頁籤選單縮合
題名 | High Ambient Pressure Attenuates Renal Reabsorption of Water and Electrolytes= |
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作者 | Lin,Yu-chong; |
期刊 | 中華民國腎臟醫學會雜誌 |
出版日期 | 19970600 |
卷期 | 11:2 1997.06[民86.06] |
頁次 | 頁57-65 |
分類號 | 415.74 |
語文 | eng |
關鍵詞 | Hyperbaria; Diving; Diuresis; Kaliuresis; Natriuresis; |
英文摘要 | Since 1966, a consistent diuresis has been reported in humans residing in hyperbaric environments. The so-called hyperbaric diuresis is not a result of increased fluid intake (from drinks, food, and oxidative sources) or cold exposure. Upon exposure to a high pressure environment, urine volume and osmotic clearance rises but urine osmolarity falls, while glomerularfiltration rate remains unchanged. The diuresis occurs throughout the pressure exposure, i.e., during compression, saturation, and decompression phases. Investigators report a consistent kaliuresis. Natriuresis and calciuria are also present in most but not in all reports. Results of endocrinological investigation are consistent with a reduced ability of the kidney to retain -water and electrolytes. The suppressed water diffusibility in a hyperbaric environment is the most likely initiation factor that causes hemodilution, a suppressed ADH release and an increased free water clearance. However, mechanisms of the sustained increase in the osmotic clearance remain unsettled. Other contributory mechanisms are also discussed. A potential for general dehydration exists because of the lack of a concurrent thirst drive. Since the diuresis occurs mostly in the night, it affects the quality of sleep and, therefore, must be understood and managed. An unmanaged diuresis may result in a hypovolemia and contribute to circulatory deconditioning. At present, we recommend a close monitoring of fluid balance in humans for all saturation dives. |
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