Details

Autor(en) / Beteiligte

• Hannon, R.J

Titel

The redistribution of water and electrolytes across the cell membrane in sepsis with reference to the clinical syndrome of hyponatraemia

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

1989

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• The membrane potential of skeletal muscle and liver is significantly altered in the early phases of sepsis. The effect of this on ion distribution has been explored using a mathematical modelling technique. Significant shifts of sodium, water and chloride occur into cells at a later stage. This decrease in extracellular volume probably acts as a trigger to vasopressin (AVP) secretion by shrinking the interstitial space around volume receptors. By varying the fluid replacement in the sepsis model I have demonstrated the importance of exogenous fluid administration on development of hyponatraemia. Muscle membrane potentials are significantly altered by the combination of sepsis and hyponatraemia and this `hypo-osmolal' poisoning may be related to poor prognosis associated with a low plasma sodium. The bromide space technique for measuring extracellular volume does not reflect the underlying changes in fluid distribution which occur following endotoxaemia. Studies which use the bromide space in sick patients to estimate extracellular compartment size are potentially inaccurate. A method for assessing the underlying membrane stability is required for their use in patients. Erythrocytes from a selected group of children with sepsis have been shown to have altered cation content. This is suggestive of a more widespread, underlying membrane permeability defect which is independent from changes in the plasma sodium.