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1.
Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study.
Akdeniz, M, Boeing, H, Müller-Werdan, U, Aykac, V, Steffen, A, Schell, M, Blume-Peytavi, U, Kottner, J
Skin pharmacology and physiology. 2018;(3):155-162
Abstract
BACKGROUND/AIM: Inadequate fluid intake is assumed to be a trigger of water-loss dehydration, which is a major health risk in aged and geriatric populations. Thus, there is a need to search for easy to use diagnostic tests to identify dehydration. Our overall aim was to investigate whether skin barrier parameters could be used for predicting fluid intake and/or hydration status in geriatric patients. METHODS An explorative observational comparative study was conducted in a geriatric hospital including patients aged 65 years and older. We measured 3-day fluid intake, skin barrier parameters, Overall Dry Skin Score, serum osmolality, cognitive and functional health, and medications. RESULTS Forty patients were included (mean age 78.45 years and 65% women) with a mean fluid intake of 1,747 mL/day. 20% of the patients were dehydrated and 22.5% had an impending dehydration according to serum osmolality. Multivariate analysis suggested that skin surface pH and epidermal hydration at the face were associated with fluid intake. Serum osmolality was associated with epidermal hydration at the leg and skin surface pH at the face. Fluid intake was not correlated with serum osmolality. Diuretics were associated with high serum osmolality. CONCLUSIONS Approximately half of the patients were diagnosed as being dehydrated according to osmolality, which is the current reference standard. However, there was no association with fluid intake, questioning the clinical relevance of this measure. Results indicate that single skin barrier parameters are poor markers for fluid intake or osmolality. Epidermal hydration might play a role but most probably in combination with other tests.
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2.
Comparison of Two Fluid Replacement Protocols During a 20-km Trail Running Race in the Heat.
Lopez, RM, Casa, DJ, Jensen, KA, Stearns, RL, DeMartini, JK, Pagnotta, KD, Roti, MW, Armstrong, LE, Maresh, CM
Journal of strength and conditioning research. 2016;(9):2609-16
Abstract
Lopez, RM, Casa, DJ, Jensen, K, Stearns, RL, DeMartini, JK, Pagnotta, KD, Roti, MW, Armstrong, LE, and Maresh, CM. Comparison of two fluid replacement protocols during a 20-km trail running race in the heat. J Strength Cond Res 30(9): 2609-2616, 2016-Proper hydration is imperative for athletes striving for peak performance and safety, however, the effectiveness of various fluid replacement strategies in the field setting is unknown. The purpose of this study was to investigate how two hydration protocols affect physiological responses and performance during a 20-km trail running race. A randomized, counter-balanced, crossover design was used in a field setting (mean ± SD: WBGT 28.3 ± 1.9° C). Well-trained male (n = 8) and female (n = 5) runners (39 ± 14 years; 175 ± 9 cm; 67.5 ± 11.1 kg; 13.4 ± 4.6% BF) completed two 20-km trail races (5 × 4-km loop) with different water hydration protocols: (a) ad libitum (AL) consumption and (b) individualized rehydration (IR). Data were analyzed using repeated measures ANOVA. Paired t-tests compared pre-race-post-race measures. Main outcome variables were race time, heart rate (HR), gastrointestinal temperature (TGI), fluid consumed, percent body mass loss (BML), and urine osmolality (Uosm). Race times between groups were similar. There was a significant condition × time interaction (p = 0.048) for HR, but TGI was similar between conditions. Subjects replaced 30 ± 14% of their water losses in AL and 64 ± 16% of their losses in IR (p < 0.001). Ad libitum trial experienced greater BML (-2.6 ± 0.5%) compared with IR (-1.3 ± 0.5%; p < 0.001). Pre-race to post-race Uosm differences existed between AL (-273 ± 146 mOsm) and IR (-145 ± 215 mOsm, p = 0.032). In IR, runners drank twice as much fluid than AL during the 20-km race, leading to > 2% BML in AL. Ad libitum drinking resulted in 1.3% greater BML over the 20-km race, which resulted in no thermoregulatory or performance differences from IR.
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3.
Effects of hydration and water deprivation on blood viscosity during a soccer game in sickle cell trait carriers.
