Showing papers on "Body water published in 2004"
TL;DR: Clinical use of BIA in subjects at extremes of BMI ranges or with abnormal hydration cannot be recommended for routine assessment of patients until further validation has proven for BIA algorithm to be accurate in such conditions.
1,759 citations
TL;DR: The amounts of water, carbohydrate and salt that athletes are advised to ingest during exercise are based upon their effectiveness in attenuating both fatigue as well as illness due to hyperthermia, dehydration or hyperhydration.
Abstract: The amounts of water, carbohydrate and salt that athletes are advised to ingest during exercise are based upon their effectiveness in attenuating both fatigue as well as illness due to hyperthermia, dehydration or hyperhydration. When possible, fluid should be ingested at rates that most closely match sweating rate. When that is not possible or practical or sufficiently ergogenic, some athletes might tolerate body water losses amounting to 2% of body weight without significant risk to physical well-being or performance when the environment is cold (e.g. 5–10°C) or temperate (e.g. 21–22°C). However, when exercising in a hot environment ( >30°C), dehydration by 2% of body weight impairs absolute power production and predisposes individuals to heat injury. Fluid should not be ingested at rates in excess of sweating rate and thus body water and weight should not increase during exercise. Fatigue can be reduced by adding carbohydrate to the fluids consumed so that 30–60 g of rapidly absorbed carbohydrate are i...
459 citations
TL;DR: It is proposed that DXA has the capacity for clinical application including prediction of metabolic abnormalities associated with excess %BF in pediatrics because of its ease of use, consistent relationship with 4-CM, and availability.
Abstract: Objective. Pediatricians are encountering body composition information more frequently, with percentage of body fat (%BF) measurement receiving particular attention as a result of the obesity epidemic. One confounding issue is that different methods may yield different %BF results in the same person. The objective of this study was to compare dual-energy X-ray absorptiometry (DXA) with the criterion 4-compartment model (4-CM) for measurement of %BF in a large pediatric cohort and to assist pediatricians in appropriate interpretation of body composition information by recognizing differences between techniques. Methods. Height, weight, anthropometrics, body density by underwater weighing, total body water by deuterium dilution, and bone mineral content and %BF by DXA (Lunar DPX/DPX-L) were measured in 411 healthy subjects, aged 6 to 18 years. Values for %BF by 4-CM and DXA were compared using regression analysis. Results. The mean ± standard deviation values for %BF by DXA (22.73% ± 11.23%) and by 4-CM (21.72% ± 9.42%) were different, but there was a strong relationship between the 2 methods (R2 = 0.85). DXA underestimated %BF in subjects with lower %BF and overestimated it in those with higher %BF. The relationship between the 2 methods was not affected by gender, age, ethnicity, pubertal stage, height, weight, or body mass index. The standard error of the estimate was 3.66%. Conclusion. This analysis demonstrates a predictable relationship between DXA and 4-CM for %BF measurement. Because of its ease of use, consistent relationship with 4-CM, and availability, we propose that DXA has the capacity for clinical application including prediction of metabolic abnormalities associated with excess %BF in pediatrics.
221 citations
TL;DR: In general, bioelectrical impedance technology may be acceptable for determining body composition of groups and for monitoring changes in body composition within individuals over time, but use of the technology to make single measurements in individual patients, however, is not recommended.
Abstract: Bioelectrical impedance analysis (BIA) is the most commonly used body composition technique in published studies. Herein we review the theory and assumptions underlying the various BIA and bioelectrical impedance spectroscopy (BIS) models, because these assumptions may be invalidated in clinical populations. Single-frequency serial BIA and discrete multifrequency BIA may be of limited validity in populations other than healthy, young, euvolemic adults. Both models inaccurately predict total body water (TBW) and extracellular water (ECW) in populations with changes in trunk geometry or fluid compartmentalization, especially at the level of the individual. Single-frequency parallel BIA may predict body composition with greater accuracy than the serial model. Hand-to-hand and leg-to-leg BIA models do not accurately predict percent fat mass. BIS may predict ECW, but not TBW, more accurately than single-frequency BIA. Segmental BIS appears to be sensitive to fluid accumulation in the trunk. In general, bioelec...
