Estimation of Body Water and Salt Contents from Plasma Sodium, Protein Concentrations, and Hematocrit

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New formulae for the estimation of change in water (ΔW) and salt (ΔNaGl) contents of the body from hematocrit, plasma Na, and protein concentrations were proposed based on a compartment model of body fluid regulation: ΔW=0.4(ΔVi/Vi0)+0.2(ΔVe/Ve0)litres/Kg of body weight; ΔNaCl=1.64[(ΔVe/Ve0+1)/(ΔVi/Vi0+1)-1]Gms/Kg of body weight; where ΔVi/Vi0, and ΔVe/Ve0 are relative increment of intra and extracellular fluid volume. ΔVi/Vi0 is considered equal to ([Na]0/[Na]-1) under the condition of normal cell membrane, where as ΔVe/Ve0 may be a nonlinear function of relative increment of plasma volume and hematocrit or sodium concentration. Thus a nomograph was presented to obtain ΔdW and ΔNaCl simultaneously. This nomograph could predict ΔW and ΔNaCl with satisfactory accuracy in the experiments with the dogs to which fluid of various osmolarity was given intravenously. It was also confirmed in a case of mixed water depletion in which the clinical estimation agreed with that of the present method. The conventional formulae of calculation based on either pure dehydration or pure salt loss proved not to be applicable in the usual cases of body fluid disturbances.
International Heart Journal刊行会の論文