body

• Hydration

  Can assist in the management of diabetes and help prevent pressure ulcers, constipation, urinary tract infections and incontinence, kidney stones, heart disease, low blood pressure, cognitive impairment, dizziness and confusion leading to falls, poor oral health, skin conditions
• Drinking enough water every day, could reduce your risk of developing cancer of the large bowel, breast and prostate
• Dehydration

  A 1 per cent or greater loss of body weight as a result of fluid loss
• We usually feel thirsty when dehydration reaches 0.8-2 per cent. This means that you can't rely on thirst to tell you when it is time to have a drink, because by the time you feel thirsty, you are already slightly dehydrated.
• The key is to keep topping up with water throughout the day
• Urinary stone formation is significantly increased when the urine volume excreted is below 1 liter per day
• Risk of fatal coronary heart disease for men reduced to 0.46 for high volume water intake (5 or more glasses) and 0.54 for women who had medium intake (3-4 glasses) compared to low water intake (2 or less glasses).
• An estimate of a minimum of 1.25 litres per capita per day for men and 0.75 litres per capita per day for women is required to reduce risks of fatal coronary heart disease
• Fluid loss corresponding to 2.5% of body weight has been shown to reduce an athlete's physical performance capacity by 45%.
• Dehydration

  The adverse consequence of inadequate water intake
• Water, is essential for cellular homeostasis and life.
• Fluid loss at 1% of body weight impairs thermoregulation and thirst occurs at this level of dehydration.
• Thirst increases at 2%, with dry mouth appearing at approximately 3%. Vague discomfort and loss of appetite appear at 2%. The threshold for impaired exercise thermoregulation is 1% dehydration.
• At 4% dehydration, decrements of 20-30% is seen in work capacity. Difficulty concentrating, headache, and sleepiness are observed at 5%. Tingling and numbness of extremities can be seen at 6%. A 10% loss of body water through dehydration is life threatening.
• Insensible loss

  600–900 mL (lungs and skin). With fever, each degree above 98.6°F [37°C] adds 2.5 mL/kg/d to insensible losses
• Afebrile 70-kg Adult fluid requirement

  35 mL/kg/24 h
• Water need in person without stress

  80-110 mls/100kcals (1ml / 1 Cal) depending on body surface area 1.5 l/m2/day depending on weight 30-40 mls/kg/day
• Metabolic Waters

  1g starch produces 0.60g of water, 1g protein produces 0.41g of water, 1g fat produces 1.07g of water
• Tissue water percentage

  • Blood 83
  • Kidneys 82.7
  • Heart 79.2
  • Lungs 79
  • Spleen 75.8
  • Muscle 75.6
  • Brain 74.8
  • Intestine 74.8
  • Skin 72
  • Liver 58.3
  • Skeleton 22
  • Adipose tissue 10
• Transcellular fluids

  1 liter (Synovial, Cerebrospinal fluids)
• Isotonic, hypertonic, hypotonic solutions

  Effects on cell volume
• Hyponatremia, hypernatremia, hyperglycemia

  Clinically caused by changes in tonicity
• Methods of calculating osmolarity

  • Osm = 2.1Na
  • Osm =2Na
  • Osm =2 Na+7
  • Osm= 2.63Na - 65.4
  • Osm= 1.86Na + BUN/2.8 + glucose/18
  • Osm= 1.86Na + BUN/2.8 + glucose/18 + 5
  • Osm= 1.86Na + BUN/2.8 + glucose/18 + 9
  • Osm= 1.85Na + BUN/2.18 + glucose/17.5 (+ ethanol/4.22)
  • Osm = 2Na + glucose/18 (effective osmolality)
  • Osm= 2Na + BUN/2.8 + glucose/18
  • Osm= 2Na + BUN/3 + glucose/20
  • Osm = 1.85Na + 1.84K + BUN/2.8 + glucose/18 + Ca + 1.17Mg + 1.15
  • Osm = 1.75Na + BUN/2.8 + glucose/18 + 10.1
  • Osm= 2(Na + K) + BUN/2.8 + glucose/18
  • Osm = 2Na + BUN/2.8
• Unlike with sodium, the concentration of most other ions in the ECF can be altered without significant change in the total number of osmotically active particles, producing only a compositional change.
• Adding isotonic saline to the body is an efficient way to expand the ECF without effect on the ICF
• Body Water Turnover

  Means the replacement of body water in a day or other given period. Ingestion and excretion rate is 6% (5-10) (2.5liter) (4% of total body weight in adults). This is 4.5 liter for active person. Hot climate and more active person's turnover is 6 liter
• Children's body water turnover

  More prone to dehydration (turnover is %16-18 or 100 to 120 mL/kg for newborns) (15% of total body weight in infants). It is higher in children till 15 years old
• Water lost

  • Normal climate: Insensible by skin 300-400ml, Insensible by breathing 350ml, Sweating 100ml, Feces 100ml, Urine 1500ml, Total 2500ml
  • Hot Climate: Insensible by skin 350ml, Insensible by breathing 250ml, Sweating 1400ml, Feces 100ml, Urine 1200ml, Total 3400ml
  • Heavy Exercise: Insensible by skin 350ml, Insensible by breathing 650ml, Sweating 5000ml, Feces 100ml, Urine 500ml, Total 6700ml
• Daily Intake

  • Oral fluid intake + foods 2100- 2200ml, Metabolism 200-300ml
• There is also skin lost in person without sweat gland. Insensible water lost by skin does not depend on sweating. Mean lost 300 - 400 ml/day. This ratio will decrease with increased cholesterol at cornified tissue.
• Without cholesterol (ex. burns), cornified tissue vaporise increase (3-5lt) So in burns, water supports should be held by means of I.V.
• Pressure of water vapor in exhaled air is 47mmHg. Pressure of water vapor in inhaled air is usually less than 47mmHg so water vapor will be lost in everytime. In cold air pressure of water vapor in atmosphere is (0) and cause lost of vapor more. It means dryness of throat in cold weather. Output increase in high altitude.
• Sweating is approximately variable depending on body action and climate.
• Daily Intake

  • Oral fluid intake
  • Foods
  • 2100-2200ml
• Metabolism

  • 200-300ml
• Insensible water lost by skin

  Water lost that does not depend on sweating
• Mean lost 300 - 400 ml/day
• Increased cholesterol at cornified tissue

  Ratio of insensible water lost by skin will decrease
• Without cholesterol (ex. burns)

  Cornified tissue vaporise increase (3-5lt)
• In burns, water supports should be held by means of I.V.