220 citations
TL;DR: Data indicate that sweat losses of water and solute in football players in training can be substantial but vary greatly between players even with the same exercise and environmental conditions, and voluntary fluid intake also shows wide inter-individual variability and is generally insufficient to match fluid losses.
Abstract: This study measured fluid balance during a 90-min preseason training session in the first team squad (24 players) of an English Premier League football team. Sweat loss was assessed from changes in body mass after correction for ingested fluids and urine passed. Sweat composition was measured by collection from patches attached to the skin at 4 sites. The weather was warm (24-29 °C), with moderate humidity (46–64%). The mean ± SD body mass loss over the training session was 1.10 ± 0.43 kg, equivalent to a level of dehydration of 1.37 ± 0.54% of the pre-training body mass. Mean fluid intake was 971 ± 303 ml. Estimated total mean sweat loss was 2033 ±413 ml. Mean sweat electrolyte concentrations (mmol/L) were: sodium,49± 12; potassium,6.0± 1.3;chloride, 43 ± 10. Total sweat sodium loss of 99 ± 24 mmol corresponds to a salt (sodium chloride) loss of 5.8 ± 1.4 g. Mean urine osmolality measured on pre-training samples provided by the players was 666 ±311 mosmol/kg (n=21). These data indicate that sweat losses ...
191 citations
TL;DR: Post-exercise restoration of fluid balance after sweat-induced dehydration avoids the detrimental effects of a body water deficit on physiological function and subsequent exercise performance.
Abstract: For a person undertaking regular exercise, any fluid deficit that is incurred during one exercise session can potentially compromise the next exercise session if adequate fluid replacement does not occur. Fluid replacement after exercise can, therefore, frequently be thought of as hydration before the next exercise bout. The importance of ensuring euhydration before exercise and the potential benefits of temporary hyperhydration with sodium salts or glycerol solutions are also important issues. Post-exercise restoration of fluid balance after sweat-induced dehydration avoids the detrimental effects of a body water deficit on physiological function and subsequent exercise performance. For effective restoration of fluid balance, the consumption of a volume of fluid in excess of the sweat loss and replacement of electrolyte, particularly sodium, losses are essential. Intravenous fluid replacement after exercise has been investigated to a lesser extent and its role for fluid replacement in the dehydrated but otherwise well athlete remains equivocal.
176 citations
TL;DR: In this paper, the authors validated vector BIA (BIVA) patterns of hydration in peritoneal dialysis patients, based on direct measurements of resistance (R) and reactance (Xc) (RXc graph) without knowledge of the body weight.
136 citations
TL;DR: It is demonstrated that water turnover is highly variable among individuals and that little of the variance is explained by anthropometric parameters.
Abstract: Despite recent interest in water intake, few data are available on water metabolism in adults. To determine the average and range of usual water intake, urine output, and total body water, we admin...
111 citations
TL;DR: An increase of prognostically relevant variables body cell and muscle mass contributes to the weight gain after TIPS in malnourished patients with cirrhosis and hypermetabolism.
107 citations
TL;DR: Three models and 10 specific methods for determining maternal body composition are discussed and their perinatal relevance reviewed and the clinical correlates of material body composition in pregnancy are outlined.