Diaw, M, samb, A, Diop, S, Sall, ND, Ba, A, Cissé, F, Connes, P
British journal of sports medicine. 2014;(4):326-31
Abstract
The present study compared the changes in blood viscosity, hydration status, body temperature and heart rate between a group of sickle cell trait (SCT) carriers and a control (Cont) group before and after a soccer game performed in two conditions: one with water offered ad libitum (hydration condition; Hyd) and the other one without water (dehydration condition; Dehyd). Blood viscosity and haematocrit per blood viscosity ratio (HVR; an index of red blood cell oxygen transport effectiveness) were measured before and at the end of each game. Resting blood viscosity was greater in the SCT carriers than in the Cont group. The increase of blood viscosity over baseline at the end of the game in the Cont group was similar in the two conditions. In contrast, the change in blood viscosity occurring in SCT carriers during soccer games was dependant on the experimental condition: (1) in Dehyd condition, blood viscosity rose over baseline; (2) in Hyd condition, blood viscosity decreased below resting level reaching Cont values. The Cont group had higher HVR than SCT carriers at rest. HVR remained unchanged in the Cont group at the end of the games, whatever the experimental condition. Although HVR of SCT carriers decreased below baseline at the end of the game performed in Dehyd condition, it increased over resting level in Hyd condition reaching the values of the Cont group. Our study demonstrated that ad libitum hydration in exercising SCT carriers normalises the blood hyperviscosity.
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4.
Ad libitum vs. restricted fluid replacement on hydration and performance of military tasks.
Nolte, HW, Noakes, TD, Nolte, K
Aviation, space, and environmental medicine. 2013;(2):97-103
Abstract
INTRODUCTION The primary objective was to evaluate the effect of ad libitum vs. restricted fluid replacement protocol on hydration markers and performance in selected military tasks. The secondary objective was to determine if 300 ml x h(-1) could be considered a safe minimum fluid intake under the experimental conditions. METHODS Data were collected simulating a route march over 16 km. There were 57 subjects who participated in the study. RESULTS The mean pre-exercise body mass of the ad libitum group was 70.4 +/- 13.3 (SD) kg compared to 69.3 +/- 8.9 kg in the restricted group. The mean total fluid intake of the ad libitum group was 2.1 +/- 0.9 L compared to 1.2 +/- 0.0 L in the restricted group. The ad libitum and restricted intake groups, respectively, lost a mean of 1.05 kg +/- 0.77 (1.5%) and 1.34 kg +/- 0.37 (1.9%). Calculated sweat rate was 608 +/- 93 ml x h(-1) compared to 762 +/- 162 ml x h(-1) in the ad libitum group. DISCUSSION There were no significant differences for either urine specific gravity (USG) or urine osmolality (UOsm) before or after the exercise. It is not clear whether fluid intake and calculated sweat rates are causally related or explained by their codependence on a third variable; for example, the exercising metabolic rate. Thus, 300 ml x h(-1) intake could be considered a current safe minimum water intake for soldiers of similar mass under similar experimental conditions, namely similar exercise durations at equivalent exercise intensities in a moderate, dry climate.
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5.
Sodium chloride 0.9% versus Lactated Ringer in the management of severely dehydrated patients with choleriform diarrhoea.
Cieza, JA, Hinostroza, J, Huapaya, JA, León, CP
Journal of infection in developing countries. 2013;(7):528-32
Abstract
INTRODUCTION Although experience within Peru suggests clinical and physiological benefits of treating dehydration caused by diarrhoea with Lactated Ringer's solution (LR) over sodium chloride 0.9%, (NaCl) there is little documented scientific evidence supporting this view. It is important to clarify this issue and determine the best solution for use during epidemics. METHODOLOGY Forty patients suffering from dehydration due to choleriform diarrhoea were enrolled in the study. Twenty patients were treated using NaCl (Group A) and the other twenty with LR (Group B). After diuresis recovery was achieved, the patients were continued on a course of oral rehydration salts. Serum electrolytes, arterial pH, HCO3-, and pCO2 were measured at three stages: at admission, after diuresis recovery, and after 12 hours. RESULTS Acidosis was corrected more quickly with LR that NaCl. The hyperosmolality and hypernatremic states were corrected with both solutions. CONCLUSION LR use resulted in a better clinical response than NaCl, illustrated by more rapid physiological correction, showing that mixed metabolic acidosis was corrected more quickly and more appropriately with this treatment.
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6.
Influence of beverage temperature on palatability and fluid ingestion during endurance exercise: a systematic review.
