pituitrin and Convalescence

Topics: Accidents, Traffic; Acidosis; Acute Kidney Injury; Adult; Aged; Alkalosis; Aortic Diseases; Aortic Rupture; Body Composition; Calorimetry; Cholecystectomy; Convalescence; Craniocerebral Trauma; Dehydration; Duodenal Ulcer; Endocrine Glands; Female; Homeostasis; Humans; Iliac Artery; Infusions, Parenteral; Kidney; Lung Neoplasms; Male; Metabolism; Middle Aged; Natriuresis; Pancreatitis; Peptic Ulcer Perforation; Postoperative Care; Postoperative Complications; Thoracic Injuries; Thrombosis; Vasopressins; Water-Electrolyte Balance

To study the physiological mechanisms of plasma hypoosmolality in patients with pneumonia and on this basis to elaborate principles of therapy for this condition.. 52 individuals of different age, including 26 patients with pneumonia, were examined. Osmolality, the concentrations of ions of sodium, potassium, magnesium, and creatinine were measured in the serum.. The patients with pneumonia were found to have osmolality, hyponatremia in combination with severe hypodiuresis, high urinary osmotic pressure and intensive reabsorption of osmotically free water in the kidney, which leads to blood dilution. As hypoosmolality usually causes higher diuresis and decreased urinary osmolality; hypodiuresis with high urinary osmolality in pneumonia is indicative of effective renal performance and its altered regulation evidently due to the hypersecretion of vasopressin or to the decreased formation of a number of autacoids in the kidney.. Blood hypoosmolality and hyponatremia in the examined patients result from inadequate blood osmolality and high urinary osmotic concentrating. The principles of this condition in pneumonia are discussed and aquaretics are proposed for use as pathogenetic therapy.

Topics: Acute Disease; Adolescent; Adult; Convalescence; Female; Humans; Hyponatremia; Male; Middle Aged; Osmolar Concentration; Pneumonia; Vasopressins

The mechanism of hyponatremia associated with pneumonia has not been definitely established. Moreover, renal water excretion was never systematically investigated in cases of pneumonia without hyponatremia. We therefore studied nine consecutive patients breathing spontaneously (nasal oxygen in five), with acute infectious pneumonia and normal plasma sodium concentration. All the patients were previously healthy. Water loads were administered during illness and after recovery. Extracellular fluid volume, arterial blood pressure, PaO2, and PaCO2 were identical during and after pneumonia. By contrast, renal water excretion was markedly impaired during pneumonia and returned to normal values after recovery. This was attested to by a significant decrease in minimum urine osmolality together with significant increases in the percentage of the excreted water load and the maximum free water clearance, after resolution of the pneumonia. Plasma arginine vasopressin values were significantly higher during pneumonia than after recovery despite similar plasma sodium concentrations, both before and after water load. A positive correlation between plasma arginine vasopressin and minimum urine osmolality was found during pneumonia. Thus, impairment in renal water excretion appeared to be due to resetting of the vasopressin osmostat and could not be attributed to any recognized nonosmotic stimulus for vasopressin secretion. On the other hand, these defects varied in severity depending on the extent of the pneumonia and persisted until clearing of alveolar opacities, accounting for their protracted course in some patients. We conclude that water excretion is impaired in most if not in all patients with acute infectious pneumonia (especially if extended), and that the administration of hypotonic solutions should be avoided in these patients.

Topics: Acute Disease; Aldosterone; Arginine Vasopressin; Convalescence; Diuresis; Humans; Lung; Osmolar Concentration; Pneumonia; Radiography; Renin; Sodium; Time Factors; Vasopressins; Water

A basal value of antidiuretic activity (ADA) of the plasma was determined in 79 HFRS patients and stimulated activity using the insulin tolerance test in 24 persons. A decrease in the plasma ADA was observed in the acute period of disease. The insulin tolerance test did not cause a statistically significant increment of the plasma ADA in the HFRS patients.

Topics: Adolescent; Adult; Convalescence; Hemorrhagic Fever with Renal Syndrome; Humans; Hypothalamo-Hypophyseal System; Insulin; Middle Aged; Oliguria; Polyuria; Time Factors; Vasopressins

Topics: Acute Kidney Injury; Atropine; Biomedical Research; Blood Volume; Convalescence; Dehydration; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Edema; Epinephrine; Female; Heart Failure; Hemorrhage; Humans; Hypertonic Solutions; Menstruation; Pharmacology; Placebos; Pregnancy; Renal Insufficiency; Salivation; Sweating; Uremia; Vasopressins; Water-Electrolyte Balance