Water Balance in Infants During Water Deprivation

Drescher, Alexander N.; Barnett, Henry L.; Troupkou, Vasiliki

doi:10.1001/archpedi.1962.02080030368008

Cited by 23 publications

(13 citation statements)

References 25 publications

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“…Additional clinical or biochemical signs of hypo(hyper)-hydration are necessary to diagnose hypo(hyper)-hydration in a subject of this life stage and gender group. Figure 2 Mean values of maximum and minimum urine osmolality in standardised tests of renal concentrating and diluting capacity according to postnatal age, gestational age (preterm and term infants) and nutrition (human milk, cow's milk, cow's milk formula , humanised formula, beikost): (K) human milk in preterm infants (Smith et al, 1949;Fisher et al, 1963), (') human milk in term infants (McCance and Widdowson, 1954;Janovsky et al, 1968;Marild et al, 1992), (&) humanised formula (Edelmann et al, 1960;Janovsky et al, 1968;Svenningsen and Aronson, 1974;Marild et al, 1992) ( ) cow's milk and cow's milk formula (Pratt et al, 1948;Barnett et al, 1952;Hansen and Smith, 1953;Edelmann et al, 1960;Drescher et al, 1962;Polacek et al, 1965;Janovsky et al, 1968), ( þ ) formula and beikost (Polacek et al, 1965;Rodriguez-Soriano et al, 1981;Assadi, 1990), (-) regression line (Winberg, 1959); (K-K; N-) repeated tests in the same infants; 830 mosm/kg: mean À2 s.d. of maximum Uosm in healthy children and adolescents consuming a typical affluent Western-type diet; 285 mosm/kg: mean plasma osmolality.…”

Section: Definition Of Euhydrationmentioning

confidence: 99%

24-h hydration status: parameters, epidemiology and recommendations

2003

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Hydration of individuals and groups is characterised by comparing actual urine osmolality (Uosm) with maximum Uosm. Data of actual, maximum and minimum Uosm in infants, children and adults and its major influencing factors are reviewed. There are remarkable ontogenetic, individual and cultural differences in Uosm. In the foetus and the breast-fed infant Uosm is much lower than plasma osmolality, whereas in children and adults it is usually much higher. Individuals and groups may show long-term differences in Uosm. In industrialised countries, the gender difference of Uosm is common. There are large intercultural differences of mean 24-h Uosm ranging from 860 mosm/kg in Germany, 649 mosm/kg in USA to 392 mosm/kg in Poland. A new physiologically based concept called 'free-water reserve' quantifies differences in 24-h euhydration. In 189 boys of the DONALD Study aged 4.0-6.9 y, median urine volume was 497 ml/24-h and median Uosm 809 mosm/kg. Considering meanÀ2 s.d. of actual maximum 24-h Uosm of 830 mosm/kg as upper level of euhydration and physiological criterion of adequate hydration in these boys, median free-water reserve was 11 ml/24-h. Based on median total water intake of 1310 ml/ 24-h and the third percentile of free-water volume of À156 ml/24-h, adequate total water intake was 1466 ml/24-h or 1.01 ml/ kcal. Data of Uosm in 24-h urine samples and corresponding free-water reserve values of homogeneous groups of healthy subjects from all over the world might be useful parameters in epidemiology to investigate the health effects of different levels of 24-h euhydration.

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Section: Definition Of Euhydrationmentioning

confidence: 99%

24-h hydration status: parameters, epidemiology and recommendations

2003

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“…If protons are released by the body, the net effect on acid-base homeostasis will depend on the efficiency of renal acidification and of the body buffering systems [21,33]. These mechanisms are known to be impaired in premature infants [17,41] and may account for their inability to compensate for the increase in H+ ion concentration resulting from disaccharide maldigestion.…”

Section: Introductionmentioning

confidence: 99%

Influence of Disaccharides on the Development of Systemic Acidosis in the Premature Infant

et al. 1971

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ExtractThe influence of disaccharides on the development of systemic acidosis in premature infants was studied by observing the changes that occurred in the blood after oral administration of carbohydrates. Lactose produced a small rise in levels of reducing sugar in blood, a stepwise increase of lactate concentrations, and a simultaneous drop in blood pH and CO 2 in serum. There were no acid-base alterations, and there was a greater increment in reducing sugars in blood in full-term patients with intrauterine malnutrition (IUM) and in premature infants after month 2 of life.In premature infants the drop in pH induced by lactose was significant during the first 15 min after the oral load and reached the lowest level (mean drop 0.09 pH unit) within S0-A5 min with gradual return to the basal point at 120 min. The maximal decrease in bicarbonate concentrations (mean drop 2.63 mEq/liter) occurred at 60-90 min after lactose feeding and was associated with a decrease in chloride concentration in serum (mean drop 7.8 mEq/liter) and an increased sodium-tochloride ratio. The increase in levels of lactate in blood did not account for the fall in levels of chloride and could only relate one-ninth of the anion substitution that occurred. In contrast, an equimolar load of mannitol induced none of the above mentioned changes.Stool composition after lactose loading did not vary in infants given oral loads of carbohydrates. When the maximal functional capacity was exceeded, however, diarrhea was induced, the pH of the stool dropped to a low of 4.50, and carbohydrates, lactate, and electrolytes were excreted in increased amounts in the feces; simultaneously severe metabolic acidosis ensued. The development of metabolic acidosis after oral loads of lactose was modified neither by neomycin treatment nor by substrate priming. There was an improvement in the response, however, as the infants grew older; those infants who received lactose during day 1 of extrauterine life were the infants who had the most striking decreases in blood pH values (mean 7.27) and bicarbonate concentrations in serum (mean 17.6 mEq/liter).An oral load of sucrose also produced a small rise in levels of reducing sugars in blood and induced metabolic acidosis, although the response was less intense than that obtained after lactose administration. There was no impairment in monosaccharide metabolism; the absorption of glucose, galactose, and fructose was normal; and the blood pH values remained stable throughout. All carbohydrates induced lactic acidemia similar to that produced by lactose. SpeculationThe observations indicate that disaccharide metabolism in newborn premature infants is impaired. Lactose loads administered orally result in subnormal elevation in reducing sugars in blood and the development of metabolic acidosis. These findings suggest that disaccharidase activity in premature infants is less than that demonstrated by full-term infants and that prematures hydrolyze sugars to a variety of organic acids, lower in the bowel. These, then, are quick...

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“…The first two mechanisms, although ingenious, are conjectural. The question of active urea transport by tubular cells in the mammalian kidney has not been answered satisfactorily to date (19)(20)(21) Troupkou have pointed out that the data commonly cited from canine and human studies are as yet inadequate to rule out the possibility (22).…”

Section: Discussionmentioning

confidence: 99%