Time course of supine and standing shifts in total body, intracellular and extracellular water for a sample of healthy adults

Gibson, Ann L.; Beam, Jason R; Alencar, Michelle; Zuhl, Micah; Mermier, Christine M.

doi:10.1038/ejcn.2013.269

Cited by 34 publications

(40 citation statements)

References 20 publications

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“…In healthy individuals, moving from recumbent to standing position, extracellular volume increases while intracellular water decreases (39). While standing up, gravitational forces exert pressure on the liquid column of the body and, consequently, hydrostatic pressure increases in the lower limbs (40).…”

Section: Discussionmentioning

confidence: 99%

Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

et al. 2017

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IntroductionObstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study.MethodsEach participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG.ResultsFourteen patients were studied (53 ± 9 years; 57% men; body mass index 29.7 ± 6.8 kg/m2). Apnea–hypopnea index (AHI) decreased from 20.8 (14.2; 39.6) at baseline to 7.9 (2.8; 25.4) during CPAP titration and to 16.7 (3.5; 28.9) events/h after wearing CS (CPAP vs. baseline, p = 0.004; CS vs. baseline, p = 0.017; and CPAP vs. CS, p = 0.017). Nocturnal intracellular trunk water was higher after wearing CS in comparison to baseline and CPAP (p = 0.03). CS reduced the fluid accumulated in lower limbs during the day, although not significantly. Overnight fluid shift at baseline, CPAP, and CS was −183 ± 72, −343 ± 220, and −290 ± 213 ml, respectively (p = 0.006). Overnight NC increased at baseline (0.7 ± 0.4 cm), decreased after CPAP (−1.0 ± 0.4 cm), and while wearing CS (−0.4 ± 0.8 cm) (CPAP vs. baseline, p < 0.0001; CS vs. baseline, p = 0.001; CPAP vs. CS, p = 0.01).ConclusionCS reduced AHI by avoiding fluid retention in the legs, favoring accumulation of water in the intracellular component of the trunk, thus avoiding fluid shift to reach the neck. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC.

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Section: Discussionmentioning

confidence: 99%

Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

et al. 2017

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“…When upright, more fluid accumulates in the legs compared with the recumbent position. Studies in healthy subjects have suggested that whereas the measurement of TBW can be reliably performed a few minutes after changing posture, measurements of ECW and ICW should preferably be delayed to obtain greater reproducibility . There are no comparable published studies in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in hydration following haemodialysis estimated with bioimpedance spectroscopy

El-Kateb

Davenport

2016

Nephrology

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“…We allowed time for changes in blood flow and electrolyte shifts to re-equilibrate at the end of the dialysis session [27], and also the potential effect of a change in posture [28], so that when we repeated up to 4 measurements post HD, we found no significant differences. Unlike with some other BIS devices, the electrodes remained in place during the dialysis session [29], and no electrode had to be replaced, thereby eliminating error due to changes in electrode position.…”

Section: Discussionmentioning

confidence: 99%

Do Bioimpedance Measurements of Over-Hydration Accurately Reflect Post-Haemodialysis Weight Changes?

Tangvoraphonkchai¹,

Davenport²

2016

Nephron

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Introduction: Bioelectrical impedance spectroscopy (BIS) devices are being used to determine ultrafiltration requirements to achieve target weight for haemodialysis (HD) patients. Pre-dialysis measurements are more convenient for both patients and staff. We wished to compare the changes in pre- and post-dialysis hydration measured by BIS with actual weight loss. Methods: We compared paired BIS measurements made pre and post HD using a BIS device based on a 3-compartmental model, designed to provide information on extracellular water (ECW) excess. Results: BIS was measured in 49 HD patients, 35 male (71.4%) with mean age 67.6 ± 14.2. Weight fell significantly from 69.2 ± 17.8 to 67.6 ± 17.4 kg, and BIS over hydration (OH) from 4.5 ± 3.3.4 to 3.4 ± 2.9 litres, and ECW from 16.8 ± 4.8 to 15.5 ± 4.4 litres, but there was no change in the amount of intracellular water. Weight loss correlated positively with the change in ECW, but exceeded the fall in OH; mean bias -0.58 (95% confidence limits -3.6 to 4.8 kg). Summary: We measured OH pre and post HD, but did not find that the change in OH correlated with changes in body weight. Although there was a correlation between changes in OH and ECW, there was none for weight. Our findings do not support total reliance on pre-dialysis BIS alone for assessing volume status in HD patients, but rather BIS should be considered an aid to clinical assessment of volume status.

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Time course of supine and standing shifts in total body, intracellular and extracellular water for a sample of healthy adults

Abstract: For TBW, 5 min appears sufficient for fluid stabilization in either position. Supine ECW and ICW stabilization require more than 30 min as does standing ECW.

Cited by 34 publications

References 20 publications

Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

Changes in hydration following haemodialysis estimated with bioimpedance spectroscopy

Do Bioimpedance Measurements of Over-Hydration Accurately Reflect Post-Haemodialysis Weight Changes?

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