Evaluating Lymph Flow Through the Thoracic Duct Using Urine Osmolarity in Human Participants

Hayashi, Moyuru; Watanabe-Asaka, Tomomi; Maejima, Daisuke; Nagashio, Sachiho; Kajihara, Ryo; Amari, Kei; Yokoyama, Yayoi; Kaidoh, Maki; Sugano, Mitsutoshi; Honda, Takayuki; Kawai, Yoshiko; Ohhashi, Toshio

doi:10.1089/lrb.2019.0054

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although our results indicate that fluid entering the blood stream has a higher protein content than plasma, it seems as if manual lymphatic drainage does not lead to major changes in plasma components (e.g.,: electrolytes) in our patients. Future studies should investigate if other plasma components such as hormones and blood cells are affected by physical therapy and if plasma volume and plasma component analysis could provide a promising and cost-effective method to assess lymphatic (out-)flow as well as lymphatic fluid concentration in different lymphedema patient groups (e.g., different grades) [56].…”

Section: Plasma Volume and Plasma Component Changes Due To Fluid Shifts During Lymphedema Therapymentioning

confidence: 99%

Fluid Shifts Induced by Physical Therapy in Lower Limb Lymphedema Patients

Brix

Apich²,

Roessler

et al. 2020

JCM

View full text Add to dashboard Cite

Complete decongestive therapy (CDT), a physical therapy including manual lymphatic drainage (MLD) and compression bandaging, is aimed at mobilizing fluid and reducing limb volume in lymphedema patients. Details of fluid shifts occurring in response to CDT are currently not well studied. Therefore, we investigated fluid shifts before, during and after CDT. Thirteen patients (3 males and 10 females, aged 57 ± 8.0 years, 167.2 ± 8.3 cm height, 91.0 ± 23.4 kg weight) diagnosed with stage II leg lymphedema participated. Leg volume, limb and whole-body fluid composition (total body water (limbTBW/%TBW), extracellular (limbECF/%ECF) and intracellular (limbICF/%ICF fluid), as well as ECF/ICF and limbECF/limbICF ratios were determined using perometry and bioelectrical impedance spectroscopy. Plasma volume, proteins, osmolality, oncotic pressure and electrolytes were assessed. Leg volume (p < 0.001), limbECF (p = 0.041), limbICF (p = 0.005) and limbECF/limbICF decreased over CDT. Total leg volume and limbTBW were correlated (r = 0.635). %TBW (p = 0.001) and %ECF (p = 0.007) decreased over time. The maximum effects were seen within one week of CDT. LimbICF (p = 0.017), %TBW (p = 0.009) and %ICF (p = 0.003) increased post-MLD, whereas ECF/ICF decreased due to MLD. Plasma volume increased by 1.5% post-MLD, as well as albumin and the albumin-to-globulin ratio (p = 0.005 and p = 0.049, respectively). Our results indicate that physical therapy leads to fluid shifts in lymphedema patients, with the greatest effects occurring within one week of therapy. Fluid shifts due to physical therapy were also reflected in increased plasma volume and plasma protein concentrations. Perometry, in contrast to bioelectrical impedance analysis, does not seem to be sensitive enough to detect small fluid changes caused by manual lymphatic drainage.

show abstract

Section: Plasma Volume and Plasma Component Changes Due To Fluid Shifts During Lymphedema Therapymentioning

confidence: 99%