increased fluid volume in exposure to e-cigarette smoke.&#x0D;

Synovial Fluid Volume at the Time of Arthroscopic Rotator Cuff Repair Correlates With Tear Size.

BackgroundInflammatory biomarkers are increased in the synovium and tendon of rotator cuff tears. Several studies demonstrate an associated increase in these markers and size of the tear, with implications of chondral destruction leading to rotator cuff tear arthropathy and glenohumeral arthritis.MethodsThis is a prospective study of 105 patients undergoing arthroscopic rotator cuff repair in which intra-articular synovial fluid was aspirated just prior to arthroscopy. Adult patients with a partial or full-thickness rotator cuff tear undergoing arthroscopic repair were included, and those with inflammatory arthritis, active infection, open cuff repair, intraoperative findings of osteoarthritis, or those undergoing revision cuff repair were excluded.ResultsThe average patient age was 58 years (range 33-74 years), with 59 (56.2%) males. The mean aspirate volume of partial tears was 0.76 ± 0.43 mL, small tears 1.46 ± 1.88 mL, medium tears 3.04 ± 2.21 mL, and large tears 6.60 ± 3.23 mL. Full-thickness versus partial tears had significantly more synovial fluid (3.64 vs. 0.76 mL, respectively, p < 0.0001). An aspiration volume of 1.5 mL or greater resulted in 91.3% specificity and 96.8% positive predictive value for a full-thickness tear. Smoking (p = 0.017), tear size (p < 0.0001), and tears of the infraspinatus (p = 0.048) were significantly correlated with synovial fluid volume. Age, body mass index, chronicity of tear, sex, subscapularis involvement, supraspinatus involvement, and teres minor involvement had no association to synovial fluid volume.ConclusionPreoperative aspiration of the glenohumeral joint to identify the volume of synovial fluid can aid to identify full-thickness rotator cuff tears, and increased fluid volume should alert the clinician of a large tear.

585 Preventing Occipital Pressure Injuries in Patients Admitted to the Burn ICU

Abstract Introduction Occipital pressure injuries (OPI) are categorized as pressure injuries on the occipital bone caused by pressure, shearing, or friction. Patients with significant burns are at a greater risk of developing these types of injuries due to increased fluid volume from resuscitation, decreased tissue perfusion, immobility, edema and length of stay. The rate of OPI in the BICU was 4.3 in 2016; this led to a comprehensive program to reduce/eliminate these injuries. Methods Early identification of at-risk patients and implementation of prevention strategies was conducted. Best practices were reviewed and the following interventions were put into place: on admission, all patients with facial burns, (intubated or not), were given a small size fluidized positioner pillow. The pillow was to be positioned with a defined divot in the center and not flattened (which is the way they were currently being utilized). The fluidized pillow must go into the hydrotherapy room with the patient and the patient’s head turned and repositioned every 2 hours. The use of a moisture-wicking fabric was utilized over the fluidized positioner pillow to prevent maceration. Nursing staff and burn technicians were educated as to practice changes; wound care nurses were available for educational support. In addition, in 2017, the Burn ICU instituted a 2 RN skin check daily for all patients in the hydrotherapy room once all dressings were removed. This tank room “time out” was instituted for early identification of areas of potential skin breakdown. Results Implementation of these protocols has significantly decreased the occurrence of OPI in the BICU. Since implementation, the rate of OPI in 2017, 2018 and Q1 and Q2 of 2019 has been 0%. The application of the fluidized positioner pillow, tank room “time-out” and staff education has greatly decreased the occurrence of OPI in the BICU. Conclusions Patients sustaining large surface area burns and/or full-thickness burns to the head and neck are susceptible to the development of OPI. The utilization of a fluidized positioner pillow in conjunction with improved assessment and identification using a 2 RN “time out” skin assessment daily, has led to a decrease in OPI in our BICU. Applicability of Research to Practice The utilization of the fluidized positioner pillow in conjunction with the described interventions can lead to a decrease in occipital HAPI and improve patient outcomes.

A2B adenosine receptor inhibition by the dihydropyridine calcium channel blocker nifedipine involves colonic fluid secretion

The adenosine A2B receptor is a critical protein in intestinal water secretion. In the present study, we screened compound libraries to identify inhibitors of the A2B receptor and evaluated their effect on adenosine-induced intestinal fluid secretion. The screening identified the dihydropyridine calcium antagonists nifedipine and nisoldipine. Their respective affinities for the A2B receptor (Ki value) were 886 and 1,399 nM. Nifedipine and nisoldipine, but not amlodipine or nitrendipine, inhibited both calcium mobilization and adenosine-induced cAMP accumulation in cell lines. Moreover, adenosine injection into the lumen significantly increased fluid volume in the colonic loop of wild-type mice but not A2B receptor-deficient mice. PSB-1115, a selective A2B receptor antagonist, and nifedipine prevented elevated adenosine-stimulated fluid secretion in mice. Our results may provide useful insights into the structure–activity relationship of dihydropyridines for A2B receptor. As colonic fluid secretion by adenosine seems to rely predominantly on the A2B receptor, nifedipine could be a therapeutic candidate for diarrhoea-related diseases.

