PURPOSE: Antenatal steroid (AS) may result in lower insensible water loss (IWL), and higher urine output (UO) in early life. We examined if the postnatal fluid balance differed between infants exposed to AS or not (control) in VLBW infants. METHODS: Fifty-four VLBW infants were grouped into AS (n=24) or control (n=30). Fluid intake, UO, IWL and maximal % of weight loss on day 1, day 2, day 3 and day 7 after birth were analyzed. Daily maintenance fluid was determined in each infants by calculation of insensible water loss (IWL=[intake-output]-Delta wt) and UO. RESULTS: Fluid intake (AS vs control; 117.2+/-33.9 vs 126.0+/-29.6 mL/kg/d, P=0.315), IWL (28.1+/-23.7 vs 21.1+/-20.5 P=0.248), UO and maximal % of weight loss on day 7 were not different between groups: similar findings were observed on day 1, day 2, and day 3 after birth. Neonatal morbidities and clinical relevant factors were not different between groups. The duration of assisted ventilation was shorter in the AS than in the control (10.8+/-9.2 vs 27.6+/-26.2, P=0.002). However, the difference disappeared after adjustment for RDS severity and oxygenation index. CONCLUSION: VLBW infants exposed to AS did not have an alteration in postnatal fluid balance during the first week of life, when given fluid based on needs reflected by IWL and UO. The decreased need for assisted ventilation in the AS group may be related to the effects of steroid on fetal lung fluid absorption or maturity, but not on postnatal fluid balance.
Absorption ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Lung ; Oxygen ; Parturition ; Ventilation ; Water Loss, Insensible ; Water-Electrolyte Balance* ; Weight Loss

PURPOSE: Extremely-low-birth-weight infants (ELBWIs), especially those < or =24 gestational weeks (GW), presented extremes in IWL and changes of water balance. The purpose of the present study was to retrospectively investigate fluid and electrolyte balance in infants of < or =24-GW during the first postnatal week under high humidification. METHODS: Medical records of extremely-low-birth-weight infants (ELBWIs) who were born and admitted to the Neonatal Intensive Care Unit at Samsung Medical Center during March 2004-September 2010 were reviewed. Fluid intake, urine output, insensible water loss (IWL), and electrolyte balance of 22-GW (n=14), 23-GW (n=40), and 24-GW (n=67) infants nursed in high humidity (95%) were compared with > or =26-GW (n=65) infants nursed in 60% humidity. RESULTS: Survival rate until discharge was 33%, 82%, 75%, and 89.3% in 22-GW, 23-GW, 24-GW, and > or =26-GW infants, respectively. Fluid intake and IWL was higher in 22-GW and 23-WG, but not different in 24-GW, than in > or =26-GW infants. At postnatal days (P) 3-5, the urine output was significantly lower in > or =26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23-, and 24-GW (P1-2) than in > or =26-GW infants. Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%), and 24-GW (21%) than in > or =26-GW infants (14%). CONCLUSION: High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not 22- and 23-GW, infants. Increased IWL in the latter might be related to more immature skin, and implicates the need for additional nurturing conditions.
Apnea ; Electrolytes ; Humans ; Humidity ; Hypernatremia ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Medical Records ; Retrospective Studies ; Seizures ; Skin ; Sodium ; Survival Rate ; Water Loss, Insensible ; Water-Electrolyte Balance

PURPOSE: Extremely-low-birth-weight infants (ELBWIs), especially those < or =24 gestational weeks (GW), presented extremes in IWL and changes of water balance. The purpose of the present study was to retrospectively investigate fluid and electrolyte balance in infants of < or =24-GW during the first postnatal week under high humidification. METHODS: Medical records of extremely-low-birth-weight infants (ELBWIs) who were born and admitted to the Neonatal Intensive Care Unit at Samsung Medical Center during March 2004-September 2010 were reviewed. Fluid intake, urine output, insensible water loss (IWL) and electrolyte balance of 22-GW (n=14), 23-GW (n=40) and 24-GW (n=67) infants nursed in high humidity (95%) were compared with > or =26-GW (n=65) infants nursed in 60% humidity. RESULTS: Survival rate until discharge was 33%, 82%, 75% and 89.3% in 22-GW, 23-GW, 24-GW and > or =26-GW infants, respectively. Compared to > or =26-GW infants, fluid intake and IWL was higher in 22-GW and 23-WG, but not as different in 24-GW. At postnatal day (P) 3-5, urine output was significantly lower in > or =26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23- and 24-GW (P1-2) than in > or =26-GW infants. Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%) and 24-GW (21%) than in > or =26-GW infants (14%). CONCLUSION: High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not in 22- and 23-GW infants. Increased IWL in the latter might be related to more immature skin, implicating the need for additional nurturing conditions.
Electrolytes ; Humans ; Humidity ; Hypernatremia ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Retrospective Studies ; Skin ; Sodium ; Survival Rate ; Water Loss, Insensible ; Water-Electrolyte Balance

