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My N Helms - One of the best experts on this subject based on the ideXlab platform.

  • receptor for advanced glycation end products regulates lung Fluid Balance via protein kinase c gp91 phox signaling to epithelial sodium channels
    American Journal of Respiratory Cell and Molecular Biology, 2015
    Co-Authors: Charles A Downs, Lisa Kreiner, Nicholle M Johnson, Lou Ann S Brown, My N Helms
    Abstract:

    The receptor for advanced glycation end-products (RAGE), a multiligand member of the Ig family, may play a crucial role in the regulation of lung Fluid Balance. We quantified soluble RAGE (sRAGE), a decoy isoform, and advanced glycation end-products (AGEs) from the bronchoalveolar lavage Fluid of smokers and nonsmokers, and tested the hypothesis that AGEs regulate lung Fluid Balance through protein kinase C (PKC)–gp91phox signaling to the epithelial sodium channel (ENaC). Human bronchoalveolar lavage samples from smokers showed increased AGEs (9.02 ± 3.03 μg versus 2.48 ± 0.53 μg), lower sRAGE (1,205 ± 292 pg/ml versus 1,910 ± 263 pg/ml), and lower volume(s) of epithelial lining Fluid (97 ± 14 ml versus 133 ± 17 ml). sRAGE levels did not predict ELF volumes in nonsmokers; however, in smokers, higher volumes of ELF were predicted with higher levels of sRAGE. Single-channel patch clamp analysis of rat alveolar epithelial type 1 cells showed that AGEs increased ENaC activity measured as the product of the nu...

  • receptor for advanced glycation end products regulates lung Fluid Balance via protein kinase c gp91phox signaling to epithelial sodium channels
    American Journal of Respiratory Cell and Molecular Biology, 2015
    Co-Authors: Charles A Downs, Lisa Kreiner, Nicholle M Johnson, Lou Ann S Brown, My N Helms
    Abstract:

    The receptor for advanced glycation end-products (RAGE), a multiligand member of the Ig family, may play a crucial role in the regulation of lung Fluid Balance. We quantified soluble RAGE (sRAGE), a decoy isoform, and advanced glycation end-products (AGEs) from the bronchoalveolar lavage Fluid of smokers and nonsmokers, and tested the hypothesis that AGEs regulate lung Fluid Balance through protein kinase C (PKC)–gp91phox signaling to the epithelial sodium channel (ENaC). Human bronchoalveolar lavage samples from smokers showed increased AGEs (9.02 ± 3.03 μg versus 2.48 ± 0.53 μg), lower sRAGE (1,205 ± 292 pg/ml versus 1,910 ± 263 pg/ml), and lower volume(s) of epithelial lining Fluid (97 ± 14 ml versus 133 ± 17 ml). sRAGE levels did not predict ELF volumes in nonsmokers; however, in smokers, higher volumes of ELF were predicted with higher levels of sRAGE. Single-channel patch clamp analysis of rat alveolar epithelial type 1 cells showed that AGEs increased ENaC activity measured as the product of the nu...

  • Nadph oxidase regulates alveolar epithelial sodium channel activity and lung Fluid Balance in vivo via O2− signaling
    American Journal of Physiology-lung Cellular and Molecular Physiology, 2011
    Co-Authors: Preston Goodson, Amrita Kumar, Kousik Kundu, Michael Koval, Lucky Jain, Niren Murthy, My N Helms
    Abstract:

    To define roles for reactive oxygen species (ROS) and epithelial sodium channel (ENaC) in maintaining lung Fluid Balance in vivo, we used two novel whole animal imaging approaches. Live X-ray fluor...

Edward F Coyle - One of the best experts on this subject based on the ideXlab platform.

