Regulation of Cell Volume in Health and Disease

McManus, Michael L.; Churchwell, Kevin B.; Strange, Kevin

doi:10.1056/nejm199511093331906

Cited by 418 publications

(282 citation statements)

References 43 publications

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“…14,15 On the other hand, hypernatremia had been shown to cause brain shrinkage and resultant vascular rupture with cerebral bleeding and IVH. 16,17 In response to brain shrinkage induced by hypernatremia, the human brain initiates an adaptive response to form idiogenic osmoles that increase intracellular sodium concentrations and restore lost water. [18][19][20] This phenomenon increases the susceptibility of the brain to cellular edema and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants

et al. 2010

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Objective: To identify the risk factors contributing to intraventricular hemorrhage (IVH) in extremely low birth weight infants during early postnatal life, after appropriate matching for gestational age (GA) and birth body weight (BBW).Study Design: A case-control retrospective study was designed to evaluate preterm infants with a GA p26 weeks and a BBW p1000 g admitted to our hospital during a 7.5-year period. From a cohort of 347 preterm infants, 36 infants (10.7%) had severe IVH (grades III and/or IV). We selected a control group of 36 preterm infants without IVH who were closely matched for GA ( ± 1 week) and body weight ( ± 100 g). Univariate and multivariate logistic regression analyses were performed to identify risk factors for severe IVH. Result:The GA and BBW of the IVH and control groups were 24.6 ± 1weeks and 764.4 ± 118.5 g, and 24.8 ± 0.9 weeks and 771.5 ± 125.9 g, respectively. Vaginal delivery, male sex, resuscitation in the delivery room, high sodium serum levels (meq l À1 ) (162.6 vs 148.8), fluctuation of serum sodium (meq l À1 ) (17.3 vs 6.2), pH, PaCO 2 , hemoglobin and platelet counts were associated with an increased risk of severe IVH. Multivariate logistic regression indicated that sodium fluctuations >13 meq l À1 , vaginal delivery, male sex and hemoglobin fluctuations are strongly associated with the development of severe IVH.Conclusion: Hypernatremia and fluctuations of sodium seem to be related to early severe IVH among preterm infants; however, further studies are required to clarify the causal relationship.

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Section: Discussionmentioning

confidence: 99%

Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants

et al. 2010

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“…Because intracellular and extracellular osmolality must be equal, cells either swell with water or extrude solutes when the serum sodium concentration is low. 61,62 Given the confines of the skull, cell swelling is most important in the brain. When hyponatremia develops over a few hours, outpacing the brain's ability to adapt, cerebral edema results.…”

Section: Brain Adaptation To Hyponatremiamentioning

confidence: 99%

Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations

Verbalis

Goldsmith

Greenberg

et al. 2007

The American Journal of Medicine

523

498

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Although hyponatremia is a common, usually mild, and relatively asymptomatic disorder of electrolytes, acute severe hyponatremia can cause substantial morbidity and mortality, particularly in patients with concomitant disease. In addition, overly rapid correction of chronic hyponatremia can cause severe neurologic deficits and death, and optimal treatment strategies for such cases are not established. Hyponatremia is the most common disorder of electrolytes encountered in clinical practice, occurring in up to 15% to 30% of both acutely and chronically hospitalized patients. 1 Although most cases are mild and relatively asymptomatic, hyponatremia is important clinically because: (1) acute severe hyponatremia can cause substantial morbidity and mortality; (2) mortality is higher in patients with hyponatremia who have a wide range of underlying diseases; and (3) overly rapid correction of chronic hyponatremia can cause severe neurologic deficits and death.Despite knowledge of hyponatremia since the mid-20th century, this common disorder remains incompletely understood in many basic areas because of its association with a plethora of underlying disease states, and its multiple etiologies with differing pathophysiologic mechanisms. 2 Optimal treatment strategies have not been well defined, both for these reasons and because of marked differences in symptomatology and clinical outcomes based on the acuteness or chronicity of the hyponatremia. 3 Vasopressin receptor antagonists have long been anticipated as a more effective method to treat hyponatremia by virtue of their unique aquaretic effect to selectively increase solute-free water excretion by the kidneys. 4 The recent approval of the first such agent, conivaptan, for clinical use by the US Food and Drug Administration (FDA) heralds the beginning of a new era in the management of hyponatremic disorders. However, effective therapy with these agents will require intelligent guidelines for their use. To this end, a panel of experts in hyponatremia convened to review current therapies for hyponatremia and to evaluate the situations in which aquaretic agents should be considered as alternatives or supplements to accepted current therapies. This review is a summary of the conclusions of this panel.

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“…Rat Liver-The rate of proteolysis was assessed by measuring the release of 3 H from isolated perfused rat livers after prelabeling of liver proteins in vivo by intraperitoneal injection of 150 Ci of L- [4, H]leucine 16 -20 h before the perfusion experiment (21). After a pre-perfusion period of 80 min, the release of trichloroacetic acid soluble 3 H label reached a steady state (about 500 cpm min Ϫ1 g liver Ϫ1 ) and was associated with effluent leucine by more than 95% as shown by chromatographic analysis (15).…”

Section: Measurement Of Proteolysis In the Perfusedmentioning

confidence: 99%

“…The anti-p70S6-kinase antibody was from Transduction Laboratories (Heidelberg, Germany). L- [4, H]Leucine, [ 3 H]inulin, and [ 14 C]urea were from Amersham Biosciences. L-Lactic acid was from Roth (Karlsruhe, Germany).…”

Section: And 4)mentioning

confidence: 99%