A Comparison Between Dehydration From Salt Loss and From Water Deprivation

Nadal, Joseph W.; Pedersen, Svend; Maddock, Walter G.

doi:10.1172/jci101262

Cited by 111 publications

(50 citation statements)

References 9 publications

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“…These changes accompany a restoration of normal tonicity to body fluids, a reexpansion of extracellular fluid, and a contraction of the overexpanded intracellular fluid. These observations are consistent with the few clinical observations available on the admninistration of saline intravenously to patients depleted of salt (2,3). It should be noted that studies of the effects of saline by various routes on the circulation in normal subjects are not directly pertinent (4 to 8).…”

Section: Discussionsupporting

confidence: 85%

The Treatment of Shock Due to Salt Depletion; Comparison of the Hemodynamic Effects of Isotonic Saline, of Hypertonic Saline, and of Isotonic Glucose Solutions 12

Danowski

Winkler²,

Elkinton³

1946

J. Clin. Invest.

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In the preceding paper, the peripheral vascular collapse induced in untraumatized dogs by the removal of sodium chloride has been described (1). In its effects on plasma volume, plasma protein, blood pressure, cardiac output, and circulation rate this type of peripheral vascular collapse is indistinguishable from that observed in traumatic shock. Depletion of water without salt, on the other hand, depresses the circulation much less severely. The reasons for this are not clear. The present experiments seek further to characterize these differences in the effects of the two procedures by studying the response of salt depletion shock to therapy. Isotonic glucose infusions will reexpand the extracellular volume, increase the intracellular overhydration, and make both compartments still more hypotonic. Isotonic and hypertonic saline infusions, on the other hand, while reexpanding the extracellular volume also will relieve intracellular overhydration and correct the generalized hypotonicity. By a comparison of the effect of these two procedures on ' Aided by grants from the Fluid Research Fund of the

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Section: Discussionsupporting

confidence: 85%

The Treatment of Shock Due to Salt Depletion; Comparison of the Hemodynamic Effects of Isotonic Saline, of Hypertonic Saline, and of Isotonic Glucose Solutions 12

Danowski

Winkler²,

Elkinton³

1946

J. Clin. Invest.

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“…Higher values, however, were obtained in infants who might have been considered as convalescing from marasmus. Bakwin and Rivkin (22) In malnutrition the hydration of the extracellular fluid can be expected to be normal or slightly reduced if water deprivation is also present (31), severely reduced if diarrhea is associated with it (32) and greatly enlarged, manifesting itself in nutritional edema, if ample fluid and salt intake are permitted (33). The large increase in body water in malnourished infants has been observed 60 years ago by Ohlmuller (34) and has been measured with the thiocyanate method by Robinow and Hamilton (35).…”

Section: Plasma Proteinsmentioning

confidence: 99%

Blood and Extracellular Fluid Studies in Chronic Malnutrition in Infancy 12

Gollan¹

1948

J. Clin. Invest.

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One problem facing the Italian Medical Nutrition Mission in 1945-46 was the great number of infants and children suffering from severe and chronic malnutrition. Through lack of sanitation, milk control and proper food, cases of severe inanition were encountered quite frequently in southern Italy.The obvious dehydration of these emaciated infants on one hand and the poor results obtained with intravenous fluid therapy on the other hand suggested that there existed a severe disturbance of the distribution of body water rather than a simple deficiency in body fluids. Studies under the actual conditions of a war-torn and povertystricken country seemed therefore to be desirable. METHODS AND MATERIAL Clinical materialTwenty-three cases of severe marasmus in infancy and six cases of chronic malnutrition in older children were examined and 55 observations were made. Prior to being admitted to the Annunziata Hospital in Naples these infants had suffered generally from several attacks of gastro-intestinal disturbances, particularly diarrhea and vomiting, which presumably caused their initial loss of 1The present studies are a part of the work of the Italian Medical Nutrition Mission, 1945-46. This Mis-sion was sponsored by the Unitarian Service Committee,

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“…The relative effects on the circulation of water depletion and of salt depletion require definition. For example, there is clinical and experimental evidence that loss of salt is more deleterious to the circulation than is loss of water (7,8). Although both may cause the same degree of contraction in extracellular volume, the contraction of plasma volume is greater after salt depletion (9).…”

mentioning

confidence: 99%