Different Effects of Frusemide Administered during Hypertonic Saline Infusion in Healthy Subjects and Hypertensive Patients

1970 ◽  
Vol 39 (6) ◽  
pp. 833-845 ◽  
Author(s):  
J. P. Radó ◽  
L. Szende ◽  
L. Borbély ◽  
Cs. Báanos ◽  
J. Takó ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Healthy Subjects ◽  
Free Water ◽  
Normal Subjects ◽  
Saline Infusion ◽  
Water Reabsorption ◽  
Salt Loading ◽  
Hypertensive Patients ◽  
Healthy Persons ◽  
Hypertonic Saline Infusion

1. The effects of hypertonic saline and frusemide administered during hypertonic saline infusion were studied during antidiuresis and infusion of lysine-vasopressin in fifteen healthy subjects and seventeen patients with hypertension. 2. Rates of excretion of water and sodium were higher during salt loading in the hypertensive patients as compared to the healthy persons. On the other hand, frusemide administered during saline infusion had a greater effect in the normal subjects. 3. Free water reabsorption increased markedly in the first 10-min clearance period after frusemide injection in the healthy subjects, while in the hypertensive group there was no significant change. This suggested that the diuretic may have a more marked proximal tubular effect in the healthy persons and/or a more intensive Henle's loop action in the hypertensives. However, the latter possibility was not supported by data concerning the correlation between solute excretion and free water reabsorption. 4. It is suggested that sodium transport is competitively inhibited in the same segment(s) of the nephron by frusemide and hypertonic saline and that this may explain the decreased effect of frusemide in the hypertensives.

Thirst and fluid regulatory responses to hypertonicity in older adults

1996 ◽  
Vol 271 (3) ◽  
pp. R757-R765 ◽  
Author(s):  
N. S. Stachenfeld ◽  
G. W. Mack ◽  
A. Takamata ◽  
L. DiPietro ◽  
E. R. Nadel
Keyword(s):  
Older Adults ◽  
Hypertonic Saline ◽  
Rating Scale ◽  
Isotonic Saline ◽  
Plasma Osmolality ◽  
Free Water ◽  
Saline Infusion ◽  
Renal Handling ◽  
Aging Adults ◽  
Hypertonic Saline Infusion

To assess the fluid regulatory responses in aging adults, we measured thirst perception and osmoregulation during and after infusion of hypertonic NaCl) saline in older (72 +/- 2 yr, n = 6) and younger (26 +/- n = 6) subjects. Hypertonic saline was infused at 0.1 min-1.kg-1 for 120 min. On a separate day, the same subjects were infused identically with isotonic saline as a control. After infusion and a 30-min equilibration period, the drank water ad libitum for 180 min. Hypertonic infusion led to graded increases in plasma osmolality (Posm; 18 +/- 2 and 20 +/- 2 mosmol/kgH2O) and percent changes plasma volume (16.2 +/- 1.9 and 18.0 +/- 1.2%) that were in older and younger subjects. Osmotically stimulated increases in thirst (94.8 +/- 18.9 and 88.3 +/- 25.6 mm), assessed on a line rating scale, and plasma arginine vasopressin concentration (6.08 +/- 1.50 and 4.51 +/- 1.37 pg/ml, for older younger, respectively) were also unaffected by age. subsequent hypervolemia, both groups of subjects sufficient water to restore preinfusion levels of Posm. Renal handling of free water and sodium was also unaffected by age during recovery from hypertonic saline infusion, but was significantly lower in older subjects during recovery from saline infusion, resulting in net fluid retention and a significant fall in Posm (6 mosmol/kgH2O). In contrast to earlier reports of a blunted thirst response to dehydration hypertonicity, we found that osmotically stimulated thirst and renal osmoregulation were intact in older adults after hypertonic saline infusion.

scholarly journals Effect of water deprivation and hypertonic saline infusion on urinary AQP2 excretion in healthy humans

2001 ◽  
Vol 280 (5) ◽  
pp. F860-F867 ◽  
Author(s):  
R. S. Pedersen ◽  
H. Bentzen ◽  
J. N. Bech ◽  
E. B. Pedersen
Keyword(s):  
Hypertonic Saline ◽  
Healthy Subjects ◽  
Water Deprivation ◽  
Saline Infusion ◽  
Fluid Restriction ◽  
Blood Samples ◽  
Positive Correlation ◽  
Maximum Change ◽  
Collecting Ducts ◽  
Hypertonic Saline Infusion

