![]() ![]() Na+ is the main extracellular cation and the main intracellular cation is potassium (K+). The principal clinical features of severe hydration disorders Electrolytes Skin elasticity decreases with age, and oral mucous membranes may appear dry in patients who breathe through their mouths. Clinical evaluations of skin turgor, eyeball tension, and mucous membranes are not always accurate. The main characteristics of disordered hydration are depicted in the table below. When interpreting electrolyte results, this ‘biochemist’s picture’ may be helpful in visualizing what is wrong with the patient’s fluid balance and what needs to be done to correct it. Overhydration: increased fluid in ICF and ECF due to increased intake The term “dehydration” simply refers to fluid loss from body compartments. the volume of the body fluid compartments, is evaluated. Clinically, the patient’s state of hydration, i.e. It is critical to understand that determining the volume of body fluid compartments is not the responsibility of the biochemistry laboratory. The water tank model depicts the relative volumes of each of these compartments and can be used to help visualize some clinical fluid and electrolyte balance disorders. However, the signs of fluid depletion are not immediately visible because the water loss, while significant, is distributed across both ECF and ICF compartments. Loss of total body water will have a similar effect in the long run. The loss of blood, an ECF fluid, causes circulatory collapse, renal failure, and shock. Intracellular fluid loss, for example, results in cellular dysfunction, most notably lethargy, confusion, and coma. Selective fluid loss from each of these compartments results in distinct signs and symptoms. Surface evaporation might be thought of as insensible loss.Ī normal Water tank Model of Body fluid compartments at equilibrium Fluids received orally or by intravenous infusion are represented by the intake supply, whereas the urinary tract is generally represented by the output. The EGL is now known to play a significant role in controlling fluid and other molecule (eg, albumin) transport across the capillary layer, with the oncotic pressure of the glycocalyx playing a larger role than the oncotic pressure of the interstitium various disease processes and therapy (eg, IV fluid administration) can significantly disrupt the EGL, resulting in altered transcapillary movement.Ī water tank model with a partition and an inlet and exit is a schematic approach of depicting fluid balance. When intravascular hydrostatic pressure exceeds COP, membrane pore size rises, the EGL is disrupted, or intravascular COP falls below interstitial COP, fluid travels into the interstitial space. The pressure exerted on the capillary membrane by blood pressure and cardiac output is known as hydrostatic pressure within the capillary. Proteins, predominantly albumin but also globulins, fibrinogen, and others, are the natural particles in blood that cause COP. The amount of fluid that passes through the capillary “membrane” is determined by several factors, including capillary colloid oncotic pressure (COP), hydrostatic pressure, and permeability, which is determined by the endothelial glycocalyx layer (EGL) and the pore diameters between the cells. Any particle movement between the interstitium and the cell must go through some sort of transport system (eg, channel, ion pump, carrier mechanism).īody Fluid Compartment indicating the Intracellular, Interstitial fluidįluids are constantly moving over the endothelial membrane of capillaries, across the interstitium, and into and out of cells. Water passes through this membrane freely, but minute and big molecular weight particles do not. A cell membrane separates the intracellular compartment from the interstitial space. The matrix and cells within the interstitial space are supported by fluids. The gap between the capillaries and the cells is known as the interstitial compartment. ![]() Water and small-molecular-weight particles like as electrolytes, glucose, acetate, lactate, gluconate, and bicarbonate pass effortlessly through this capillary “membrane.” Gases such as oxygen and carbon dioxide can freely pass through this membrane and enter or depart the intravascular compartment by following their concentration gradient. The endothelial glycocalyx, endothelial cells, and the subendothelial cell matrix form the capillary “membrane,” which separates the capillary intravascular region from the interstitial fluid compartment. Capillaries transport fluid from the intravascular to the interstitial and intracellular compartments. Intravascular, interstitial, and intracellular fluid compartments are the three major bodily fluid compartments. ![]()
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