Bioactive Candy: Effects of Licorice on the Cardiovascular System.

Licorice, today chiefly utilized as a flavoring additive in tea, tobacco and candy, is one of the oldest used herbs for medicinal purposes and consists of up to 300 active compounds. The main active constituent of licorice is the prodrug glycyrrhizin, which is successively converted to 3β-monoglucuronyl-18β-glycyrrhetinic acid (3MGA) and 18β-glycyrrhetinic acid (GA) in the intestines. Despite many reported health benefits, 3MGA and GA inhibit the 11-β-hydrogenase type II enzyme (11β-HSD2) oxidizing cortisol to cortisone. Through activation of mineralocorticoid receptors, high cortisol levels induce a mild form of apparent mineralocorticoid excess in the kidney and increase systemic vascular resistance. Continuous inhibition of 11β-HSD2 related to excess licorice consumption will create a state of hypernatremia, hypokalemia and increased fluid volume, which can cause serious life-threatening complications especially in patients already suffering from cardiovascular diseases. Two recent meta-analyses of 18 and 26 studies investigating the correlation between licorice intake and blood pressure revealed statistically significant increases both in systolic (5.45 mmHg) and in diastolic blood pressure (3.19/1.74 mmHg). This review summarizes and evaluates current literature about the acute and chronic effects of licorice ingestion on the cardiovascular system with special focus on blood pressure. Starting from the molecular actions of licorice (metabolites) inside the cells, it describes how licorice intake is affecting the human body and shows the boundaries between the health benefits of licorice and possible harmful effects.

Radiogenic isotopes record a ‘drop in a bucket’ – A fingerprint of multi-kilometer-scale fluid pathways inferred to drive fault-valve behavior

Minerals precipitated from fluids carry a chemical signature of fluid origin and transport history. We use this concept to test the hypothesis that a subset of veins precipitated in the Loma Blanca fault zone, Rio Grande rift, NM, USA, record fault-valve behavior. Previous studies of this site show syntectonic calcite veins formed in response to post-seismic fluid discharge following repeated ground-rupturing earthquakes. U-Th ages on veins constrain the timing of fault slip over a period of >400,000 years. The radiogenic isotope (Sr, Pb, and U) data we report here demonstrate that a cluster of earthquakes that occurred at ∼430 ka, when fault-slip frequency increased by nearly one order of magnitude, corresponds with a brief period of particularly large and rapid variations in post-seismic fluid chemistry. Isotopic variations are consistent with fluid input from the Socorro magma body, a large, active, mid-crustal basalt intrusion 19 km below the surface. The short duration of the earthquake cluster (<50,000 years) precludes a role of thermal weakening of the crust in increased extension. We suggest that volatile exsolution and heating of ambient fluids during magma crystallization increased fluid volume and thereby pore-fluid pressure at depth, weakening the fault and driving more frequent failure through fault-valve action. This conclusion could not have been reached using traditional approaches in structural geology, stable isotope geochemistry, or geochronology alone, illustrating the utility of integrated data sets including radiogenic isotope analyses in studies of fluid-fault interactions.

Effects of a 24-h naproxen dose on hydration and electrolyte measures during moderate-intensity cycling in the heat

Few controlled laboratory studies have examined the negative effects non-steroidal anti-inflammatory drugs can have on fluid–electrolyte balance during exercise. Our objective was to determine whether a 24-h naproxen dose negatively affected hydration and electrolyte measures before, during, and 3 h after 90 min of cycling in a hot or ambient environment. Using a double blind, randomized and counterbalanced cross-over design, 11 volunteers (six male, five female) completed four trials, with conditions as follows: (1) placebo and ambient, (2) placebo and heat, (3) naproxen and ambient, and (4) naproxen and heat. We found no statistically significant differences among experimental conditions for any dependent measures. Though not statistically significant, mean fluid volume was higher and urine volume was lower during naproxen trials compared with placebos. Mean aggregate plasma sodium was &lt;135 mmol/L at all time points and did not significantly change over time. Overall plasma potassium significantly increased pre- (3.9 ± 0.4) to post-exercise (4.2 ± 0.4 mmol/L, p = 0.02). In conclusion, an acute naproxen dose did not significantly alter hydration–electrolyte balance. The trend for naproxen to increase fluid volume and decrease urine volume suggests the start of fluid retention, which should concern individuals at risk for hyponatremia or with pre-existing cardiovascular conditions.

