Insensible Water Loss Research Articles

INSENSIBLE WATER LOSS IN SURGICAL PATIENTS

University Surgical Unit, Royal Infirmary, Sheffield, Great Britain Br. J. Surg., 61: 53–56, January, 1974

Insensible Water Loss in Preterm Infants: Changes With Postnatal Development and Non-ionizing Radiant Energy

Insensible water loss (IWL) was measured by an Electronic Potter Baby Scale in 170 healthy preterm infants, with birthweights ranging from 800 to 2,000 gm, who were appropriate for gestational age. IWL was found to increase with decreasing birth weight, i.e., from a mean of 0.7 ml/kg/hr in infants weighing 1,751 to 2,000 gm to 2.67 ml/kg/hr in infants weighing < 1,000 gm. This correlation between IWL and birthweight was high (r = 0.91; P = < 0.001). In infants < 1,500 gm, IWL decreased with postnatal age while in infants > 1,500 gm, IWL increased in the second week and was stable in the third and fourth weeks. Exposure to non-ionizing radiant energy from three radiant heat warmers was found to increase IWL by 50% to 190% depending on the maturity of the infant and the type of warmers. Phototherapy was associated with a twofold to threefold increase in IWL, which can be minimized by careful temperature control of the infant. The magnitude of increase in IWL in response to exposure to non-ionizing radiant energy, both from radiant heat warmers and phototherapy was greater in infants with birthweight > 1,500 gm than in infants < 1,500 gm.

Fluid Balance and Physical Work Capacity in Humans Exposed to Cold

The influence of cold on normal persons was studied in climate-chamber experiments under strictly standardized conditions. Even under moderate cold there occurred an increase in urine flow to a greater extent than could be explained by reduced insensible water loss, leading to a negative water balance, orthostatism, and reduced physical work capacity. The diuresis was shown to be an osmolal diuresis, accompanied by an increased excretion of sodium, chloride, potassium, calcium, and phosphate together standing for more than 80% of the increased osmolal excretion.

Effects of radiant warmer on insensible water loss in newborn infants.

Twenty-four insensible water loss (IWL) studies, measured as insensible weight loss (IL), were performed on 24 normal, term, newborn infants during the first two days of life. The IWL of infants placed under a radiant warmer (infrared radiant energy source) was significantly greater than the IWL of infants placed in a standard convection-type incubator (1.08±0.12 vs 0.53±0.05 gm/kg/hr; M±SE;P The higher IWL of infants in the radiant warmer is probably on the basis of a higher skin-ambient temperature gradient or a higher skin-ambient vapor pressure gradient, or both. These data illustrate the importance of providing proportionally larger fluid intake for maintenance in infants under the radiant warmer environment for thermal control.

INFANTILE PSYCHOGENIC WATER DRINKING

Psychogenic water drinking has been reported only in older children and adults. We shall report successful management of three young children with psychogenic water drinking. One infant, 2½ mo. old was extremely irritable unless the oral fluid intake ranged from 1200-2100 ml/day. Urine Osm. was 42 mOsm/L and serum Osm. was 272 mOsm/L. Urine output was 1705 ml/day. Serum Na was 132 mEq/L;serum K 5.2 mEq/L;BUN 8 mg%;serum Ca 10.5 mg% and 24 hr. Ca excretion less than 3 mg/kg/24 hr. During the water loading portion of a modified Carter Robbin's Test, CH2O was +10.9 ml/min/1.73m2. CH2O fell to -0.37 ml/min/1.73m2 when 3% NaCl was infused. A 6 mo. old and a 2½ yr. old had polydipsia and polyuria without dehydration and were able, after overnight water deprivation,to concentrate their urines. An abnormal maternal child relationship in two patients, and a prescribed fluid diet in the third had led to excessive water ingestion through inappropriate maternal responses. Appropriate psychological advice coupled with restriction of fluid to estimated insensible water loss plus 25-35% of expected normal urine output resulted in a “cure” in all patients within 6 weeks. In summary: Psychogenic water drinking in the very young appears to be a real entity and responds to parental counseling along with carefully monitored water restriction. Supported in part by NIH grant RR-75, RR-5624.

Maximum oxygen consumption and heat loss facilitation in small homeotherms by He-O2.