In newborn infants with mechanical ventilation in the first few days of life, fluid balance must be closely monitored because inadequate therapy related to overload may result in serious complications such as patent ductus arteriosus and pulmonary edema. Very low birth weight infants have significant change in body water balance in early neonatal period secondary to a large insensible water loss (IWL) and immaturity of renal function. Consequently these infants tend to have a high incidence of fluid overload so that fluid restriction with high humidification is effective during especially the first week of life. In infants with bronchopulmonary dysplasia, diuretics such as furosemide may act directly to improve lung mechanics by reabsorption of lung fluid, but chronic use may cause electrolyte imbalance, nephrocalcinosis and hearing deficit. In the early phase of perinatal asphyxia with oliguria, fluid restriction to amount equal to urine output and IWL is critical in order to prevent volume excess and potassium should not be given to avoid hyperkalemia. Blood components should always be infused through transfusion set with standard filter. To minimize adverse reactions of transfusion, basic rules must be observed. Moreover, storage of blood cells in small aliquots, using leukocyte removal filters and irradiation of blood can be helpful to prevent multiple donor exposure, cytomegalovirus infection, alloimmunization, and graft-versus-host rejection.
Asphyxia ; Blood Cells ; Body Water ; Bronchopulmonary Dysplasia ; Cytomegalovirus Infections ; Diuretics ; Ductus Arteriosus, Patent ; Fluid Therapy* ; Furosemide ; Hearing ; Humans ; Hyperkalemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Leukocytes ; Lung ; Mechanics ; Nephrocalcinosis ; Oliguria ; Potassium ; Pulmonary Edema ; Respiration, Artificial* ; Tissue Donors ; Water Loss, Insensible ; Water-Electrolyte Balance

Clinical observation was made on 11 cases of ureterosigmoidostomy during the period from 1959 to 1976. Age ranged from 27 to 65 years and 7 female and 4 male each. Underlying diseases at the time of operation were 6 cases of vesico-vaginal fistula and 5 cases of bladder tumor. Their operation time, amount of transfusion, electrolyte balance, early and late complications after operation were analyzed. It seemed to us that despite the many urologist abandon ureterosigmoidostomy and prefer ileal diversion, its usefulness is assessed in our paper and applicable to some selected patients.
Female ; Fistula ; Humans ; Male ; Urinary Bladder Neoplasms ; Water-Electrolyte Balance

A good hydration status is important to the exercise performance and cognitive function of exercisers.The effective restoration of fluid balance after exercise is helpful to prevent dehydration,maintain body fluid balance,accelerate fatigue recovery,and enhance exercise performance.As the most effective sports nutrition supplement,sports beverage has different ingredients and formulas,and also has various effects.To provide clues for the development of sports beverage,this article reviews the types,components,effects,and mechanisms of sports beverage currently used in post-exercise fluid restoration.
Beverages ; Dehydration ; Exercise ; Fluid Therapy ; Humans ; Sports ; Water-Electrolyte Balance

Nephrogenic diabetes insipidus is a rare genetic renal disease characterized by insensitivity of the kidney to the anti-diuretic effect of vasopressin in spite of elevated serum anti-diuretic hormone (ADH). Failure of the kidney to respond to ADH results in impaired osmoregulation and water reabsorption of the kidney, therefore, nephrogenic diabetes insipidus presents with a large amount of hypotonic polyuria, polydipsia, and dehydration. We report our experience of two familial cases of nephrogenic diabetes insipidus in brothers both having c.910+1delG in intron 2 of the AVPR2 gene with the brief review of related literatures.
Dehydration ; Diabetes Insipidus, Nephrogenic ; Humans ; Introns ; Kidney ; Polydipsia ; Polyuria ; Siblings ; Vasopressins ; Water ; Water-Electrolyte Balance