Abstract: Three models and 10 specific methods for determining maternal body composition are discussed and their perinatal relevance reviewed. English language publications (1950 to January 2004) were searched electronically and by hand. Search terms included "body composition," "human," " pregnancy," "obesity," "adiposity," "regional," "2-, 3-, 4-component," "truncal," "peripheral," "central," "visceral" along with specific techniques and outcomes listed subsequently. Three models of body composition are described: 2-component being fat and fat-free mass; 3-component being fat, water, and protein; and 4-component being fat, water, protein, and osseous mineral. Ten techniques of body composition assessment are described: 1) anthropometric techniques including skinfold thicknesses and waist-hip ratio; 2) total body water (isotopically labeled); 3) hydrodensitometry (underwater weighing); 4) air-displacement plethysmography; 5) bio-impedance analysis (BIA); 6) total body potassium (TBK); 7) dual-energy x-ray absorptiometry (DEXA); 8) computed tomography (CT); 9) magnetic resonance imaging (MRI); and 10) ultrasound (USS). Most methods estimate total adiposity. Regional fat distribution-central (truncal) compared with peripheral (limb) or visceral compared with subcutaneous-is important because of regional variation in adipocyte metabolism. Skinfolds, DEXA, CT, MRI, or USS can distinguish central from peripheral fat. CT, MRI, or USS can further subdivide central fat into visceral and subcutaneous. Perinatal outcomes examined in relation to body composition include pregnancy duration, birth weight, congenital anomalies, gestational diabetes, gestational hypertension, and the fetal origins of adult disease. A few studies suggest that central compared with peripheral fat correlates better with birth weight, gestational carbohydrate intolerance, and hypertension. Means of accurately assessing maternal body composition remain cumbersome and impractical, but may more accurately predict perinatal outcomes than traditional assessments such as maternal weight.
79 citations
TL;DR: L-carnitine supplementation led to a significant increase in 13C-fat oxidation whereas protein synthesis and breakdown rates remained unchanged, indicating that the increased dietary fat oxidation in slightly overweight subjects was not accompanied by protein catabolism.
Abstract: We used a combined tracer technique with the stable isotopes 13C and 15N to gain further insight into the metabolic changes that accompany supplementation of L-carnitine. The aim of the present study was to investigate whether L-carnitine supplementation can influence fat oxidation, protein turnover, body composition, and weight development in slightly overweight subjects. Twelve volunteers received an individual regular diet either without or with L-carnitine supplementation of 3 g/d for 10 days. Protein turnover and fat oxidation were investigated after administration of [15N]glycine and an [U-13C]algae lipid mixture. The 15N- and 13C-enrichment in urine and breath were measured by isotope ratio mass spectrometry. Body fat mass (BFM), total body water (TBW), and lean body mass (LBM) were calculated by using bioelectric impedance analysis. L-carnitine supplementation led to a significant increase in 13C-fat oxidation (15.8% v 19.3%; P = .021) whereas protein synthesis and breakdown rates (3.7 and 3.4 g/kg/d, respectively) remained unchanged, indicating that the increased dietary fat oxidation in slightly overweight subjects was not accompanied by protein catabolism.
TL;DR: Study of nutrient partitioning during antimycobacterial treatment found change in the p-ratio is a suitable parameter for use in studying the effect of disease on body composition because it allows transformation of such effects into a normal distribution across a wide range of baseline proportion between fat and protein mass.
TL;DR: As rapid rehydration of children with malaria may have risks, it is suggested that fluid replacement regimens should aim to correct fluid losses over 12–24 h.
Abstract: Background The degree of volume depletion in severe malaria is currently unknown, although knowledge of fluid compartment volumes can guide therapy. To assist management of severely ill children, and to test the hypothesis that volume changes in fluid compartments reflect disease severity, we measured body compartment volumes in Gabonese children with malaria. Methods and Findings Total body water volume (TBW) and extracellular water volume (ECW) were estimated in children with severe or moderate malaria and in convalescence by tracer dilution with heavy water and bromide, respectively. Intracellular water volume (ICW) was derived from these parameters. Bioelectrical impedance analysis estimates of TBW and ECW were calibrated against dilution methods, and bioelectrical impedance analysis measurements were taken daily until discharge. Sixteen children had severe and 19 moderate malaria. Severe childhood malaria was associated with depletion of TBW (mean [SD] of 37 [33] ml/kg, or 6.7% [6.0%]) relative to measurement at discharge. This is defined as mild dehydration in other conditions. ECW measurements were normal on admission in children with severe malaria and did not rise in the first few days of admission. Volumes in different compartments (TBW, ECW, and ICW) were not related to hyperlactataemia or other clinical and laboratory markers of disease severity. Moderate malaria was not associated with a depletion of TBW.