ROSENMANN, MARIO, AND PETER MORRISON. Maximum oxygen consumption and heat loss facilitation in small homeotherms by He-02 . Am. J. Physiol. 226(3) : 490495. 1974.-The high thermal conductance of an 80% He-20y0 02 atmosphere was used to elicit maximum metabolism (Mmax) in moderate cold in species ranging from 7-g pygmy mice (Baiomys taylori) to 250-g white rats, including redpolls (Acanthis J?ammea), two vesper mice (Calomys d&la, C. callosus), tundra voles (Microtus oeconomus), and four strains of Mus musculus. Values slightly exceeded those in similar animals using other methods to confirm the low metabolic ratio (Mmax/M, in) in rodents (4-8 X). Submaximal values at higher temperatures defined thermal conductance in He-02 and air. In different species the ratios of these conductances ranged from 1.4 to 2.6, differences which relate to the extent and quality of the respective insulation. M,,, was obtained at 13-70°C warmer in He-02 than required in air for the same metabolic effort. Avoidance of low-temperature technology and freezing injury, elimination of treadmills and training in running, prompt attainment of M,,., (3-10 min after He-02 exposure), and obviation of shaving or wetting procedures are advantages of the present technique.

Physiological Responses to Temperature Stress by an Australian Murid, Rattus lutreolus

The native Australian murid, Rattus lutreolus , regulates its body temperature well at ambient temperatures between 10°C and approximately 31°C, being assisted by a basically low thermal conductance that is indirectly related to ambient temperature within this range. Above this range, significant hyperthermia commences, and is accompanied by a pronounced increase in the rate of evaporative water loss. I suggest that the change in rate of water loss may be due mostly to increased cholinergic activity that promotes salivation and insensible cutaneous water loss. At high temperatures, R. lutreolus continues to exhibit controlled hyperthermia, to a stage where equality of ambient and body temperatures is achieved at approximately 41.5°C. This response is permitted by the extremely effective dissipation of metabolic heat that results from insensible cutaneous water loss, licking, drooling, and hyperventilation. Regardless of its geographic location, R. lutreolus encounters its greatest heat stress in the field when occupying burrows during the day. It is therefore advantageous that this species possesses a depressed B.M.R. (0.52 ± 0.05 SD ml CO2/gm hr) and normothermic body temperature (36.7 ± 0.1 SD °C). Although burrows are probably humid, and evaporative cooling therefore restricted, the temperatures actually experienced by the rats probably rarely exceed approximately 30°C, so that R. lutreolus would seldom need to exercise its considerable potential for evaporative cooling at high temperatures.

Transductal fluxes of Na, K, and water in the human eccrine sweat gland.

