FLUID BALANCE

D. C. Mikulecky
FLUID BALANCE

 The Balance Concept: Input -Output =

Storage/Depletion
 Body Fluid Compartments
 Regulation of fluid balance
 Relation between Salt Balance and ECF
Volume
The Balance Concept:
Input -Output =
Storage/Depletion

Storage

Internal Excretion
Inputs from Pool (ECF Inside
environment Concentration) Body
of substance

Metabolic Metabolic
Production Consumption
Body Fluid Compartments
Compartment Fluid Vol. % Body % Body
(l) Fluid Wgt.
Total Body
Fluid
42 100 60
Intracellular
Fluid
28 67 40
(ICF)
Extracellular
Fluid (ECF)
14 33 20
Plasma 2.8 6.6 4
(20% ECF)
Interstitial 11.2 26.4 16
Fluid (80% ECF)
Lymph & Neg. Neg. Neg.
Transcellular
Fluid
BODY FLUID COMPARTMENT
COMPOSITION
Intracellular
Plasma Interstitial Fluid
Fluid
Regulation of fluid balance

 ECF Volume: Maintains blood pressure

 ECF Osmolarity: Prevents swelling or

shrinking of cells
ECF Volume: Maintains
blood pressure - Short Term

 A Change in ECF Volume can raise or lower

blood pressure
 Barorecepter reflexes: Alter Cardiac output
and Total Peripheral Resistance leading to a
compensatory alteration in blood pressure
 Fluid automatically shifts between plasma
and interstitial fluid with rises or fall in
blood pressure
Relation between Salt
Balance and ECF Volume

 The total sodium load (quantity of

sodium, not its concentration) in the ECF
determines the total amount of water
that will be osmotically retained
 The total sodium load is determined by
the balance relation
The Balance Concept:
Input -Output =
Storage/Depletion

Storage

Internal Excretion
Inputs from Pool (ECF Inside
environment Concentration) Body
of substance

Metabolic Metabolic
Production Consumption
Control of sodium load

 Control of amount filtered by regulating

GFR (Glomerular Filtration Rate)

 Control of sodium reabsorption through

the Renin-Angiotensin-Aldosterone system
ECF Osmolarity: Prevents swelling or
shrinking of cells

 ECF hypertonicity is associated with

dehydration

 ECF hypotonicity is associated with

overhydration

 Control of water balance is by thirst and

vasopressin
Blood pressure and renal
handling of sodium
FALL IN SODIUM LOAD
RELIEVES

FALL IN ARTERIAL PRESSURE

INCREASE IN
FALL IN GFR ALDOSTERONE
SECRETION
FALL IN EXCRETION OF
FALL IN FILTERED SODIUM, CHLORIDE, AND
SODIUM FLUID INCREASE IN
SODIUM
ABSORPTION

INCREASED CONSERVATION
OF SODIUM AND FLUID
DAILY WATER BALANCE
(LITERS)
INPUT (ml/day) OUTPUT (ml/day)

 FLUID INTAKE 1.25  INSENSIBLE 0.9

 IN FOOD 1.0  SWEAT 0.1

 METABOLIC 0.35  FECES 0.1

TOTAL 2.6
 URINE 1.5
TOTAL 2.6
WATER DEFICIT
 FALL IN ECF VOLUME
RELIEVES
 INCREASED OSMOLARITY SENSED BY
HYPOTHALAMIC WATER RECEPTORS
 FALL IN ARTERIAL BLOOD PRESSURE

RELIEVES STIMULATION
OF HYPOYHALAMIC
NEURONS INCREASED VASOPRESSIN

OPEN PORES ARTERIOLAR

IN COLLECTING VASOCONSTRICTION
INCREASED THIRST
DUCT

MORE WATER REABSORBED

INCREASED WATER INTAKE
FALL IN URINE OUTPUT

DECREASED PLASMA OSMOLARITY DECREASED PLASMA OSMOLARITY