Assessment of thermal dehydration using the human eye: What is the potential?

Sollanek, Kurt J.; Kenefick, Robert W.; Walsh, Neil P.; Fortes, Matthew B.; Esmaeelpour, Marieh; Cheuvront, Samuel N.

doi:10.1016/j.jtherbio.2011.12.006

Cited by 15 publications

(15 citation statements)

References 61 publications

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“…When left chronically untreated, moderate-to-severe dehydration increases the risk of urinary tract infection, chronic kidney disease (4)(5)(6), and also increases medical costs, morbidity, and mortality (7). Unfortunately, despite numerous investigations (8), the methods of dehydration assessment have not been refined to the point that a single reference standard has been identified for clinical decision making (9); this magnifies the difficulty of diagnosing dehydration in clinical practice (9)(10)(11)(12). This article provides recommendations to improve clinical decision making based on the strengths and weaknesses of commonly-used hydration biomarkers and clinical assessment methods.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing dehydration? Blend evidence with clinical observations

Armstrong

Kavouras

Walsh

et al. 2016

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Section: Introductionmentioning

confidence: 99%

Diagnosing dehydration? Blend evidence with clinical observations

Armstrong

Kavouras

Walsh

et al. 2016

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…Net movement of water from intracellular to ECF spaces ensues which partially replenishes losses from within the ECF space; intravascular water content decreases (relative to the intravascular sodium and protein content) and the plasma osmolarity increases. This occurs following excessive sweating (following exercise, fever or high environmental temperatures), insufficient oral hydration or osmotic diuresis secondary to glycosuria or mannitol . In these circumstances, serum osmolality will usually exceed 300 mmol/kg and serum sodium will usually exceed 145 mmol/L…”

Section: Introductionmentioning

confidence: 99%

“…This occurs following excessive sweating (following exercise, fever or high environmental temperatures), insufficient oral hydration or osmotic diuresis secondary to glycosuria or mannitol. 7,8 In these circumstances, serum osmolality will usually exceed 300 mmol/kg and serum sodium will usually exceed 145 mmol/L. 6 In the elderly, the aetiology of dehydration is generally multifactorial: reduced patient access to fluid, lower intake of fluids, decreased sensation of thirst and hormonal resistance within the reninangiotensin-aldosterone system (RAAS), each play a role.…”

Section: Introductionmentioning

confidence: 99%

Hydration, fluid regulation and the eye: in health and disease

Sherwin

Kokavec

Thornton

2015

Clinical Exper Ophthalmology

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Variation in systemic hydration status, namely chronic systemic hypohydration or dehydration, can influence the development of several chronic non-ophthalmic diseases. Owing to the eye's high water content and unique system of fluid regulation, we hypothesized that hydration status may affect the eye in health and disease states. Therefore, we performed a systematic review of the current evidence implicating changes in hydration and their association with ocular physiology and morphological characteristics. We also reviewed relevant clinical correlations of changes in hydration and major common eye diseases. Our findings suggest that systemic hydration status broadly affects a variety of ocular pathophysiologic processes and disease states. For example, dehydration may be associated with development of dry eye syndrome, cataract, refractive changes and retinal vascular disease. On the other hand, excessive hydration is associated with some ocular diseases. Tear fluid osmolarity may be an effective marker of systemic hydration status. Recent studies implicate chronic renin-angiotensin-aldosterone system activation in the pathogenesis of diabetic retinopathy and glaucoma but also suggest its antagonism may be a useful therapeutic target. Our findings indicate that assessment of hydration status may be an important consideration in the management of patients with chronic eye diseases and undergoing eye surgery. Further research investigating the role of acute and chronic changes in hydration in individuals with and without ocular disease is warranted.

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“…This study is the first to experimentally evaluate the efficacy and sensitivity of using IOP to assess hydration status following intermittent exercise in the heat, with and without fluid restriction. Assessing thermal hypohydration using ocular fluids has recently gained interest in sports medicine literature (Fortes et al, 2011 ; Hunt et al, 2012 ; Sollanek et al, 2012 ; Sherwin et al, 2015 ) and IOP, in particular, may be appealing to sports medicine practitioners, clinicians, and researchers because the procedure is non-invasive, causes minimal discomfort, requires minimal training to perform accurately, and provides a reading within seconds. The novel findings of this investigation were: (1) in partial agreement with our initial hypothesis, a statistically significant interaction was observed between IOP and the level of hypohydration; however, there was no difference in IOP at any time during exercise in the heat irrespective of fluid provision or restriction (Table 1 ), and (2) using an IOP value of 13.2 mm Hg as a criterion reference to assess a 2% loss in body mass resulted in only 57% of the data being correctly classified (Figure 1A ).…”

Section: Discussionmentioning

confidence: 99%

“…Recently the eye has been identified (Sollanek et al, 2012 ; Sherwin et al, 2015 ) as having the potential to provide a valid hydration assessment in field settings, where the use of invasive procedures is limited. The relationship between ocular fluids (tear and aqueous humor), blood pressure and plasma osmolality has provided a case for tear fluid osmolarity (Fortes et al, 2011 ), tear break-up time (Sweeney et al, 2013 ), and intraocular pressure (IOP) (Hunt et al, 2012 ) as potential non-invasive measures of hydration status.…”

Section: Introductionmentioning

confidence: 99%

Intraocular Pressure Is a Poor Predictor of Hydration Status following Intermittent Exercise in the Heat

et al. 2017

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Current hydration assessments involve biological fluids that are either compromised in dehydrated individuals or require laboratory equipment, making timely results unfeasible. The eye has been proposed as a potential site to provide a field-based hydration measure. The present study evaluated the efficacy and sensitivity of intraocular pressure (IOP) to assess hydration status. Twelve healthy males undertook two 150 min walking trials in 40°C 20% relative humidity. One trial matched fluid intake to body mass loss (control, CON) and the other had fluid restricted (dehydrated, DEH). IOP (rebound tonometry) and hydration status (nude body mass and serum osmolality) were determined every 30 min. Body mass and serum osmolality were significantly (p < 0.05) different between trials at all-time points following baseline. Body mass losses reached 2.5 ± 0.2% and serum osmolality 299 ± 5 mOsmol.kg−1 in DEH. A significant trial by time interaction was observed for IOP (p = 0.042), indicating that over the duration of the trials IOP declined to a greater extent in the DEH compared with the CON trial. Compared with baseline measurements IOP was reduced during DEH (150 min: −2.7 ± 1.9 mm Hg; p < 0.05) but remained stable in CON (150 min: −0.3 ± 2.4 mm Hg). However, using an IOP value of 13.2 mm Hg to predict a 2% body mass loss resulted in only 57% of the data being correctly classified (sensitivity 55% and specificity 57%). The use of ΔIOP (−2.4 mm Hg) marginally improved the predictive ability with 77% of the data correctly classified (sensitivity: 55%; specificity: 81%). The present study provides evidence that the large inter-individual variability in baseline IOP and in the IOP response to progressive dehydration, prevents the use of IOP as an acute single assessment marker of hydration status.

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Assessment of thermal dehydration using the human eye: What is the potential?

Cited by 15 publications

References 61 publications

Diagnosing dehydration? Blend evidence with clinical observations

Diagnosing dehydration? Blend evidence with clinical observations

Hydration, fluid regulation and the eye: in health and disease

Intraocular Pressure Is a Poor Predictor of Hydration Status following Intermittent Exercise in the Heat

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