ARTICLESTransductal fluxes of Na, K, and water in the human eccrine sweat glandJ MangosJ MangosPublished Online:01 May 1973https://doi.org/10.1152/ajplegacy.1973.224.5.1235MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Download PDF FiguresReferencesRelatedInformation Cited ByHuman temperature regulation under heat stress in health, disease, and injuryMatthew N. Cramer, Daniel Gagnon, Orlando Laitano, and Craig G. Crandall19 August 2022 | Physiological Reviews, Vol. 102, No. 4Method for Human Eccrine Sweat Gland Isolation from the Scalp by Means of the Micropunch Technique and Vital Dyes21 April 2020An efficient method for eccrine gland isolation from human scalp3 April 2018 | Experimental Dermatology, Vol. 27, No. 6Sweating as a heat loss thermoeffectorComprehensive and Quantitative Profiling of the Human Sweat Submetabolome Using High-Performance Chemical Isotope Labeling LC–MS8 July 2016 | Analytical Chemistry, Vol. 88, No. 14Abolished InsP3R2 function inhibits sweat secretion in both humans and mice20 October 2014 | Journal of Clinical Investigation, Vol. 124, No. 11From frog integument to human skin: dermatological perspectives from frog skin biology3 December 2013 | Biological Reviews, Vol. 89, No. 3Hot bath for the treatment of chronic renal failure24 September 2013 | Renal Failure, Vol. 36, No. 1Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans1 February 2013 | Extreme Physiology & Medicine, Vol. 2, No. 1Changes in Na+, K+ concentrations in perspiration and perspiration volume with alternating current iontophoresis in palmoplantar hyperhidrosis patients2 August 2008 | Archives of Dermatological Research, Vol. 300, No. 10Na+ secretion rate increases proportionally more than the Na+ reabsorption rate with increases in sweat rateMichael J. Buono, Ryan Claros, Teshina DeBoer, and Janine Wong1 October 2008 | Journal of Applied Physiology, Vol. 105, No. 4Na+/H+ exchangers in the human eccrine sweat ductD. Granger, M. Marsolais, J. Burry, and R. Laprade1 November 2003 | American Journal of Physiology-Cell Physiology, Vol. 285, No. 5Effects of non-pharmacological sympathetic sudomotor denervation on sweating in humans with essential palmar hyperhidrosisClinical Biochemistry, Vol. 30, No. 2An analysis on the rates and regulation of insensible water loss through the eccrine sweat glandsJournal of Theoretical Biology, Vol. 141, No. 3Biology of sweat glands and their disorders. I. Normal sweat gland functionJournal of the American Academy of Dermatology, Vol. 20, No. 4The pathogenesis of cystic fibrosis: A proposal for calmodulin as the basic biochemical defectMedical Hypotheses, Vol. 20, No. 3Effects of some ion transport inhibitors on secretion and reabsorption in intact and perfused single human sweat glandsPflügers Archiv - European Journal of Physiology, Vol. 391, No. 4Studies on the basic defect in cystic fibrosis: The kinin hypothesis1 December 1978 | Journal of Inherited Metabolic Disease, Vol. 1, No. 4EXOCRINE-GLAND FUNCTION AND THE BASIC BIOCHEMICAL DEFECT IN CYSTIC FIBROSISThe Lancet, Vol. 312, No. 8086Cystic FibrosisThe Sweat GlandsEpithelial transport of potassiumKidney International, Vol. 11, No. 6The physiology, pharmacology, and biochemistry of the eccrine sweat gland22 June 2005 More from this issue > Volume 224Issue 5May 1973Pages 1235-1240 Copyright & PermissionsCopyright © 1973 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1973.224.5.1235PubMed4700643History Published online 1 May 1973 Published in print 1 May 1973 Metrics

Partial target organ resistance to thyroid hormone.

An 8-year old boy with a small goiter, normal basal metabolic rate (BMR), and elevated serum thyroid hormone levels (thyroxine [T(4)] 19.5 mug per 100 ml, free T(4) 4 ng per 100 ml, triiodothyronine [T(3)] 505 ng per 100 ml) was studied. He had measurable serum thyroid-stimulating hormone (TSH) levels (average 5.5 muU per ml), and the thyroxine-binding proteins, hearing, and epiphyseal structures were normal. There was no parental consanguinity nor were there thyroid abnormalities either in the parents or six siblings.Methimazole, 50 mg daily, depressed thyroxine synthesis (T(4) 10.5, free T(4) 2.5) and caused a rise in TSH to 11 muU per ml. After discontinuation of treatment, TSH declined to 4.2 muU per ml and chemical hyperthyroidism returned (T(4) 21.0 mug per 100 ml, free T(4) 4.2, and total T(3) 475 ng per 100 ml, radioactive iodine [RAI] uptake 68%), but studies of BMR and insensible water loss showed the patient to be clinically euthyroid. Thyrotropin-releasing hormone (TRH), 200 mug i.v., caused a brisk rise in TSH to 28 muU per ml, with T(4) rising to 28 mug per 100 ml, free T(4) to 5.6, and T(3) to 730 ng per 100 ml, thus indicating that the pituitary-thyroid system was intact and that the patient's TSH was biologically active. The unusual sensitivity of the pituitary cells to TRH in spite of the markedly elevated serum thyroid hormone levels also suggested that the pituitary was insensitive to suppression by T(3) or T(4). Serum dilution studies gave immunochemical evidence that this patient's TSH was normal. Neither propranolol, 60 mg, chlorpromazine, 30 mg, nor prednisone, 15 mg daily, influenced thyroid indices. Steroid treatment, however, suppressed the pituitary response to TRH, T(3) in doses increased over a period of 12 days to as much as 150 mug daily caused a rise in serum T(3) to above 800 ng per 100 ml, a decline of T(4) to euthyroid levels (T(4) 9.5 mug per 100 ml, free T(4) 1.6 ng per 100 ml), suppression of the RAI uptake from 68% to 35%, and marked blunting of the responses to TRH, but the BMR and insensible water loss remained normal. The data suggest that the patient's disorder is due to partial resistance to thyroid hormone.