Arginine vasopressin (AVP) mediates water transport in the renal collecting ducts by forming water channels of aquaporin-2 (AQP2) in the apical plasma membrane. AQP2 is excreted in human urine. We wanted to test the hypothesis that urinary excretion of AQP2 (u-AQP2) reflects the effect of AVP on the renal collecting ducts during water deprivation and hypertonic saline infusion in healthy subjects. Fifteen healthy subjects underwent a 24-h period of fluid restriction. Urine and blood samples were collected at timed intervals. Fifteen healthy subjects were given 7 ml/kg 3% hypertonic saline infusion for 30 min. Urine and blood samples were collected at timed intervals. During fluid restriction, the u-AQP2 rate increased from 3.9 (25th percentile: 3.1; 75th percentile: 5.2) to 7.6 (5.9–9.1; P < 0.001) ng/min, and the plasma AVP (p-AVP) level increased from 0.5 (0.4–0.6) to 3 (1.7–3.3) pmol/l. There was a positive correlation between the maximum change in u-AQP2 rate and the maximum change in p-AVP ( r = 0.57, P < 0.03). During the infusion study, u-AQP2 rate was at maximum 90 min after the infusion [baseline: 4.5 ng/min (3.5–4.8); 90 min: 5 ng/min (4.5–6.0) P < 0.02]. p-AVP increased from 1.0 (0.9–1.1) to 1.5 (1.2–1.8; P < 0.002) pmol/l. There was a positive correlation between the maximum change in u-AQP2 rate and the maximum change in p-AVP ( r = 0.83; P < 0.0001). It can be concluded that p-AVP and u-AQP2 are increased during thirst and hypertonic saline infusion and that u-AQP2 reflects the action of AVP on the collecting ducts.

Effect of ethanol ingestion on plasma vasopressin and water balance in humans

1982 ◽  
Vol 242 (5) ◽  
pp. R522-R527 ◽  
Author(s):  
G. Eisenhofer ◽  
R. H. Johnson
Keyword(s):  
Hypertonic Saline ◽  
Free Water ◽  
Urine Osmolality ◽  
Saline Infusion ◽  
Ethanol Ingestion ◽  
Free Water Clearance ◽  
Vasopressin Release ◽  
Plasma Vasopressin ◽  
Hypertonic Saline Infusion ◽  
Water Clearance

The effects of 75 ml ethanol ingested over 60 min on plasma osmolality (Posmol) and plasma vasopressin (PAVP) in four normal subjects were studied. In the 1st h of the investigation PAVP fell, then rose, even though plasma ethanol levels were still rising. The rise in PAVP was preceded by a rise in Posmol corrected for the influence of ethanol. The fall in PAVP was followed by an increase in free water clearance and a decrease in urine osmolality, while the later rise in PAVP was followed by a decrease in free water clearance (CH2O) and a rise in urine osmolality. The relationship between PAVP and Posmol was then studied during intravenous (iv) hypertonic saline infusion in five subjects. The results were compared with those from a second infusion in the same subjects after ingestion of ethanol (0.5 ml/kg). Ethanol reduced vasopressin release in response to iv hypertonic saline infusion, and this correlated with a reduced decrease in CH2O. We conclude that ethanol inhibits PAVP release by decreasing the response of the osmosodium receptors to changes in plasma tonicity.

scholarly journals Lidocaine coinfusion alleviates vascular pain induced by hypertonic saline infusion: a randomized, placebo-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiping Song ◽  
Shibiao Chen ◽  
Yang Zhang ◽  
Xiaoyun Shi ◽  
Na Zhao ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Saline Solution ◽  
Time Slot ◽  
Controlled Trial ◽  
Saline Infusion ◽  
Clinical Trial Registry ◽  
Hypertonic Saline Solution ◽  
Vas Scores ◽  
Vascular Pain ◽  
Hypertonic Saline Infusion

Abstract Background Hypertonic saline solution has been frequently utilized in clinical practice. However, due to the nonphysiological osmolality, hypertonic saline infusion usually induces local vascular pain. We conducted this study to evaluate the effect of lidocaine coinfusion for alleviating vascular pain induced by hypertonic saline. Methods One hundred and six patients undergoing hypertonic saline volume preloading prior to spinal anesthesia were randomly allocated to two groups of 53 each. Group L received a 1 mg/kg lidocaine bolus followed by infusion of 2 mg/kg/h through the same IV line during hypertonic saline infusion; Group C received a bolus and infusion of normal saline of equivalent volume. Visual analogue scale (VAS) scores of vascular pain were recorded every 4 min. Results The vascular pain severity in Group L was significantly lower than that in Group C for each time slot (P < 0.05). The overall incidence of vascular pain during hypertonic saline infusion in Group L was 48.0%, which was significantly lower than the incidence (79.6%) in Group C (P < 0.05). Conclusion Lidocaine coinfusion could effectively alleviate vascular pain induced by hypertonic saline infusion. Trial registration Chinese Clinical Trial Registry, number: ChiCTR1900023753. Registered on 10 June 2019.

