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脱水男性在静息和运动状态下通过口服液体实现血浆容量扩张。

Plasma volume expansion with oral fluids in hypohydrated men at rest and during exercise.

作者信息

Greenleaf J E, Jackson C G, Geelen G, Keil L C, Hinghofer-Szalkay H, Whittam J H

机构信息

Life Science Division, NASA, Ames Research Center, Moffett Field, CA 94035-1000, USA.

出版信息

Aviat Space Environ Med. 1998 Sep;69(9):837-44.

PMID:9737753
Abstract

BACKGROUND

The purpose for this study was to evaluate various carbohydrate (CHO)-electrolyte fluid formulations for consumption by astronauts to maintain or restore their plasma volume (PV) and total body water (TBW) during and after extravehicular activity (exercise experiment, EE) and for a few hours before reentry and immediately after landing (rest experiment RE).

HYPOTHESIS

That fluid formulation electrolyte content would be more important than osmotic (Osm) content for increasing or maintaining PV during the RE and EE.

METHODS

In the RE, 5 healthy men (23-44 yr), previously dehydrated for 24 h, drank 6 fluid formulations (Water, 19.6 Na, 157 Na, 19.6 Na + glucose, and the prepared drinks Performances and Power)--one each at weekly intervals, and then sat for 70 min. In the EE, four healthy 24-h dehydrated men (30-46 yr) exercised for 70 min supine on a cycle ergometer (load = 71 +/- 1% peak VO2).

RESULTS

Rest: Subjects who consumed formulations with total Osm concentrations nearer the normal range (157 Na - 270 mOsm x kg(-1), Performance with 19.6 mEq x L(-1) Na - 380 mOsm, and to some extent Power with 23.5 mEq x L(-1) Na - 390 mOsm) had the greater increases in PV; intake of drink 157 Na, with the largest Na content, induced the greatest hypervolemia of 7.6% (p < 0.05). The various additional ions, in addition to 19.6 Na, probably contributed to the 4.6% (p < 0.05) hypervolemia with Performance. Water was not effective. Exercise: Stabilization of PV between 15-70 min was not related to drink total CHO, Na or Osm content. Performance and 157 Na were no more effective than 19.6 Na or 19.6 Na + glu for PV stabilization. Water was the least effective. Regulatory mechanisms controlling PV during exercise appear to be independent of oral fluid formulation Osm-electrolyte content.

CONCLUSIONS

Drink cation (sodium) content is more important that its total osmotic content for increasing plasma volume at rest. Fluid formulations with greater hypervolemic action in resting subjects may not be as effective during exercise; therefore different formulations for use during exercise appear to be necessary.

摘要

背景

本研究的目的是评估各种碳水化合物(CHO)-电解质液体制剂,供宇航员在舱外活动期间及之后(运动实验,EE)以及再入大气层前数小时和着陆后立即饮用(休息实验,RE),以维持或恢复其血浆容量(PV)和总体水(TBW)。

假设

在休息实验和运动实验期间,对于增加或维持血浆容量而言,液体制剂的电解质含量比渗透压(Osm)含量更重要。

方法

在休息实验中,5名健康男性(23 - 44岁),预先脱水24小时,饮用6种液体制剂(水、19.6钠、157钠、19.6钠 + 葡萄糖,以及配制饮料Performance和Power)——每周饮用一种,然后静坐70分钟。在运动实验中,4名健康的、24小时脱水男性(30 - 46岁)在卧式自行车测力计上仰卧运动70分钟(负荷 = 71 ± 1% 峰值摄氧量)。

结果

休息:饮用总渗透压浓度更接近正常范围的制剂(157钠 - 270 mOsm·kg⁻¹、含19.6 mEq·L⁻¹钠 - 380 mOsm的Performance,以及在一定程度上含23.5 mEq·L⁻¹钠 - 390 mOsm的Power)的受试者血浆容量增加幅度更大;摄入钠含量最高的157钠饮料,导致最大的血容量过多,达7.6%(p < 0.05)。除了19.6钠之外的各种额外离子,可能促成了Performance饮料导致的4.6%(p < 0.05)血容量过多。水无效。运动:15 - 70分钟期间血浆容量的稳定与饮料的总CHO、钠或渗透压含量无关。Performance和157钠在稳定血浆容量方面并不比19.6钠或19.6钠 + 葡萄糖更有效。水最无效。运动期间控制血浆容量的调节机制似乎独立于口服液体制剂的渗透压 - 电解质含量。

结论

对于在休息时增加血浆容量而言,饮料中的阳离子(钠)含量比其总渗透压含量更重要。在休息受试者中具有更大扩容作用 的液体制剂在运动期间可能效果不佳;因此,运动期间似乎需要使用不同的制剂。

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