  • serum sodium concentration changes are related to Fluid Balance and sweat sodium loss
    Medicine and Science in Sports and Exercise, 2010
    Co-Authors: Matthew D Pahnke, John R. Stofan, Joel D Trinity, Jeffrey J Zachwieja, Douglas W B Hiller, Edward F Coyle
    Abstract:

    PURPOSE: This study determined if changes in serum sodium concentration are related to Fluid Balance as well as sweat sodium losses in triathletes competing in the Hawaii Ironman triathlon. METHODS: Endurance trained athletes (N = 46, age = 24-67 yr) were studied during 30 min of stationary cycling at 70%-75% of HRmax in a warm outdoor laboratory (26.4 degrees C +/- 1.7 degrees C wet bulb globe temperature [WBGT], 28.3 degrees C +/- 1.2 degrees C dry bulb [DB]) 3-7 d before race day. Sweat sodium concentration was measured from absorbent patches on the forearm and scapula, and sweating rate was derived from changes in body mass. Before and after the race, serum sodium concentration, body mass, and nutritional intake during the race were also measured (N = 46). Sweating and race day comparisons and changes in serum sodium concentration were analyzed via Student's t-test, correlation, and multiple regression. RESULTS: In men, the change in serum sodium concentration during the race was correlated with relative sweating rate (mL.kg.h; r = -0.49, P = 0.012), rate of sweat sodium loss (mEq.kg.h; r = -0.44, P = 0.023), and body mass change (kg; r = -0.54, P = 0.005). Together, the rate of sweat sodium loss and body mass change accounted for 46% of the change in serum sodium concentration in men (R = 0.46). In women, body mass change alone was significantly correlated with the change in serum sodium concentration (r = 0.31). The rate of sodium intake (mEq.kg.h) was related to the rate of sweat sodium loss in women (mEq.kg.h; r = 0.64, P = 0.035) but not in men (r = 0.27, P = 0.486). CONCLUSION: Changes in serum sodium concentration during an ultraendurance triathlon are significantly related to interactions of Fluid Balance, sweat sodium loss, and sodium ingestion.

  • serum sodium concentration changes are related to Fluid Balance and sweat sodium loss
    Medicine and Science in Sports and Exercise, 2010
    Co-Authors: Matthew D Pahnke, John R. Stofan, Joel D Trinity, Jeffrey J Zachwieja, Douglas W B Hiller, Edward F Coyle
    Abstract:

    Purpose: This study determined if changes in serum sodium concentration are related to Fluid Balance as well as sweat sodium losses in triathletes competing in the Hawaii Ironman® triathlon. Methods: Endurance trained athletes (N = 46, age = 24-67 yr) were studied during 30 min of stationary cycling at 70%-75% of HRmax in a warm outdoor laboratory (26.4°C ± 1.7°C wet bulb globe temperature [WBGT], 28.3°C ± 1.2°C dry bulb [DB]) 3-7 d before race day. Sweat sodium concentration was measured from absorbent patches on the forearm and scapula, and sweating rate was derived from changes in body mass. Before and after the race, serum sodium concentration, body mass, and nutritional intake during the race were also measured (N = 46). Sweating and race day comparisons and changes in serum sodium concentration were analyzed via Student's t-test, correlation, and multiple regression. Results: In men, the change in serum sodium concentration during the race was correlated with relative sweating rate (mL·kg-1·h-1; r = -0.49, P = 0.012), rate of sweat sodium loss (mEq·kg-1·h-1; r = -0.44, P = 0.023), and body mass change (kg; r = -0.54, P = 0.005). Together, the rate of sweat sodium loss and body mass change accounted for 46% of the change in serum sodium concentration in men (R2 = 0.46). In women, body mass change alone was significantly correlated with the change in serum sodium concentration (r2 = 0.31). The rate of sodium intake (mEq·kg-1·h-1) was related to the rate of sweat sodium loss in women (mEq·kg-1·h-1; r = 0.64, P = 0.035) but not in men (r = 0.27, P = 0.486). Conclusion: Changes in serum sodium concentration during an ultraendurance triathlon are significantly related to interactions of Fluid Balance, sweat sodium loss, and sodium ingestion

Michael A Matthay - One of the best experts on this subject based on the ideXlab platform.