Reproducibility of osmotic and nonosmotic tests of vasopressin secretion in men

1991 ◽  
Vol 260 (3) ◽  
pp. R533-R539 ◽  
Author(s):  
C. J. Thompson ◽  
P. Selby ◽  
P. H. Baylis
Keyword(s):  
Blood Glucose ◽  
Linear Regression ◽  
Hypertonic Saline ◽  
Linear Regression Analysis ◽  
Plasma Osmolality ◽  
Saline Infusion ◽  
Intraindividual Variation ◽  
Insulin Tolerance ◽  
Vasopressin Secretion ◽  
Hypertonic Saline Infusion

We have studied the reproducibility of the thirst and arginine vasopressin (AVP) responses to osmotic and hypoglycemic stimulation in healthy volunteers undergoing repeat hypertonic (855 mmol/l) saline infusion and insulin tolerance tests (ITTs). Hypertonic saline infusion caused similar mean rises in plasma osmolality, AVP, and thirst on each occasion. Linear-regression analysis defined close relationships between the slopes (r = +0.72, P less than 0.05) and the abscissal intercepts (r = +0.89, P less than 0.001) of the regression lines relating plasma osmolality (Posmol) and plasma AVP (PAVP), and the group intraindividual component of the variance for the slopes and intercepts was 7 and 0.6%, respectively. There were close correlations between the slopes (r = +0.79, P less than 0.02) and the intercepts (r = +0.84, P less than 0.01) of the regression lines relating Posmol and thirst, and group intraindividual component of the variance was 14 and 0.7%, respectively. Hypertonic saline infusion was infused on four occasions in four subjects, and the results showed that the linear regression lines relating PAVP and Posmol and thirst and Posmol were reproducible within an individual. There were similar falls in blood glucose and elevations in PAVP in both ITTs. No relationship was defined between the fall in blood glucose and either the rise in PAVP or the area under the AVP curve (AUC). The intraindividual component of the variance for the rise in AVP and the AUC was 77 and 22.5%, respectively. The AVP and thirst responses to osmotic stimulation are highly reproducible, but there is considerable intraindividual variation in the AVP response to hypoglycemia.

scholarly journals Tolvaptan Use to Treat SIADH in a Child

2018 ◽  
Vol 23 (6) ◽  
pp. 494-498
Author(s):  
Adem Yasin Koksoy ◽  
Meltem Kurtul ◽  
Aslı Kantar Ozsahin ◽  
Fatma Semsa Cayci ◽  
Meltem Tayfun ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Treatment Option ◽  
Pediatric Patients ◽  
Hormone Secretion ◽  
Saline Infusion ◽  
Fluid Restriction ◽  
Effective Treatment Option ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Electrolyte Abnormalities ◽  
Hypertonic Saline Infusion

Hyponatremia is one of the most common electrolyte abnormalities encountered in the clinical setting in hospitalized patients. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the leading cause of hyponatremia in most of these cases. While fluid restriction, hypertonic saline infusion, diuretics, and the treatment of underlying conditions constitute the first line of treatment of SIADH, in refractory cases, and especially for pediatric patients, there seems not to be any other choice for treatment. Tolvaptan, although its use in pediatric patients is still very limited, might be an attractive treatment option for correction of hyponatremia due to SIADH. Here we present a pediatric case of SIADH that was resistant to treatment with fluid restriction and hypertonic saline infusion and was treated successfully with tolvaptan. Tolvaptan could be a good, safe, and effective treatment option in pediatric SIADH cases that are resistant to treatment. However, the dosage should be titrated carefully.

172: Recipient Hypertonic Saline Infusion Prevents Cardiac Allograft Dysfunction

2009 ◽  
Vol 28 (2) ◽  
pp. S126
Author(s):  
D. Ramzy ◽  
L.C. Tumiati ◽  
M. Badiwala ◽  
E. Tepperman ◽  
R. Sheshgiri ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Cardiac Allograft ◽  
Saline Infusion ◽  
Allograft Dysfunction ◽  
Hypertonic Saline Infusion
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