Phototherapy and insensible water loss in the newborn infant

Water balance studies were performed in 12 full-term hyperbilirubinemic newborn infants receiving phototherapy. The results were compared with 14 control and 10 jaundiced infants who did not receive phototherapy. In phototherapy infants, the respiratory rate, stool water loss, and insensible water loss were significantly greater than the control and jaundiced infants who did not receive phototherapy. These results emphasize the importance of careful calculation of water intake to maintain positive water balance in infants receiving this form of therapy.

Peripheral circulatory response to phototherapy in newborn infants.

SummaryCalf blood flow (CBF), calf skin temperature, incubator wall and ambient temperature, and respiratory rate, were measured in 8 newborn infants 10 to 127 hours of age, who were treated by phototherapy because of jaundice. During phototherapy (within 30 min) the CBF increased to a range of 30 to 80% above the control values of 8.8 ± 0.9 ml/min/100 g. The CBF is correlated directly with the leg skin temperature (γ= 0.724 and 0.588 at 15 and 30 min after phototherapy respectively). The increase in CBF was associated with a fall in incubator ambient temperature, the latter is a result of the use of servo control unit in monitoring incubator temperature by epigastric skin temperature. The increase in CBF is probably evidence of peripheral vasodilatation to facilitate evaporative heat loss. An increase in respiratory rate was also observed during phototherapy. The observed increase in heat loss (and water loss) from vasodilatation and increased respiratory rate serve as a basis for the increase in insensible water loss as previously reported.

Phototherapy and insensible water loss in the newborn infant.

Water balance studies were performed in 12 full-term hyperbilirubinemic newborn infants receiving phototherapy. The results were compared with 14 control and 10 jaundiced infants who did not receive phototherapy. In phototherapy infants, the respiratory rate, stool water loss, and insensible water loss were significantly greater than the control and jaundiced infants who did not receive phototherapy. These results emphasize the importance of careful calculation of water intake to maintain positive water balance in infants receiving this form of therapy.

INSENSIBLE WATER LOSS IN LOW BIRTH WEIGHT INFANTS

Insensible water loss (IWL) was determined from measurements of insensible weight loss during the first 7 weeks of life on 30 immature and nine small-for-gestational age, low birth weight infants. Under standard conditions (single-walled incubator, infant nude, gavage feeding), 10 infants with birth weights less than 1,250 gm, gestational age < 230 days (32 weeks) and postnatal age <10 days lost >2.5 gm/kg/hr (equivalent to 60-120 ml/kg/day), considerably higher than previously reported. Studies following the insertion of a plastic heat shield revealed a 25% reduction in IWL. The heat shield facilitates achievement of neutral thermal environment and reduced water losses in low birth weight infants. IWL measurements in infants with birth weights >1,500 gm and those small-for-gestational age were similar to previously reported studies. Because of the known limited ability of small immature infants to increase metabolic rate, these extremely high losses are believed to represent disproportionately larger water losses from skin. Skin factors predisposing to large water loss in immature infants include thinner epidermis, increased water content, and increased permeability.

Topical antisepsis studies in the burned rat.

<i>An in vivo model is the only means whereby organisms of low virulence can be investigated. A 20% surface area, third degree burned rat has been utilized in the study of burn wound sepsis. Studies with it show that the mortality is directly proportional to the bacterial concentration in the burn wound. Following topical seeding with</i>Pseudomonas aeruginosa,<i>72 hours pass before lethal levels are attained in the subeschar tissue. Various topical and systemic agents are evaluated on their ability to control the number of bacteria, to reduce mortality, and to affect insensible water loss. Studies determining the lung's ability to clear bacteria show that it is related to the total number of bacteria in the wound. This suggests a reason for the failure of reduction in mortality in burns of over 60% of body surface</i>.

Heat loss in the newborn infant.

On the basis of our investigations in which for the first time the insensible water loss was measured directly in newborn infants during the first 24 hours of life, the magnitude of the heat loss from the total heat production due to evaporation of water was calculated. It was shown that this is lower than the 25% value obtained in infants and up to the adult age group. The amount of heat lost due to evaporation of water is dependant on the relative humidity of the surrounding air. In our investigations with the relative humidity in the incubator between 57 and 78%, 13–15% of the heat produced in the body was dissipated through the evaporation of water.