  • positive Fluid Balance is associated with higher mortality and prolonged mechanical ventilation in pediatric patients with acute lung injury
    Critical Care Research and Practice, 2011
    Co-Authors: Heidi R Flori, Kathleen D Liu, Gwynne D Church, Ginny Gildengorin, Michael A Matthay
    Abstract:

    Introduction. We analyzed a database of 320 pediatric patients with acute lung injury (ALI), to test the hypothesis that positive Fluid Balance is associated with worse clinical outcomes in children with ALI. Methods. This is a post-hoc analysis of previously collected data. Cumulative Fluid Balance was analyzed in ml per kilogram per day for the first 72 hours after ALI while in the PICU. The primary outcome was mortality; the secondary outcome was ventilator-free days. Results. Positive Fluid Balance (in increments of 10 mL/kg/24 h) was associated with a significant increase in both mortality and prolonged duration of mechanical ventilation, independent of the presence of multiple organ system failure and the extent of oxygenation defect. These relationships remained unchanged when the subgroup of patients with septic shock (n = 39) were excluded. Conclusions. Persistently positive Fluid Balance may be deleterious to pediatric patients with ALI. A confirmatory, prospective randomized controlled trial of Fluid management in pediatric patients with ALI is warranted.

  • acute effects of tidal volume strategy on hemodynamics Fluid Balance and sedation in acute lung injury
    Critical Care Medicine, 2005
    Co-Authors: Ivan W Cheng, Mark D Eisner, Taylor B Thompson, Lorraine B Ware, Michael A Matthay
    Abstract:

    Objective: To examine the effects of mechanical ventilation with a tidal volume of 6 mL/kg compared with 12 mL/kg predicted body weight on hemodynamics, vasopressor use, Fluid Balance, diuretics, sedation, and neuromuscular blockade within 48 hrs in patients with acute lung injury and acute respiratory distress syndrome. Design: Retrospective analysis of a previously conducted randomized, clinical trial. Setting: Two adult intensive care units at a tertiary university medical center and a large county hospital. Patients: One hundred eleven patients who were enrolled in the National Institutes of Health ARDS Network trial at the University of California, San Francisco. Interventions: None. Measurements and Main Results: Compared with 12 mL/kg predicted body weight, treatment with a tidal volume of 6 mL/kg predicted body weight had no adverse effects on hemodynamics. There were also no differences in the need for supportive therapies, including vasopressors, intravenous Fluids, or diuretics. In addition, there were no differences in body weight, urine output, and Fluid Balance. Finally, there was no difference in the need for sedation or neuromuscular blockade between the two tidal volume protocols. Conclusions: When compared with ventilation with 12 mL/kg predicted body weight, patients treated with the lung-protective 6 mL/kg predicted body weight tidal volume protocol had no difference in their supportive care requirements. Therefore, concerns regarding potential adverse effects of this protocol should not preclude its use in patients with acute lung injury or the acute respiratory distress syndrome. (Crit Care Med 2005; 33:63‐70)

  • integrated control of lung Fluid Balance
    American Journal of Physiology-lung Cellular and Molecular Physiology, 2004
    Co-Authors: Dolly Mehta, Jahar Bhattacharya, Michael A Matthay, Asrar B. Malik
    Abstract:

    This review summarizes the highlights of the EB2004 symposium that dealt with the integrated aspects of the lung Fluid Balance. It is apparent that maintenance of lung Fluid Balance requires the pr...

Claudio Ronco - One of the best experts on this subject based on the ideXlab platform.