TL;DR: Using the 4C model as the standard for determination of body fat and fat-free mass, this study revealed that apart from the prediction equation based on BMI and the 3Cb model, all methods gave acceptable group mean values.
Abstract: VAN MARKEN LICHTENBELT, W. D., F. HARTGENS, N. B. J. VOLLAARD, S. EBBING, and H. KUIPERS. Body Composition Changes in Bodybuilders: A Method Comparison. Med. Sci. Sports Exerc., Vol. 36, No. 3, pp. 490 – 497, 2004. Introduction: Few studies report on validation of body composition changes using the four-compartment model (4C), and no such studies are available in strength training. Here we present such a validation study for the determination of body fat and fat-free mass changes in bodybuilders, who used exercise and androgenic-anabolic steroids. Methods: The study was carried out with 27 male bodybuilders in a crosssectional study. Fifteen of these subjects also participated in an intervention program where body composition changes were measured. The 4C model served as the gold standard. The alternative mechanistic methods were underwater weighing (uww), deuterium dilution (dil), three-compartment model incorporating total body water (3Cw), three-compartment model incorporating bone mineral content (3Cb), and descriptive methods, namely dual-energy x-ray absorptiometry (DXA), prediction equations based on body mass index (BMI), skinfold measurement, and bioimpedance analyses. Results: From the cross-sectional study, it appeared that biases and errors of most mechanistic methods were small (maximal 0.5% BF and 3.4%BF, respectively; exception 3Cb model). The 3Cw model had the lowest error (0.9%BF). The descriptive methods had small biases (exception BMI) but relatively large errors (range: 5.5– 8%). Results on body composition changes (intervention study) were comparable with the results from the cross-sectional study. Conclusions: Using the 4C model as the standard for determination of body fat and fat-free mass, this study revealed that apart from the prediction equation based on BMI and the 3Cb model, all methods gave acceptable group mean values. When accurate measurements on body composition and/or body composition changes on an individual level are needed, only the 3Cw model could serve as an alternative for the 4C method. Key Words: ANDROGENIC-ANABOLIC STEROIDS, STRENGTH TRAINING, FOUR COMPARTMENT MODEL, DEUTERIUM DILUTION, DXA
TL;DR: The BIS technique, which was based on a model developed for the nonpregnant body, estimated increases in ICW accurately, whereas increases in ECW and TBW tended to be underestimated.
Abstract: Bioimpedance spectroscopy (BIS) is a technique of interest in the study of human pregnancy because it can assess extracellular (ECW), intracellular (ICW), and total body water (TBW) as ECW plus ICW...
TL;DR: The results of this study suggest that the PPAR gamma 2 PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.
Abstract: The effects of peroxisome proliferator-activated receptor gamma2 (PPAR2) Pro12Ala (P12A) polymorphism on body mass index (BMI) and type 2 diabetes are well documented; however, until now, only a few studies have evaluated the effects of this polymorphism on body fat distribution. This study was conducted to elucidate the effects of this polymorphism on computed tomography (CT)-measured body fat distribution and other obesity-related parameters in Korean female subjects. The frequencies of PPAR2 genotypes were: PP type, 93.0%; PA type, 6.8%; and AA type, 0.2%. The frequency of the A allele was 0.035. Body weight (P .012), BMI (P .012), and waist-to-hip ratio (WHR) (P .001) were significantly higher in subjects with PA/AA compared with subjects with PP. When body composition was analyzed by bioimpedance analysis, lean body mass and body water content were similar between the 2 groups. However, body fat mass (P .003) and body fat percent (P .025) were significantly higher in subjects with PA/AA compared with subjects with PP. Among overweight subjects with BMI of greater than 25, PA/AA was associated with significantly higher abdominal subcutaneous fat (P .000), abdominal visceral fat (P .031), and subcutaneous upper and lower thigh adipose tissue (P .010 and .013). However, among lean subjects with BMI of less than 25, no significant differences associated with PPAR2 genotype were found, suggesting that the fat-accumulating effects of the PA/AA genotype were evident only among overweight subjects, but not among lean subjects. When serum lipid profiles, glucose, and liver function indicators were compared among overweight subjects, no significant difference associated with PPAR2 genotype was found. Changes in body weight, BMI, WHR, and body fat mass were measured among overweight subjects who finished a 1-month weight lose program of a hypocaloric diet and exercise; no significant differences associated with PPAR2 genotype were found. The results of this study suggest that the PPAR2 PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.
