Body fluid compartments

Water is the key to life, and it takes up a big proportion of our body weight, typically
around 60 percent! The precise amount of water depends on a person’s body
composition.
Since fat doesn’t store any water, a person’s water content is inversely proportional
to a person’s fat content.
So a really muscular and lean person would have a relatively high proportion of
their body weight made up of water.
Additionally, females tend to have more fat than males and so on average tend to
have lower proportion of their body weight made up of water.
Total body water can be subdivided into two major compartments, intracellular fluid
which is fluid inside cells, and extracellular fluid which is fluid outside of cell like in
the blood and in the interstitial tissue between cells.
Assuming that the total body water is about 60% of their body weight, roughly 2/3
of that, or 40% is intracellular fluid, and the other 1/3 or 20% is extracellular fluid.
This is also known as the 60-40-20 rule.
Intracellular fluid is important for dissolving cations which are molecules with a
positive charge, and anions which are molecules with a negative charge.
The major intracellular cations are potassium (K+) and magnesium (Mg2+),
whereas the major anions are proteins and organic phosphates like ATP.
Fluid compartments always maintain the same concentration of positive charges as
negative ones in order to stay electrically neutral - that’s called the principle of
macroscopic electroneutrality. So for example, the K+ in the intracellular fluid is
balanced out by negatively charged proteins and organic phosphates.
The extracellular fluid can be subdivided further into interstitial fluid, which is the
fluid that can be found surrounding the cell, and plasma, which is the aqueous
portion of blood.
The major cation in extracellular fluid, both in the interstitial fluid and in the plasma,
is sodium (Na+) and the major anions are chloride (Cl-) and bicarbonate (HCO3-).
Now, the plasma makes up about 55% of the blood, while the remaining 45% is
mostly made of red blood cells, white blood cells, and platelets.
Plasma is made up of around 90% water and 10% proteins like albumin which help
transport hormones and minerals.
Interstitial fluid and plasma are really similar, and that’s not surprising since plasma
leaks out of the blood and goes into the interstitium through tiny pores between
endothelial cells in the capillaries. These tiny pores between capillaries lets small
solutes and water to pass through but block large proteins and cells.
In fact, because some proteins are too large to pass into the interstitium, a
phenomenon called the Gibbs-Donnan effect helps the plasma remain electrically
neutral.
This Gibbs-Donnan effect is when the abundance or negatively charged large
proteins repels smaller anions into the interstitium while attracting small cations
into the plasma.
So compared to the plasma, interstitial fluid tends to have higher concentrations of
small anions like Cl- and lower concentrations of small cations like Na+.
Ultimately, the difference between plasma and interstitial fluid is small, whereas the
difference between intracellular fluid and extracellular fluid is quite large and
physiologically important.
For example, Na+K+ ATPases help to establish a high concentration of K+ inside
the cell and a high concentration of Na+ outside the cell.
Establishing these differences between intracellular and extracellular environments
is incredibly important for allowing cells like neurons to fire action potentials,
among many functions.
Measuring the volume of each of the body fluid compartments can be done using
what’s called the dilution method. That’s where various substances which settle in
a specific fluid compartment are given to an individual and their concentration is
measured.
For plasma, it’s done with radiolabeled albumin, because albumin is a large
protein that cannot move into the interstitial space.
For the interstitial compartment, it’s done with slightly smaller molecules
like mannitol and inulin which can pass through the capillaries into the interstitium
but cannot cross the cell membrane.
Finally, for the intracellular compartment, it’s done with molecules that can freely
diffuse across the cell membrane like heavy water isotopes, or D2O, which can
easily be differentiated from normal water, or H2O, that’s in the body.
Once adsorbed, D2O will act just like water and distribute in the 60-40-20 fashion,
so 2/3s of it is intracellular and ⅓ is extracellular.
So, by injecting a known amount of the substance and allowing the substance to
diffuse through the fluid compartments, it’s possible to measure the concentration
of that substance in the blood, as well as if any was lost in the urine.
Ultimately, it’s possible to calculate the volume of distribution via the equation:
volume equals amount divided by concentration.
Here’s a sample problem. A 70-kg man is injected with 150 mCi, or millicurie, of
D2O and 650 mg of mannitol. During a 2-hour equilibration period, he excretes
10% of the D2O and 10% of the mannitol in his urine. After that, the concentration
of D2O in plasma is 0.32 mCi/100 mL and the concentration of mannitol is 4.6
mg/100 mL.
Now that we’ve got our amounts and concentrations, we can figure out some
volumes.
To figure out the volume of total body water, we look at D2O which will settle in the
extracellular and intracellular fluid compartments.
First, we subtract out the amount of D20 excreted from the total amount, so that’s
150 mCi minus ten percent of that or 15 mCi or 135 mCi.
Then we divide that amount by the concentration of 0.32 mCi/100 mL, which gives
us the volume of 42.2 Liters.
Now, to figure out the extracellular fluid, we look at the volume of distribution
of mannitol.
The extracellular fluid volume equals the amount of mannitol injected, minus the
amount of mannitol excreted, divided by the concentration of mannitol, which gives
us 12.7 liters.
Finally, if we want to calculate the intracellular fluid volume which cannot be
measured directly, we need to take the difference between the total body water
and the extracellular fluid volume, which comes out to 42.2 liters - 12.7 liters or
29.5 liters.

Summary
All right, as a quick recap, the 60-40-20 rule states that total body water takes up
about 60% of our body weight, and more specifically, 40% is intracellular fluid, and
20% is extracellular fluid.
Measurements of these fluid compartments uses the dilution method where various
substances are injected and allowed to distribute differently among these fluid
compartments.
Final concentrations from plasma are taken to calculate the volume of fluid
compartments.
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