  • Fluid Balance and urine volume are independent predictors of mortality in acute kidney injury
    Critical Care, 2013
    Co-Authors: Catarina Teixeira, Pasquale Piccinni, Michele Iannuzzi, Silvia Gramaticopolo, Nicola Brienza, Francesco Garzotto, Monica Rocco, Francesco Forfori, Paolo Pelaia, Claudio Ronco
    Abstract:

    In ICUs, both Fluid overload and oliguria are common complications associated with increased mortality among critically ill patients, particularly in acute kidney injury (AKI). Although Fluid overload is an expected complication of oliguria, it remains unclear whether their effects on mortality are independent of each other. The aim of this study is to evaluate the impact of both Fluid Balance and urine volume on outcomes and determine whether they behave as independent predictors of mortality in adult ICU patients with AKI. We performed a secondary analysis of data from a multicenter, prospective cohort study in 10 Italian ICUs. AKI was defined by renal sequential organ failure assessment (SOFA) score (creatinine >3.5 mg/dL or urine output (UO) <500 mL/d). Oliguria was defined as a UO <500 mL/d. Mean Fluid Balance (MFB) and mean urine volume (MUV) were calculated as the arithmetic mean of all daily values. Use of diuretics was noted daily. To assess the impact of MFB and MUV on mortality of AKI patients, multivariate analysis was performed by Cox regression. Of the 601 included patients, 132 had AKI during their ICU stay and the mortality in this group was 50%. Non-surviving AKI patients had higher MFB (1.31 ± 1.24 versus 0.17 ± 0.72 L/day; P <0.001) and lower MUV (1.28 ± 0.90 versus 2.35 ± 0.98 L/day; P <0.001) as compared to survivors. In the multivariate analysis, MFB (adjusted hazard ratio (HR) 1.67 per L/day, 95%CI 1.33 to 2.09; <0.001) and MUV (adjusted HR 0.47 per L/day, 95%CI 0.33 to 0.67; <0.001) remained independent risk factors for 28-day mortality after adjustment for age, gender, diabetes, hypertension, diuretic use, non-renal SOFA and sepsis. Diuretic use was associated with better survival in this population (adjusted HR 0.25, 95%CI 0.12 to 0.52; <0.001). In this multicenter ICU study, a higher Fluid Balance and a lower urine volume were both important factors associated with 28-day mortality of AKI patients.

  • Fluid management in the intensive care unit bioelectrical impedance vector analysis as a tool to assess hydration status and optimal Fluid Balance in critically ill patients
    Blood Purification, 2013
    Co-Authors: Flavio Basso, Pasquale Piccinni, Dinna N Cruz, Giovanna Berdin, Grazia Maria Virzi, Giacomo Mason, Marzena Wjewodzka, Anna Giuliani, A Brendolan, Claudio Ronco
    Abstract:

    Background: Fluid Balance disorders are a relevant risk factor for morbidity and mortality in critically ill patients. Volume assessment in the intensive care uni

  • Fluid Balance as a biomarker impact of Fluid overload on outcome in critically ill patients with acute kidney injury
    Critical Care, 2008
    Co-Authors: Sean M Bagshaw, Patrick D Brophy, Dinna N Cruz, Claudio Ronco
    Abstract:

    Fluid therapy is fundamental to the acute resuscitation of critically ill patients. In general, however, early and appropriate goal-directed Fluid therapy contributes to a degree of Fluid overload in most if not all patients. Recent data imply that a threshold may exist beyond which, after acute resuscitation, additional Fluid therapy may cause harm. In patients with acute kidney injury and/or oliguria, a positive Fluid Balance is almost universal. Few studies have examined the impact of Fluid Balance on clinical outcomes in critically ill adults with acute kidney injury. Payen and coworkers, in a secondary analysis of the SOAP (Sepsis Occurrence in Acutely Ill Patients) study, now present evidence that there is an independent association between mortality and positive Fluid Balance in a cohort of critically ill patients with acute kidney injury. In this commentary, we discuss these findings within the context of prior literature and propose that assessment of Fluid Balance should be considered as a potentially valuable biomarker of critical illness.

Manu L N G Malbrain - One of the best experts on this subject based on the ideXlab platform.