TL;DR: Increased variance in plasma osmolality and urea during mass loss indicated altered homeostatic control during rut, which may be the consequence of selection for large body size and aggression in a highly variable competition for mates.
Abstract: Reindeer are polygynous ruminants that breed when plant growth declines in the Arctic. We studied seven males (2 years and older) in two herds with a total of 34 females to describe the costs and consequences of mating or rut. Body mass declined between September and November and did not recover through winter even though food was available ad libitum. Dominance did not affect body mass or any correlate of mass loss, indicating similar costs of rut among males. Males lost 34% of ingesta-free mass in 77 days of rut, which corresponded to depletion of 23% body protein and 78% body lipid. Water flux, plasma insulin, and plasma thyroxine were minimal 23 days after the peak in body mass, indicating low food intake. Maximum plasma testosterone and cortisol also followed peak mass and coincided with the death of two males from acute infections. Loss in body protein did not increase the ratio of urea to creatinine in plasma. Increased variance in plasma osmolality and urea during mass loss indicated altered homeostatic control during rut. Mating compromises survival of males through reduction of body reserves, food intake, and maintenance of tissues. These adverse effects may be the consequence of selection for large body size and aggression in a highly variable competition for mates.
TL;DR: Multifrequency phase-sensitive BIA seems to be a promising tool for the assessment of changes in nutritional status and body composition in patients with AN and an individually determined and controlled hyperenergetic diet as part of a multidimensional, interdisciplinary treatment program for eating disorders seems to quickly improve the nutritional status of AN patients.
Abstract: In patients with anorexia nervosa (AN), an assessment of changes in body composition and nutritional status is crucial for adequate nutritional management during refeeding therapies. Phase-sensitive multifrequency bioelectrical impedance analysis (BIA) is an inexpensive and noninvasive technique with which to determine nutritional status and body composition. We investigated 21 female adolescents with AN (initial BMI 15.5 +/- 1.1 kg/m(2)) 4 times between wk 3 and 15 of inpatient refeeding and 19 normal-weight, age-matched female controls. From wk 3 to 15, BMI, fat mass, body cell mass (BCM), total body water (TBW), intracellular water (ICW) but not extracellular mass (ECM), and extracellular water (ECW) increased significantly. Reactance (Xc), phase angle (PhA), and the ECM/BCM index as parameters of nutritional status improved significantly in patients and no longer differed from controls in wk 15, although the BMI of patients was significantly lower than those of controls. Changes in the ECM/BCM index were due to accretion of BCM, which was associated with an increase of ICW. Multifrequency phase-sensitive BIA seems to be a promising tool for the assessment of changes in nutritional status and body composition in patients with AN. An individually determined and controlled hyperenergetic diet as part of a multidimensional, interdisciplinary treatment program for eating disorders seems to quickly improve the nutritional status of AN patients.
TL;DR: The most common body composition methods used with dialysis patients are dual energy X-ray absorptiometry (DEXA), bioelectrical impedance, total body water (TBW), and prediction equations, but they are not recommended for assessment of predialysis patients, as estimates are best obtained postdialysis as discussed by the authors.