The Sodium Paradox: Dysnatremia and Mortality in Patients Implanted With Extracorporeal Mechanical Circulatory Support Devices

Dysnatremia, abnormal serum sodium levels, has long been used as a marker for disease progression in heart failure patients. Classically, hyponatremia is associated with increased fluid volume in heart failure and is often a result of neuroendocrine dysfunction and poor cardiac output. Recent studies have noted that dysnatremia and hypernatremia are predictive of worsened outcomes in critical care and renal disease populations. We investigated the relationship between dysnatremia and postoperative outcomes in patients implanted with extracorporeal mechanical circulatory devices. A total of 97 patients who underwent implantation with the CentriMag mechanical circulatory assist system were included in this retrospective study. Patients were divided into 2 groups based on preoperative serum sodium level cutoff of 135 mEq/L. Outcomes and mortality were compared between groups. The mean age for the study population was 56.21 ± 15.13 years, and 57 patients (58.8%) were male. The mean time on CentriMag support was 22.7 days. Patients with serum sodium levels ≤135 mEq/L were noted to have significantly worsened indicators of preoperative cardiac function. However, patients with serum sodium levels >135 mEq/L had significantly shorter postoperative survival ( P = .006). When entered into a multivariate Cox proportional hazards model, sodium was an independent predictor for increased risk of mortality (hazard ratio: 1.224; 95% confidence interval: 1.009-1.485; P = .040). Our results indicate that elevated preoperative sodium in patients undergoing implantation of a temporary mechanical circulatory support system is predictive of worsened postoperative survival.

Lymph Transport in Rat Mesenteric Lymphatics Experiencing Edemagenic Stress

To assess lymphatic flow adaptations to edema, we evaluated lymph transport function in rat mesenteric lymphatics under normal and increased fluid volume (edemagenic) conditions in situ. Twelve rats were infused with saline (intravenous infusion, 0.2 mL/min/100 g body weight) to induce edema. We intravitally measured mesenteric lymphatic diameter and contraction frequency, as well as lymphocyte velocity and density before, during, and after infusion. A 10-fold increase in lymphocyte velocity (0.1-1 mm/s) and a sixfold increase in flow rate (0.1-0.6 μL/min), were observed post infusion, respectively. There were also increases in contraction frequency and fractional pump flow one minute post infusion. Time-averaged wall shear stress increased 10 fold post infusion to nearly 1.5 dynes/cm(2) . Similarly, maximum shear stress rose from 5 to 40 dynes/cm(2) . Lymphatic vessels adapted to edemagenic stress by increasing lymph transport. Specifically, the increases in lymphatic contraction frequency, lymphocyte velocity, and shear stress were significant. Lymph pumping increased post infusion, though changes in lymphatic diameter were not statistically significant. These results indicate that edemagenic conditions stimulate lymph transport via increases in lymphatic contraction frequency, lymphocyte velocity, and flow. These changes, consequently, resulted in large increases in wall shear stress, which could then activate NO pathways and modulate lymphatic transport function.

Lymph transport in rat mesenteric lymphatics experiencing edemagenic stress (LB851)

Objective: To assess lymphatic adaptations to edema, we evaluated lymph transport function in rat mesenteric lymphatics under normal and increased fluid volume (edemagenic) conditions in situ.Methods: Twelve rats were infused with saline (venous infusion, 0.2 ml/min/100g body weight) to induce edema. We intravitally measured mesenteric lymphatic diameter and contraction frequency, as well as immune cell velocity and density before, during and after infusion.Results: A 10‐ and 6‐fold increase in lymph velocity (0.1‐1 mm/s) and flow rate (0.1‐0.6 µL/min), were observed post‐infusion, respectively (p&lt;0.05). There were also increases in contraction frequency and fractional pump flow 1‐minute post‐infusion (p&lt;0.05). Time‐averaged wall shear stress increased 10 times post‐infusion to nearly 1.5 dynes/cm2 (p&lt;0.05). Similarly, maximum shear stress rose from 5 dynes/cm2 to 40 dynes/cm2.Conclusions: Lymphatic vessels adapted to edemagenic stress by increasing lymph transport. Specifically, increases in lymphatic contraction frequency, lymph velocity, and shear stress were statistically significant. Although the changes in lymphatic diameter were not statistically significant, lymph pumping increased post‐infusion. These results suggest that edemagenic conditions stimulate lymph transport via increases in lymphatic contraction frequency, lymph velocity and flow. These changes, consequently, resulted in large increases in wall shear stress, which will activate nitric oxide pathways and modulate lymphatic transport function.Grant Funding Source: NIH Grant No. R01 HL094269, NSF Graduate Research Fellowship