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The Body Fluid Compartment (2) Measurement

the body fluid compartment (2) measurement of fluid volumes in different body compartment the indicator dilution principle:
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The Body Fluid Compartment (2)
Measurement of Fluid Volumes in Different Body Compartment
The Indicator Dilution Principle:
1.
Select an appropriate marker or indictor substance
2.
Know mass or amount of indicator (marker) substance volume X
concentration
3.
Administration (injection) of the indicator substance
4.
Give time for dilution until the indicator become mixed in equal
concentration in all areas
5.
Take a sample of fluid to analyze the extent of dilution e.g.
(chemically, photoelectrical etc)
6.
Calculation of the volume of the body fluid

Calculation
*
Indicator Mass A Volume A X concentration A
*
Indicator Mass B Volume B X concentration B
*
Indicator Mass A Indicator Mass B
*
Volume A X concentration AVolume B X concentration B
*
Volume B Volume A X concentration A
concentration B
*
We need to know total amount of substance injected in to the
chamber
*
The concentration of the fluid in the sample after complete
dilution
The Method used to Measure the Volume of Body Compartment As Long As:
1.
The indicator disperses only in the measured compartment
2.
It is disperses evenly through the compartment
3.
It is not metabolized or excreted
NB: There are two compartment which cannot be measured directly
instead they have to be calculated

Regulation Of Fluid Exchange:
*
Intracellular – cell member
*
Extracellular – highly permeable to water
– relatively impermeable to small ions
i.e. only water is moving.
*
(osmotic effect of electrolytes Na, K, Cl)
*
Osmosis: is the net diffusion of water from a region of high water
concentration to region of low water concentration
*
Rate of osmosis: the rate of water diffusion
*
Osmotic pressure: the pressure required to prevent the osmosis
π CRT
C concentration of solutes osmoles /L
R gas constant
T Temperature in Kelvin (273° +c)
π 1.0 osm/L X(273+37)X g
310
19.3 mm Hg
i.e. for each 1.0 osm/L concentration gradient across the cell
membrane 19.3 mmHg osmotic pressure is exerted
Osmotic equilibrium is maintained between intracellular and
extracellular fluids:
*
Small changes in concentration of solutes in the extracellular
fluid can cause tremendous change in cell volume
*
Intracellular osmolarity extracellular osmolarity
*
≈ 300 mosm/L
*
Isotonic solution:
*
(no swells or shrink)
*
0.9% solution of sodium
*
chloride or 5% glucose
*
same in and out
*
Hypotonic solution:
*
(swelling) 0.9%
*
in is higher than out
*
Hypertonic solution:
*
(shrink) 0.9%
*
out is higher than in

Volumes and Osmolarities of ECF and ICF in Abnormal States
Some factors can cause the change:
*
dehydration
*
intravenous infusion
*
abnormal sweating
*
etc
Changes in volume:
1.
Volume expansion
2.
Volume contraction
Volume contraction decrease in the ECF volume:
1. Diarrhea
*
osmolarity of fluid lost ≈ osmolarity of ECF
*
(loss of isosmotic fluid)
*
 volume in ECF
*
 arterial pressure
2. Water deprivation
*
Water and NaCl
*
Osmolarity and volume will change
*
Hyposmotic fluid (small NaCl large water)
*
 Osmolarity in both ECF and ICF
*
 Volume in both ECF and ICF
3. Adrenal insufficiency:
*
Aldosterone deficiency
*
Na  in the ECF
*
 osmolarity in both
*
 in ECF volume
*
 in ICF volume
Volume Expansion
1. Infusion of isotonic NaCl
*
 ECF volume
*
No change in osmolarity
*
Isomotic expansion
2. High NaCl intake
*
eating salt
*
osmolarity in both
*
volume of ICF
*
volume of ECF
*
hyperosmotic volume expansion
3. Syndrome of inappropriate antidiurtic hormone (SIADH):
*
 volume
*
 osmolarity

Disturbances of Body Fluids
Type
Example
ECF Volume
ICF Volume
Molarity
Hematocrit
Plasma [protein]
Isosmotic volume contraction
Diarrhea

N.C.
N.C.


Hyperosmotic volume contraction
Sweating; fever; diabetes insipidus



N.C.

Hyposmotic volume contraction
Adrenal insufficiency





Isosmotic volume expansion
Infusion of isotonic NaCl

N.C.
N.C.


Hyperosmotic volume expansion
High NaCl intake





Hyposmotic volume expansion
SIADH



N.C.

ECF: extracellular fluid; ICF: intracellular fluid; NaCl: sodium
chloride; N.C.: No change; SIADH: Syndrome of inappropriate
antidiuretic hormone.
Effect of adding saline solution to the ECF

Glucose and other solutions administered for nutritive purposes
*
People who can not take adequate amount of food
*
Slowly
*
Prepared in isotonic solution
*
Water is excreted
Edema
Edema: excessive fluid in the tissues
*
Intracellular edema
*
Extracellular edema
Edema occurs mainly in the extracellular fluid compartment
Intracellular Edema:
Inflammation of tissues   membrane permeability   Na inside cells
  water  edema
Extracellular edema:
Common clinical cause is excessive capillary fluid filtration
Heart failure   capillary pressure   filtration  edema

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