Abstract: Anthropometric and body composition assessments provide important information about the nutritional status of dialysis patients. Anthropometric measurements describe body size, fatness, and leanness in dialysis patients and have been collected in the Modification of Diet in Renal Disease (MDRD) and HEMO studies. Dialysis patients present special problems for anthropometry, including decreased functional status and increased comorbidity, that challenge nutrition assessment methodology. Recumbent anthropometric techniques are recommended and stature is estimated from knee height. Measures of weight, stature, calf circumference, arm circumference, and triceps and subscapular skinfolds have recently been reported for dialysis patients, who tend to be shorter, lighter, and have less adipose tissue than healthy persons of the same age. The HEMO study anthropometric data provide a clinical reference for assessing the nutritional status of dialysis patients. The most common body composition methods used with dialysis patients are dual energy X-ray absorptiometry (DEXA), bioelectrical impedance, total body water (TBW), and prediction equations, but they are not recommended for assessment of predialysis patients, as estimates are best obtained postdialysis. The TBW volume used in calculating the dose of dialysis has commonly been predicted from the limited, out-of-date equations of Watson, based on nonrepresentative samples. New prediction equations are available for white, black, and Mexican American children and adults. Watson's data are not representative of the TBW of U.S. men and women. The greater TBW in non-Hispanic black men and women and Mexican American women reflects the greater levels of obesity in the U.S. population.
TL;DR: It is observed that, regardless of the direction of the PV change, both upright immersions elicited reductions in intracellular fluid, and this observation has two implications: first, one cannot assume that PV changes reflect those of the entire extracellular compartment, and second, since immersion also increases interstitial fluid pressure, fluid leaving the interstitium must have been rapidly replaced by intrACEllular water.
Abstract: AIM In this study, we quantified acute changes in the intracellular and extracellular fluid compartments during upright neutral- and cold-water immersion. We hypothesized that, during short-term cold immersion, fluid shifts would be wholly restricted to the extracellular space. METHODS Seven males were immersed 30 days apart: control (33.3 degrees SD 0.6 degrees C); and cold (18.1 degrees SD 0.3 degrees C). Posture was controlled for 4 h prior to a 60-min seated immersion. RESULTS Significant reductions in terminal oesophageal (36.9 degrees +/- 0.1 degrees -36.3 degrees +/- 0.1 degrees C) and mean skin temperatures (30.3 degrees +/- 0.3 degrees -23.0 degrees +/- 0.3 degrees C) were observed during the cold, but not the control immersion. Both immersions elicited a reduction in intracellular fluid [20.17 +/- 6.02 mL kg(-1) (control) vs. 22.72 +/- 9.90 mL kg(-1)], while total body water (TBW) remained stable. However, significant plasma volume (PV) divergence was apparent between the trials at 60 min [12.5 +/- 1.0% (control) vs. 6.1 +/- 3.1%; P < 0.05], along with a significant haemodilution in the control state (P < 0.05). Plasma atrial natriuretic peptide concentration increased from 18.0 +/- 1.6 to 58.7 +/- 15.1 ng L(-1) (P < 0.05) during cold immersion, consistent with its role in PV regulation. We observed that, regardless of the direction of the PV change, both upright immersions elicited reductions in intracellular fluid. CONCLUSION These observations have two implications. First, one cannot assume that PV changes reflect those of the entire extracellular compartment. Second, since immersion also increases interstitial fluid pressure, fluid leaving the interstitium must have been rapidly replaced by intracellular water.
TL;DR: The two-component model for assessing body fat is as appropriate during late gestation as it is in the nonpregnant state, although its precision may be impaired when applied during the first part of pregnancy.
TL;DR: Fat-free mass and total body water explained a major proportion of the variability of birth weight in comparison with the mother’s weight gain during the pregnancy period, which has already been considered an important predictor of birthWeight.
Abstract: In order to establish the relationship between maternal body composition indicators (fat-free mass, fat mass, total body water) and birth weight, a cross-sectional study was designed, based on 196 pairs of mothers and live singleton newborns with gestational age of 37 weeks or more. Immediately after delivery, the mothers were interviewed to obtain information about different birth weight predictors. An analysis of maternal body composition through bioelectric impedance was held. Multiple linear regression was used to measure the effect of each variable on birth weight. The birth weight mean was 3,251 +/- 514 g. Maternal height was 160.44 +/- 6.3 cm, total net weight gain was 5.85 +/- 5.15 kg, fat mass consisted of 15.84 +/- 6.72 kg, and fat-free mass was 50.42 +/- 7.65 kg; total body water was 34.82 +/- 5.61 liters. The model which included total body water and all predictors found to be associated with birth weight in the bivariate analysis (maternal age, gestational age, gender, placenta weight, and placenta weight squared) was found to be the best in explaining the variability of birth weight (R(2) = 45.26%). Fat mass was an important predictor only in the subgroup of women within the low tertile of body mass index. In conclusion, fat-free mass and total body water explained a major proportion of the variability of birth weight in comparison with the mother's weight gain during the pregnancy period, which has already been considered an important predictor of birth weight.
