Measurement of Total Body Water in Patients on Maintenance Hemodialysis Using an Ethanol Dilution Technique

Walle, A. J.; Grüner, O.; Niedermayer, W.

doi:10.1159/000182003

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…This is supported by a persistent arterio-venous difference after both intravenous (Jones et al, 1997) and oral administration of ethanol (Martin et al, 1984;Sedman et al, 1976). All previous investigators of ethanol dilution for estimation of TBW used a 1C model with zero-order elimination (Dahl et al, 1999;Endres and Grüner, 1994;Grüner, 1957;Loeppky et al, 1977;Walle et al, 1980). Figure 5 shows the agreement between observed and pre-dicted data for one of the subjects in our study.…”

Section: The 2c and 1c Models For Ethanol Pharmacokineticssupporting

confidence: 82%

See 1 more Smart Citation

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

Norberg¹,

Sandhagen²,

Bratteby³

et al. 2001

Alcoholism: Clinical and Experimental Research

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Ethanol does not distribute uniformly into the TBW. The precision of measuring Vss by ethanol dilution was comparable to estimates of TBW by isotope dilution. Results of noninvasive breath ethanol analysis compared well with use of venous blood for estimating Vss. The sophisticated two-compartment model was much superior to the classical one-compartment model in explaining the total concentration-time course of intravenously given ethanol.

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Section: The 2c and 1c Models For Ethanol Pharmacokineticssupporting

confidence: 82%

“…Ethanol dilution was first applied to estimating TBW by Grüner (1957) and has since been investigated by others (Dahl et al, 1999;Jones et al, 1992;Pawan and Hoult, 1963;Walle et al, 1980). One difficulty in calculating TBW by ethanol dilution is the relatively rapid metabolism of the marker; careful pharmacokinetic modeling is necessary.…”

mentioning

confidence: 99%

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

Norberg¹,

Sandhagen²,

Bratteby³

et al. 2001

Alcoholism: Clinical and Experimental Research

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show abstract

“…'s pooled data [9] gave a similar estimate. The partition coefficient estimate is similar to the alcohol partition coefficient between CSF and serum measured in rats [20] and would be predicted for drugs that distribute in plasma water but which do not bind to plasma proteins [21] because plasma water occupies 90% of plasma by volume.…”

Section: Discussionsupporting

confidence: 64%

Paracetamol plasma and cerebrospinal fluid pharmacokinetics in children

Anderson

Holford

Woollard

et al. 1998

Brit J Clinical Pharma

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Aims Paracetamol has a central action for both antipyresis and analgesia. Maximum temperature decrease and peak analgesia are reported at 1-2 h after peak plasma paracetamol concentration. We wished to determine the relationship between plasma and cerebrospinal fluid (CSF) pharmacokinetics in children. Methods Concentration-time profiles in plasma and CSF after nasogastric paracetamol 40 mg kg −1 were measured in nine children who had indwelling ventricular drains.Estimation of population pharmacokinetic parameters was made using both a standard two-stage population approach (MKMODEL) and a nonlinear mixed effect model (NONMEM). Results were standardized to a 70 kg person using an allometric power model. Results Both approaches gave similar estimates. NONMEM parameter estimates were clearance 10.2 l h −1 (CV 47%), volume of distribution 67.1 l (CV 58%) and absorption rate constant 0.77 h −1 (CV 49%). Cerebrospinal fluid concentrations lagged behind those of plasma. The equilibration half time was 0.72 h (CV 117%). The CSF/plasma partition coefficient was 1.18 (CV 8%). Conclusions Higher concentrations in the CSF probably reflect the lower free water volume of plasma. The CSF equilibration half time suggests that CSF kinetics approximate more closely to the effect compartment than plasma, but further time is required for paracetamol to exert its effects. Effect site concentrations equilibrate slowly with plasma. Paracetamol should be given 1-2 h before anticipated pain or fever in children.

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“…This is supported by a persistent arterio-venous difference after both intravenous (Jones et al, 1997) and oral administration of ethanol (Martin et al, 1984;Sedman et al, 1976). All previous investigators of ethanol dilution for estimation of TBW used a 1C model with zero-order elimination (Dahl et al, 1999;Endres and Grüner, 1994;Grüner, 1957;Loeppky et al, 1977;Walle et al, 1980). Figure 5 shows the agreement between observed and predicted data for one of the subjects in our study.…”

Section: The 2c and 1c Models For Ethanol Pharmacokineticssupporting

confidence: 81%

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

Norberg

Sandhagen²,

Bratteby³

et al. 2001

Alcoholism Clin & Exp Res

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Background: The volume of distribution at steady state for ethanol (V ss ) is thought to be identical to the total body water (TBW). We compared a two-compartment pharmacokinetic model with parallel Michaelis-Menten and first-order renal elimination with the classical one-compartment zero-order elimination model. Ethanol concentration-time profiles were established for breath, venous blood, and urine. The values of V ss obtained for ethanol were compared with TBW determined by deuterium oxide dilution.Methods: Sixteen healthy volunteers each received a 30-min intravenous infusion of ethanol on two occasions. Ethanol was measured in breath by a quantitative infrared analyzer and in blood and urine by headspace gas chromatography. Deuterium oxide was given as an intravenous injection and measured in serum by isotope-ratio mass spectrometry. Components of variation were calculated by ANOVA to determine the precision of the estimates of V ss and TBW.Results: Mean TBW, determined by deuterium oxide dilution, was 44.1 Ϯ 3.9 liters (ϮSD) for men, corresponding to 0.61 liters/kg, and 37.4 Ϯ 3.2 liters for women, or 0.54 liters/kg. Estimates of V ss from blood-ethanol pharmacokinetics were 87.6% of TBW according to isotope dilution and 84.4% for breath analysis with the two-compartment model. This compares with 95.1% and 95.4% for blood and breath alcohol, respectively, when the classical zero-order kinetic analysis is used. The precision of the estimates of V ss and TBW was between Ϯ1.56 and Ϯ2.19 liters (95% confidence interval).Conclusions: Ethanol does not distribute uniformly into the TBW. The precision of measuring V ss by ethanol dilution was comparable to estimates of TBW by isotope dilution. Results of noninvasive breath ethanol analysis compared well with use of venous blood for estimating V ss . The sophisticated twocompartment model was much superior to the classical one-compartment model in explaining the total concentration-time course of intravenously given ethanol.

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Measurement of Total Body Water in Patients on Maintenance Hemodialysis Using an Ethanol Dilution Technique

Cited by 15 publications

References 14 publications

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

Paracetamol plasma and cerebrospinal fluid pharmacokinetics in children

Do Ethanol and Deuterium Oxide Distribute Into the Same Water Space in Healthy Volunteers?

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