A typical pattern of daily water exchange was determined in 10 medical students during three different seasons: summer, autumn and winter. The daily water intake was averaged to 3,810ml of which 1,256ml was from liquids, 2,055ml from the water contained in food and 500ml from the water of oxidation. On the other hand, the daily water output was 1,844ml by urinary loss, 144ml by fecal loss and 1,819ml by evaporative loss. The above quantitative pattern of daily water exchange in the Korean remained unchanged throughout the year. The daily urinary output of NaCl and urea-nitrogen was in the order of 20gm and 10gm, respectively. Furthermore, the magnitude of daily water intake was well correlated to the daily urinary output of NaCl but little correlated to that of urea-nitrogen. A comparison of these data with the corresponding figures obtained from the occidental indicates that the daily water intake and the daily urinary output of NaCl were significant1y greater in the Korean than those in the occidental. On the basis of these results, the greater water intake in the Korean was attributed to their high salt intake.
Adult ; Asian Continental Ancestry Group ; *Diuresis ; Human ; Kidney/*physiology ; Korea ; Male ; *Water ; Water-Electrolyte Balance

Our own preliminary experiences with the use of lactated Ringer solution during major surgery have been reported. We used 10cc/kg/hr in 40 patients throughout the operative period, and compared them with a control group of 30. Observations were made for the following; RBC, Hct, Hgb, electrolytes, and urine output. There were no significant differences in blood constituents and electrolytes between the two groups, but considerable increase in urinary outupt was noticed in the experimental group during 24 hour post-operative period. Blood transfusion had been done to replace blood loss and the experimental group had considerable reduction of transfused blood volume during surgery. We accept and produce evidence for the concept, pronounced by Epstein, that decrease in functional rextra-cellular fluid is a major determinant to sodium excretion. A major limitation of post-operative sodium excretion seemed to be the acute contraction of the functional extracelluar fluid incurred by surgery. If the losses of extracellular fluid were replaced during the operation, the phenomenon of sodium retention, was not seen. Neither normal saline nor 5% dextrose adequately replace the extracellular loss and kidneys do not eliminate excess water in this way. Lactated Ringer solution prevents acidosis and concomittant retention of water and sodium, and at the same time, sodium is adequately eliminated. It appears that this is an advance in managing fluid and electrolyte balance during surgery.
Acidosis ; Blood Transfusion ; Blood Volume ; Electrolytes ; Extracellular Fluid ; Glucose ; Humans ; Kidney ; Sodium ; Water ; Water-Electrolyte Balance

Maintaining adequate fluid balance is essential for all biological functions in the body. The purpose of this study was to evaluate vulnerability to dehydration by analyzing age, gender, body mass index (BMI), and blood lipid parameters in health checkup examinees who visited Sahmyook Seoul Hospital for comprehensive health checkups. In a binary logistic regression analysis stratified by age and body mass index the odd ratio for dehydration was as high as 3.317 (95% CI: 1.666~6.605) in the 50s age group, 4.224 (95% CI: 2.038~8.755) in the 60s age group, and 4.610 (95% CI: 1.943~10.940) in the above 70s age group compared to 20s reference age group. Aged females showed greater vulnerability to dehydration with significance levels of P<0.01 and P<0.001. Compared to a normal weight (BMI: 18.5~22.9) the odd ratio was higher in males with an under weight (BMI: less than 18.5) (5.130 [95% CI: 1.631~16.132]) and in females with an over weight (BMI: 23.0~24.9) (1.500 [95% CI: 1.065~2.114]). In conclusion, our results showed that vulnerability to dehydration increased with age and was higher in under weight males and over weight females than that in normal weight.
Body Mass Index* ; Dehydration* ; Female ; Humans ; Logistic Models ; Male ; Seoul ; Water-Electrolyte Balance