TL;DR: Careful attention to fluid therapy formulation ensures positive fluid support without adding to the physiologic stress of the critical neonate, as they make the transition from fetal physiology.
Abstract: Fluid therapy is one of the most commonly used therapeutic modalities in critical care. Water is the milieu of life. All cellular functions occur in water and depend on proper osmolality. With few exceptions, cells only survive if surrounded by a fluid reservoir in the form of the interstitium. Fluid balance, including total body water and interstitial and cellular osmolarity, are extremely important in maintaining cellular health. When normal physiology is not overly disrupted and when there is adequate renal function, gross errors in fluid therapy are forgiven. When renal function is severely compromised, as is true in many critical neonates, or when the special limitations the neonate must deal with during the transition from fetal physiology are ignored, mistakes in fluid therapy can have devastating consequences, however. As with all therapeutic interventions, fluid therapy should be based on an understanding of the patient’s physiology and an educated guess about the pathophysiology occurring at the time. No one fluid therapy plan is suitable for all cases. Fluid therapy should be tailored to the individual rather than having one fluid plan forced on all cases. Nevertheless, the starting point of the fluid plan should be universal so that gross errors in formulation are avoided. This article outlines a fluid plan based on neonatal physiology that can form the starting point in formulating fluid therapy for the critical neonate.
TL;DR: In this paper, the accuracy of total body water (TBW) predicted by foot-to-foot bioelectrical impedance compared with a deuterium oxide dilution technique in oncology outpatients receiving radiotherapy was investigated.
Abstract: Objective: To investigate the accuracy of total body water (TBW) predicted by foot-to-foot bioelectrical impedance compared with a deuterium oxide dilution technique in oncology outpatients receiving radiotherapy.
TL;DR: Patients on PD have increased extracellular fluid volume as compared with healthy controls and hyperhydration is related to inflammation and to higher peritoneal transport types.
TL;DR: The results show that the administration of 200 mg.wk(-1) of ND (intramuscularly) for 8 wk significantly increased body mass and FFM, whereas fat mass, bone mineral content, bone Mineral density, and the hydration of the FFM remained unaffected, indicating that the changes can be attributed to an increase of muscle mass.
Abstract: INTRODUCTION: The use of androgenic-anabolic steroids (AAS) among bodybuilders to increase muscle mass is widespread. Nandrolone decanoate (ND) is one of the most popular misused AAS, although the effects on body composition are equivocal. Therefore, the purpose of this study was to determine the effect of ND on body composition in male bodybuilders, with special reference to muscle mass alterations. METHODS: Using a randomized "double-blind" "placebo-controlled" design, 16 experienced male bodybuilders (age: 19-44 yr) either received ND (200 mg.wk(-1), intramuscularly) or placebo for 8 wk. Body composition was assessed using the four-component model, combining results from underwater weighing, dual-energy x-ray absorptiometry (DXA), and deuterium dilution. Total bone mineral content and density were measured using DXA. Water compartments (extracellular water [ECW] and intracellular water [ICW]) were determined using deuterium dilution and bromide dilution. RESULTS: ND administration resulted in significant increments of body mass (+2.2 kg), fat-free mass (FFM: +2.6 kg), and total body water (+1.4 kg). No significant changes in fat mass, percentage fat, ECW, ICW, ECW/ICW ratio, hydration of the FFM, and on bone mineral measurements were observed. CONCLUSIONS: The results show that the administration of 200 mg.wk(-1) of ND (intramuscularly) for 8 wk significantly increased body mass and FFM, whereas fat mass, bone mineral content, bone mineral density, and the hydration of the FFM remained unaffected. These data indicate that the changes can be attributed to an increase of muscle mass.
