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Download - Week 6 Fluid and Electrolyte Imbalance There are several … · - Hypovolaemia or fluid volume deficit is a decrease in intravascular, interstitial and/or intracellular fluid in the

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Page 1: Week 6 Fluid and Electrolyte Imbalance There are several … · - Hypovolaemia or fluid volume deficit is a decrease in intravascular, interstitial and/or intracellular fluid in the

Week6 FluidandElectrolyteImbalanceFluidmovementthroughthecapillarymembraneisduetopressureplacedonthemembranebytheblood(hydrostaticpressure)

- Thehydrostaticpressurepushesthefluidoutthecapillary,whereasosmoticpressurepullsfluidintothecapillary

Thereareseveralmechanismsthatcreatethebalancebetweenfluidintakeandoutput:ð Thirstð Antidiuretichormone(ADH)ð RAASð Arterialnatureticpeptide(ANP)

HypovolemiaThethirstmechanism:

- Thirstcentreisactivatedwhenthebloodvolumedropsduetowaterlossorwhenserumosmolalityincreases.Thismechanismishighlyeffectiveinregulatingextracellularsodiumlevels

- Increasedsodiumlevelsintheextracellularfluid,increaseserumosmolalityandthereforestimulatesthethirstcentre

- Anincreaseof2-3%inplasmaosmolalitytriggersthethirstcentreofthehypothalamus

- Secondarily,a10-15%dropinbloodvolumealsotriggersthirst- Thisisasignificantlyweakerstimulus

ADH- Regulatorofthewaterexcretionbythekidneys- Osmoreceptorslocatedinthehypothalamusrespondtoanincreaseinserum

osmolalityandtheassociateddecreaseinthebloodvolume;thisactivatesADHproductionandrelease

- WithincreasedwaterabsorptionthankstotheADH,theurineoutputfalls,bloodvolumeisrestored,andserumosmolalitydropsasthewaterdilutesbodilyfluid

RAAS

- Workstomaintainthebalanceofintravascularfluidandbloodpressure- Whenthereisadecreasetothebloodflowandpressuretothekidneys,special

receptorsarestimulatedinthenephronstoproducethereninenzyme- ReninconvertsangiotensintoangiotensinI- ANGIthentravelsthroughthebloodstreamintothelungs,whereitsconvertedinto

ANGII

Page 2: Week 6 Fluid and Electrolyte Imbalance There are several … · - Hypovolaemia or fluid volume deficit is a decrease in intravascular, interstitial and/or intracellular fluid in the

- ANGIIhelpstoincreasetheBP,asit’sapowerfulvasoconstrictor

- Theadrenalcortexisactivatedandaldosteroneisreleasebecauseofthis- Aldosteronehelpswithsodiumandwaterretentioninthedistalnephrons,which

helpstorestorebloodvolumeinthebodyANP

- ANPisahormonereleasedbyatrialmusclecellsafterthedistentionassociatedwith

fluidoverload- Ithasaneffectonmanybodysystems,butprimarilytheRAAS

Page 3: Week 6 Fluid and Electrolyte Imbalance There are several … · - Hypovolaemia or fluid volume deficit is a decrease in intravascular, interstitial and/or intracellular fluid in the

- ANPopposesthiscompensatorysystembyinhibitingreninsecretionandblockingcapabilitiesofaldosterone

- Becauseofthisprocess,thesodiumwastinganddiuresispromotionresultsinvasodilationinthebody

- Hypovolaemiaorfluidvolumedeficitisadecreaseinintravascular,interstitialand/orintracellularfluidinthebody


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