Burdon, CA, Johnson, NA, Chapman, PG, O'Connor, HT
International journal of sport nutrition and exercise metabolism. 2012;(3):199-211
Abstract
UNLABELLED Beverage palatability is known to influence fluid consumption during exercise and may positively influence hydration status and help prevent fatigue, heat illness, and decreased performance. PURPOSE The aims of this review were to evaluate the effect of beverage temperature on fluid intake during exercise and investigate the influence of beverage temperature on palatability. METHODS Citations from multiple databases were searched from the earliest record to November 2010 using the terms beverage, fluid, or water and palatability, preference, feeding, and drinking behavior and temperature. Included studies (N = 14) needed to use adult (≥18 yr) human participants, have beverage temperatures ≤50 °C, and measure consumption during exercise and/or palatability. RESULTS All studies reporting palatability (n = 10) indicated that cold (0-10 °C) or cool (10-22 °C) beverages were preferred to warmer ones (control, ≥22 °C). A meta-analysis on studies reporting fluid consumption (n = 5) revealed that participants consumed ~50% (effect size = 1.4, 0.75-2.04, 95% CI) more cold/cool beverages than control during exercise. Subanalysis of studies assessing hydration status (n = 4) with consumption of cool/cold vs. warm beverages demonstrated that dehydration during exercise was reduced by 1.3% of body weight (1.6-0.9%, 95% CI; p < .001). CONCLUSION Cool beverage temperatures (<22 °C) significantly increased fluid palatability, fluid consumption, and hydration during exercise vs. control (≥22 -°C).
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7.
Reflex inhibition of electrically induced muscle cramps in hypohydrated humans.
Miller, KC, Mack, GW, Knight, KL, Hopkins, JT, Draper, DO, Fields, PJ, Hunter, I
Medicine and science in sports and exercise. 2010;(5):953-61
Abstract
INTRODUCTION Anecdotal evidence suggests that ingesting small volumes of pickle juice relieves muscle cramps within 35 s of ingestion. No experimental evidence exists supporting the ingestion of pickle juice as a treatment for skeletal muscle cramps. METHODS On two different days (1 wk apart), muscle cramps were induced in the flexor hallucis brevis (FHB) of hypohydrated male subjects (approximately 3% body weight loss and plasma osmolality approximately 295 mOsm x kg(-1) H2O) via percutaneous tibial nerve stimulation. Thirty minutes later, a second FHB muscle cramp was induced and was followed immediately by the ingestion of 1 mL x kg(-1) body weight of deionized water or pickle juice (73.9 +/- 2.8 mL). RESULTS Cramp duration and FHB EMG activity during the cramp were quantified, as well as the change in plasma constituents. Cramp duration (water = 151.9 +/- 12.9 s and pickle juice = 153.2 +/- 23.7 s) and FHB EMG activity (water = 60% +/- 6% and pickle juice = 68% +/- 9% of maximum voluntary isometric contraction EMG activity) were similar during the initial cramp induction without fluid ingestion (P > 0.05). During FHB muscle cramp induction combined with fluid ingestion, FHB EMG activity was again similar (water = 55% +/- 9% and pickle juice = 66% +/- 9% of maximum voluntary isometric contraction EMG activity, P > 0.05). However, cramp duration was 49.1 +/- 14.6 s shorter after pickle juice ingestion than water (84.6 +/- 18.5 vs 133.7 +/- 15.9 s, respectively, P < 0.05). The ingestion of water or pickle juice had little impact on plasma composition 5 min after ingestion. CONCLUSIONS Pickle juice, and not deionized water, inhibits electrically induced muscle cramps in hypohydrated humans. This effect could not be explained by rapid restoration of body fluids or electrolytes. We suspect that the rapid inhibition of the electrically induced cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and acts to inhibit the firing of alpha motor neurons of the cramping muscle.
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8.
Intravenous versus oral rehydration in athletes.
