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Body Fluid Balance During Heat Stress in Humans

Gary W. Mack, Ethan R. Nadel

10.1002/cphy.cp040110

Source: Supplement 14: Handbook of Physiology, Environmental Physiology

Originally published: 1996

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Water Balance During Heat Stress
2 Methodological Limitations
2.1 Estimation of the Absolute Size of the Body Fluid Compartments
2.2 Estimates of Relative Changes in Body Fluid Compartments
3 Body Fluid Compartments
3.1 Effects of Acute Heat Stress
3.2 Effects of Dehydration
4 Control of Body Fluid Balance During Dehydration
4.1 Sweat Gland Function
4.2 Kidney Function
4.3 Hormonal Control of Renal Function
5 Heat Acclimatization
5.1 Expansion of Body Fluid Compartments
5.2 Mechanism of Plasma Volume Expansion
5.3 Salt Conservation in Sweat Gland
6 Summary
Figure 1. Figure 1.

Distribution of TBW between ICF and ECF compartments. The ECF compartment is divided into five main subdivisions: (1) plasma, (2) rapidly equilibrating interstitial and lymph fluid, (3) slowly equilibrating interstitial fluid of dense connective tissue and cartilage, (4) inaccessible interstitial fluid in bone, and (5) transcellular fluid as suggested by Edelman and Leibman 75. Redrawn from Edelman and Leibman 75.
Figure 2. Figure 2.

Distribution of total body sodium between the ICF and ECF compartments. Similar to Figure 1, the ECF compartment is divided into five main subdivisions: (1) plasma, (2) rapidly equilibrating interstitial‐lymph fluid, (3) slowly equilibrating interstitial fluid in dense connective tissue and cartilage, (4) inaccessible bone sodium, and (5) transcellular. In this diagram the size of each compartment reflects the water content, with their respective sodium concentrations given in mEq Na+ per kg body weight. Redrawn from Edelman and Leibman 75.
Figure 3. Figure 3.

Influence of hydration status on urinary excretion rate in humans during thermal stress. From Lee 152.
Figure 4. Figure 4.

Relationship between changes in interstitial pressure and interstitial volume of dog hindlimb skin during hypohydration and hyperhydration. From Wigg and Reed 267.
Figure 5. Figure 5.

Influence of hyperthermia on CVP‐blood volume relationship of the dog during saline infusion. Total effective vascular compliance determined from slope of pressure volume curve during infusion is reduced during hyperthermia. In this plot, y intercept reflects unstressed blood volume, which was increased following recovery from saline infusion in hyperthermic dogs. From Morimoto et al. 163,164.
Figure 6. Figure 6.

Relationship between reduction in plasma volume (ΔPV) and decrease in volume (ΔECF) following a 2.3% decrease in total body weight induced by light exercise in the heat. Dashed line represents theoretical line determined assuming water is lost from each compartment in proportion to initial volume. Solid line represents regression line determined from experimental data. Taken from Nose et al. 177.
Figure 7. Figure 7.

Increase in plasma osmolality (ΔPosm) in response to a 2.3% decrease in TBW induced by light exercise in the heat is determined by loss of free water (ΔFW) from ECF space. Free water loss represents that volume of pure water which would have to be removed from total fluid loss (sweat and urine) to make it isoosmotic to plasma. Dashed line represents theoretical line determined assuming that TBW is 65% of body weight and that plasma osmolality represents that of TBW in equilibrium. Solid line represents regression line determined from experimental data. From Nose et al. 177.
Figure 8. Figure 8.

Relationship between increase in plasma osmolality (ΔPosm) and decrease in intracellular compartment size (ΔICF) following a 2.3% reduction in TBW induced by light exercise in the heat. Dashed line represents theoretical line determined assuming that initial volume of ICF space is 38% of body weight, that potassium in urine and sweat comes from only ICF space, and that plasma osmolality represents that of ICF space in steady state. Solid line represents regression line determined from experimental data. From Nose et al. 177.
Figure 9. Figure 9.

Changes in body fluid compartments immediately following and at 30 and 60 min after a 2.3% decrease in TBW (20.3 ± 1.3 ml/kg body weight) induced by light exercise in the heat. ΔPV, ΔISF, ΔECF, and ΔICF denote changes in plasma, interstitial, extracellular, and intracellular fluid volumes, respectively. Return of plasma volume control occurs at the expense of the ISF space. From Nose et al. 177.
Figure 10. Figure 10.

Influence of [Na+] in human sweat on loss of free water (ΔFW) and extracellular fluid (ΔECF) normalized for TBW loss (ΔTW). From Nose et al. 177.
Figure 11. Figure 11.

Water losses from ICF and ISF compartments of various organs of thermally dehydrated rat. Volumes are given as % of TBW lost during dehydration. From Nose et al. 178.
Figure 12. Figure 12.