TL;DR: It is concluded that non-invasive measurement of total body water by bioimpedance may enable preoperative fluid depletion and its influence on perioperative outcome to be assessed and may serve as a useful indicator of peri operative fluid depletion.
Abstract: Background. Fluid depletion during the perioperative period is associated with poorer outcome. Non-invasive measurement of total body water by bioimpedance may enable preoperative fluid depletion and its influence on perioperative outcome to be assessed. Methods. Weight and foot bioimpedance were recorded under standardized conditions in patients undergoing bowel preparation ( n =43) or day surgery ( n =44). Fifteen volunteers also followed standard nil-by-mouth instructions on two separate occasions to assess the variabilities of weight and bioimpedance over time. Results. Body weight fell by 1.27 kg (95% CI 1.03–1.50 kg; P P P =0.07) correlated ( r =–0.46; P =0.005) with an increase in bioimpedance (16 ohms, 95% CI 5–27 ohms; P =0.01). No difference between two separate bioimpedance measurements was seen in the volunteer group. Conclusions. Further work is warranted to determine if bioimpedance changes may serve as a useful indicator of perioperative fluid depletion.
TL;DR: It is suggested that creatine supplementation cannot be considered to be an ergogenic supplement ensuring improved performance and muscle mass gain in swimmers.
Abstract: The objective of this study was to determine the effect of creatine supplementation on performance and body composition of swimmers. Eighteen swimmers were evaluated in terms of post-performance lactate accumulation, body composition, creatine and creatinine excretion, and serum creatinine concentrations before and after creatine or placebo supplementation. No significant differences were observed in the marks obtained in swimming tests after supplementation, although lactate concentrations were higher in placebo group during this period. In the creatine-supplemented group, urinary creatine, creatinine, and body mass, lean mass and body water were significantly increased, but no significant difference in muscle or bone mass was observed. These results suggest that creatine supplementation cannot be considered to be an ergogenic supplement ensuring improved performance and muscle mass gain in swimmers.
TL;DR: The study investigators conducted a vigorous screening protocol for delirium in rural long-term care (LTC) facilities for a period of 28 days focusing on Bioelectrical Impedance Analysis (BIA) and other hydration parameters as risk factors, but in general the BIA measures did not predictDelirium events.
Abstract: Background. The study investigators conducted a vigorous screening protocol for delirium in rural long-term care (LTC) facilities for a period of 28 days focusing on Bioelectrical Impedance Analysis (BIA) and other hydration parameters as risk factors. Methods. A two-stage cluster sampling procedure was used to randomly select participants (n ¼ 313) from 13 LTC facilities located in southeastern Iowa, stratified on facility bed size. BIA was used to estimate intracellular water (ICW), extracellular water (ECW), and total body water (TBW) on four occasions—baseline and follow-up days 7, 14, and 28. Volume estimates were calculated as a percent of body weight (%WT). Serum electrolytes and hematology were also measured. Delirium was measured with four strict criteria: a NEECHAM Confusion Scale score , 25, Vigilance ‘‘A’’ score . 2, a Mini-Mental Status Examination , baseline, and a positive Confusion Assessment Method score. Results. There were n ¼69 delirium cases (22.0%). Blood urea nitrogen/creatinine ratios greater than 21:1 (odds ratio ¼ 1.76, 95% confidence interval 1.02‐3.06). No significant risk for delirium was associated with ICW, ECW, or TBW as a percent of body weight. Conclusions. Some changes were observed with a slight decrease in ICW between day 7 and day 14 of follow-up that tended to follow an increase in delirium events, but in general the BIA measures did not predict delirium events.
TL;DR: Gender influences the assessment of hydration status of PD patients when employing bioimpedance, such that women tend to have more ECF, whereas peritoneal solute transport is not.
Abstract: ObjectivesTo establish which clinical factors are associated with an increased proportion of extracellular fluid (ECF) in peritoneal dialysis (PD) patients.DesignA single-center, cross-sectional an...