Osmotic Volumes of Distribution

McDowell, Marion E.; Wolf, A. V.; Steer, Arthur

doi:10.1152/ajplegacy.1955.180.3.545

Cited by 105 publications

(18 citation statements)

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“…As hypernatraemia increases, breakdown of protein molecules in brain cells is thought to occur, producing more numerous osmotically active particles, so reducing brain cell shrinkage to some extent (McDowell, Wolf, and Steer, 1955;Logothetis, 1966). During rehydration with rapid falls of extracellular osmolality, the increased intracellular osmoles could lead to excess water passing into brain cells.…”

Section: Discussionmentioning

confidence: 99%

Treatment of hypernatraemic dehydration in infancy.

Banister¹,

Matin‐Siddiqi²,

Hatcher³

1975

Archives of Disease in Childhood

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. Treatment of hypernatraemic dehydration in infancy. Thirty-eight infants with severe hyperosmolar dehydration and hypernatraemia were treated, using three regimens of intravenous fluids: A. i normal saline, given fast; B. i normal saline given slowly; C. normal saline. 28 of the infants were studied in a treatment trial, and it is concluded that 0 * 18% saline in 4 *3 % dextrose, with the early addition of potassium given at a rate of 100 ml/kg estimated rehydrated weight per 24 hours gives satisfactory rehydration within 48 hours, with little risk of convulsions.The best means of rehydrating hypernatraemic infants remains controversial. Though there is general agreement that reduction of hyperosmolality should be gradual, some achieve this with slow rates of fluid of low sodium content, while others use faster rates of high sodium content. It was therefore decided to study the use of different intravenous fluid regimens in severely affected infants. As the use of normal saline or full strength Darrow's solution has been incriminated in the production of hypernatraemia in infants originally suffering from normonatraemic dehydration (Skinner and Moll, 1956;Weil and Wallace, 1956; Stickler, 1967;Ahmed and Agusto-Odutola, 1970) this study was confined to a comparison of 0-18% saline in dextrose with 0 *45 /% saline in dextrose.Patients and method Infants suffering from hypernatraemic dehydration (plasma sodium > 150 mEq/l) and a measured plasma osmolality >350 mOsm/kg were studied. With the exception of one infant with Down's syndrome, infants known to have previous cerebral or renal abnormalities, which might have influenced the course of treatment, were excluded. During 18 months 37 infants with 38 episodes of hypematraemia of this severity were studied in 2 children's hospitals. All were suffering from primary water depletion, and subsequent urine excretion showed that all had some degree of sodium and potassium depletion. The primary cause of illness was gastroenteritis in 27, respiratory infection in 8, septicaemia in 2, and unknown in one. The one infant seen during this time with evidence of sodium

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Section: Discussionmentioning

confidence: 99%

Treatment of hypernatraemic dehydration in infancy.

Banister¹,

Matin‐Siddiqi²,

Hatcher³

1975

Archives of Disease in Childhood

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show abstract

“…Under experimental conditions mimicking closed systems, formulas similar to formula 7 predicted accurately the changes in [Na] after the induction of hypernatremia 39,47 or hyponatremia. 46,48 However, patients with dysnatremia do not represent closed systems.…”

Section: Management Principlesmentioning

confidence: 94%

“…Not accounting for the water infused has caused errors in calculations of the changes in [Na] resulting from hypertonic infusions in experimental settings. 38–39 The magnitude of the error increased as the infused volume increased.…”

Section: Management Principlesmentioning

confidence: 99%

Principles of Management of Severe Hyponatremia

Tzamaloukas

Malhotra

Rosen

et al. 2013

JAHA

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“…(Kennedy et al, 1962) and that this does not cause any distortion of the body-fluid compartments (McDowell et al, 1955), whereas mannitol causes an expansion of the extracellular fluid (Seldin and Tarail, 1949). For this reason urea has been used in the treatment of oedema in advanced heart failure by Crawford and McIntosh (1925) and more recently by Papp and Shirley Smith (1957).…”

Section: Discussionmentioning

confidence: 99%

Intravenous Urea as a Diuretic in Prostatectomy

McKELVIE¹

1962

BMJ

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Osmotic Volumes of Distribution

Cited by 105 publications

References 0 publications

Treatment of hypernatraemic dehydration in infancy.

Treatment of hypernatraemic dehydration in infancy.

Principles of Management of Severe Hyponatremia

Intravenous Urea as a Diuretic in Prostatectomy

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