van Rosendal, SP, Osborne, MA, Fassett, RG, Lancashire, B, Coombes, JS
Sports medicine (Auckland, N.Z.). 2010;(4):327-46
Abstract
Fluid is typically administered via intravenous (IV) infusion to athletes who develop clinical symptoms of heat illness, based on the perception that dehydration is a primary factor contributing to the condition. However, other athletes also voluntarily rehydrate with IV fluid as opposed to, or in conjunction with, oral rehydration. The voluntary use of IV fluids to accelerate rehydration in dehydrated, though otherwise healthy athletes, has recently been banned by the World Anti-Doping Agency. However, the technique remains appealing to many athletes. Given that it now violates the Anti-Doping Code, it is important to determine whether potential benefits of using this technique outweigh the risks involved. Several studies have shown that rehydration is more rapid with IV fluid. However, the benefits are generally transient and only small differences to markers of hydration status are seen when comparing IV and oral rehydration. Furthermore, several studies have shown improvements in cardiovascular function and thermoregulation with IV fluid, while others have indicated that oral fluid is superior. Subsequent exercise performance has not been improved to a greater extent with one technique over the other. The paucity of definitive findings is probably related to the small number of studies investigating these variables and the vast differences in the designs of studies that have been conducted. The major limitation of IV rehydration is that it bypasses oropharyngeal stimulation, which has an influence on factors such as thirst sensation, antidiuretic hormone (arginine vasopressin) release, cutaneous vasodilation and mean arterial pressure. Further research is necessary to determine the relative benefits of oral and IV rehydration for athletes.
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9.
Voluntary fluid intake, hydration status, and aerobic performance of adolescent athletes in the heat.
Wilk, B, Timmons, BW, Bar-Or, O
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2010;(6):834-41
Abstract
We determined whether beverage flavoring and composition would stimulate voluntary drink intake, prevent dehydration, and maintain exercise performance in heat-acclimated adolescent males running in the heat. Eight adolescent (age, 13.7 ± 1.1 years) runners (peak oxygen uptake, 59.5 ± 4.0 mL·kg-1·min-1) underwent at least four 80-min exercise heat-acclimation sessions before completing 3 experimental sessions. All sessions were performed at 30 °C and 60%-65% relative humidity. Each experimental session consisted of five 15-min treadmill runs at a speed eliciting 65% peak oxygen uptake, with a 5 min rest prior to each run. Ten minutes after the final run, a time to exhaustion test was performed at a speed eliciting 90% peak oxygen uptake. Counterbalanced experimental sessions were identical, except for fluid intake, which consisted of tap water (W), flavored water (FW), and FW with 6% carbohydrate and 18 mmol·L-1 NaCl (CNa) consumed ad libitum. Fluid intake and body weight were monitored to calculate dehydration. Voluntary fluid intake was similar to fluid losses in W (1032 ± 130 vs. 1340 ± 246 g), FW (1086 ± 86 vs. 1451 ± 253 g), and CNa (1259 ± 119 vs. 1358 ± 234 g). As a result, significant dehydration was avoided in all trials (-0.45% ± 0.68% body weight in W, -0.66% ± 0.50% body weight in FW, and -0.13% ± 0.71% body weight in CNa). Core temperature increased by ~1 °C during exercise, but was not different between trials. Time to exhaustion was not different between trials and averaged 8.8 ± 1.7 min. Under exercise conditions more closely reflecting real-life situations, heat-acclimatized adolescent male runners can appropriately gauge fluid intake regardless of the type of beverage made available, resulting in consistency in exercise performance.
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10.
Effects of commercially formulated water on the hydration status of dehydrated collegiate wrestlers.
Valiente, JS, Utter, AC, Quindry, JC, Nieman, DC
Journal of strength and conditioning research. 2009;(8):2210-6
Abstract
The objective of this study was to evaluate the effects of three different drinks (commercially formulated water, bottled water, and a carbohydrate-electrolyte beverage) on blood and urinary markers of hydration after acute dehydration in collegiate wrestlers. Twenty-one athletes were recruited to perform a randomized, crossover study comparing the effectiveness of commercially formulated water, carbohydrate-electrolyte (6% or 60 g L(-1)), or regular bottled water (placebo) in promoting rehydration after a 3% reduction in body mass. Urine specific gravity (U(sg)), urine osmolarity (U(osm)), plasma osmolarity (P(osm)), and plasma volume were measured pre- and post-dehydration and at 1 hour after rehydration. Statistical analyses used a 3 (conditions) x 3 (times) repeated measures analysis of variance. Significant (p < 0.01) interactions were found for P(osm), U(osm), and U(sg). P(osm) returned to baseline levels and U(osm) remained in a lower balance after 1 hour of rehydration in the trials of the commercially formulated water and regular bottled water. No significant interactions were found for plasma volume shift. The findings of this study demonstrate that the commercially formulated water was no more effective in promoting rehydration than either a carbohydrate-electrolyte solution or plain water in collegiate wrestlers after a 3% reduction in body mass and a rehydration period of 1 hour when consuming 100% of their body weight loss.