Respiratory quotient as an index of selective tissue catabolism by water-deprived laboratory rats and Spermophilus lateralis

1. 1. Respiratory quotients and observations of dissected animals indicated that during periods of water deprivation laboratory rats selectively catabolized fat tissue whereas ground squirrels in summer and thin ground squirrels in winter selectively catabolized skeletal muscle. Under similar conditions fat squirrels in winter appeared to selectively catabolize fat and muscle at different times. 2. 2. Catabolism of muscle results in net water gain for an animal during homeothermia. Reduced insensible water loss during hypothermia allows net water gain from catabolism of fat.

The insensible loss of water of the newborn infant.

The insensible loss of water of the newborn infant.

Large Insensible Water Loss (IWL) in Low Birth Weight Infants Treated with a Plastic Heat Shield

Published fluid requirements appear to be grossly inadequate for some small premaute infants. To explain the large water needs of these infants, detailed water balance studies were performed during the first six weeks of life on 22 infants whose birth weights ranged between 700 and 1,800 g, mean 1,232 g, and whose weights were appropriate for their gestational age. IWL determinations were made from measurements of loss in body weight over 3-h periods, with the infants nude in standard single walled isolettes, humidity 45 to 90% and the environmental air temperature in the neutral thermal range. In 9 infants with birth weights under 1,200 g, who were below 10 days of age, IWL was 2 to 4 times greater (equivalent to 80 to 120 g/kg/day) than previously reported for larger infants. To elucidate these large lossesm paired measurements were made within 24 h on 11 infants before and after the insertion of a plastic hear shield converting the isolette ito a double walled chamber. Mean IWL within the double waled chamber was 1.5 g/kg/h S.D. 55 compared to a mean of 2.18 g/kg/h S.D. 1.0 under standard conditions (p < 0.001). There is thus a 30% decrease within the double walled chamber. Thses results, in contrast to previous reports, indicate the ability of the small premature infant to markedly increase IWL in a relatively cool environment. These large losses can be reduced by diminishing radiant heat losses. Heat shields are useful not only for controlling the thermal needs of small immature infants but also in significantly reducing fluid requirements.

Fluid and Electrolyte Homeostasis in Newborn Baby

Assessment of fluid and electrolyte properly in neonate is very important but difficult. Fluid and electrolyte homeostasis during this period depends on some factors notably gestational age of baby, its postnatal age, pathological conditions and environmental situation. In fetus, water and electrolytes is constantly supplied from mother, which is cut-off by delivery of the baby. Extracellular fluid volume that is greater than intracellular fluid volume in fetus precipitously decreases after birth. Adaptation of fluid and electrolyte after birth is due to discontinuation of placental exchange, onset of insensible water loss, thermoregulation, autonomic renal regulation and intake of fluid and other nutrients. The adaptation course is divided into transition phase, intermediate phase and stable growth phase. Fluid and electrolyte therapy in neonate should be very judicious, because administration of minimum fluid and electrolyte may bring a maximum proportionate change of such environment. Fluid requirement in neonate after birth increases gradually by first few days. Preterm baby require more fluid than term baby during the first week of life due to high insensible water loss in the former. Electrolytes with intravenous fluid should be offered after ensuring initial diuresis, a decrease in sodium or at least 5-6% weight loss in neonates. Key words: Fluid, electrolyte, homeostasis, newborn baby. DOI: 10.3329/jbcps.v26i1.4232 J Bangladesh Coll Phys Surg 2008; 26: 39-45

Absolute hemodilution cardiopulmonary bypass: Free water distribution and protein mobilization in body compartments

Water retention in the body compartments was studied in patients who underwent cardiopulmonary bypass with absolute hemodilution and blood replacement exclusively with nonhemic solutions. During operation, 3 1 2 volumes of fluid had to be administered for each volume of blood lost in order to maintain cardiovascular stability. Of this amount, 1 volume was excreted as urine and insensible water loss, 2 1 2 volumes were held in the body, 1 2 volume of it in the blood stream. The extravascular to intravascular partition ratio of retained water varied from 1 : 3 to 1 : 9. These figures are higher than those usually cited for compartmental equilibration of retained fluid following resuscitative therapy for hemorrhage. It is suggested that water distribution in patients subjected to open-heart surgery is influenced to an appreciable extent by ill-defined effects on the circulation by the mechanics of the bypass procedure itself.