These data illustrate the inability of humans to restore water balance following sodium deprivation induced by prolonged exercise in the heat. During rehydration subjects drank deionized water ad libitum and ingested two sodium‐free meals. Despite a continued thirst drive, water balance was never regained in sodium‐depleted subjects. From Takamata et al. 248.
Figure 13. Figure 13.

Human sweating responses during exercise as a function of internal body temperature at varying levels of dehydration. From Sawka et al. 215.
Figure 14. Figure 14.

Relationship between changes in plasma volume (ΔPV), expressed as % change from control, and PRA following thermally induced dehydration (2.3% body weight loss) and following 3 h of rehydration with either water (H2O‐R) or 0.45% saline (Na‐R). From Nose et al. 175.


Figure 1.

Distribution of TBW between ICF and ECF compartments. The ECF compartment is divided into five main subdivisions: (1) plasma, (2) rapidly equilibrating interstitial and lymph fluid, (3) slowly equilibrating interstitial fluid of dense connective tissue and cartilage, (4) inaccessible interstitial fluid in bone, and (5) transcellular fluid as suggested by Edelman and Leibman 75. Redrawn from Edelman and Leibman 75.



Figure 2.

Distribution of total body sodium between the ICF and ECF compartments. Similar to Figure 1, the ECF compartment is divided into five main subdivisions: (1) plasma, (2) rapidly equilibrating interstitial‐lymph fluid, (3) slowly equilibrating interstitial fluid in dense connective tissue and cartilage, (4) inaccessible bone sodium, and (5) transcellular. In this diagram the size of each compartment reflects the water content, with their respective sodium concentrations given in mEq Na+ per kg body weight. Redrawn from Edelman and Leibman 75.



Figure 3.

Influence of hydration status on urinary excretion rate in humans during thermal stress. From Lee 152.



Figure 4.

Relationship between changes in interstitial pressure and interstitial volume of dog hindlimb skin during hypohydration and hyperhydration. From Wigg and Reed 267.



Figure 5.

Influence of hyperthermia on CVP‐blood volume relationship of the dog during saline infusion. Total effective vascular compliance determined from slope of pressure volume curve during infusion is reduced during hyperthermia. In this plot, y intercept reflects unstressed blood volume, which was increased following recovery from saline infusion in hyperthermic dogs. From Morimoto et al. 163,164.



Figure 6.

Relationship between reduction in plasma volume (ΔPV) and decrease in volume (ΔECF) following a 2.3% decrease in total body weight induced by light exercise in the heat. Dashed line represents theoretical line determined assuming water is lost from each compartment in proportion to initial volume. Solid line represents regression line determined from experimental data. Taken from Nose et al. 177.



Figure 7.

Increase in plasma osmolality (ΔPosm) in response to a 2.3% decrease in TBW induced by light exercise in the heat is determined by loss of free water (ΔFW) from ECF space. Free water loss represents that volume of pure water which would have to be removed from total fluid loss (sweat and urine) to make it isoosmotic to plasma. Dashed line represents theoretical line determined assuming that TBW is 65% of body weight and that plasma osmolality represents that of TBW in equilibrium. Solid line represents regression line determined from experimental data. From Nose et al. 177.



Figure 8.

Relationship between increase in plasma osmolality (ΔPosm) and decrease in intracellular compartment size (ΔICF) following a 2.3% reduction in TBW induced by light exercise in the heat. Dashed line represents theoretical line determined assuming that initial volume of ICF space is 38% of body weight, that potassium in urine and sweat comes from only ICF space, and that plasma osmolality represents that of ICF space in steady state. Solid line represents regression line determined from experimental data. From Nose et al. 177.



Figure 9.

Changes in body fluid compartments immediately following and at 30 and 60 min after a 2.3% decrease in TBW (20.3 ± 1.3 ml/kg body weight) induced by light exercise in the heat. ΔPV, ΔISF, ΔECF, and ΔICF denote changes in plasma, interstitial, extracellular, and intracellular fluid volumes, respectively. Return of plasma volume control occurs at the expense of the ISF space. From Nose et al. 177.



Figure 10.

Influence of [Na+] in human sweat on loss of free water (ΔFW) and extracellular fluid (ΔECF) normalized for TBW loss (ΔTW). From Nose et al. 177.



Figure 11.

Water losses from ICF and ISF compartments of various organs of thermally dehydrated rat. Volumes are given as % of TBW lost during dehydration. From Nose et al. 178.



Figure 12.

These data illustrate the inability of humans to restore water balance following sodium deprivation induced by prolonged exercise in the heat. During rehydration subjects drank deionized water ad libitum and ingested two sodium‐free meals. Despite a continued thirst drive, water balance was never regained in sodium‐depleted subjects. From Takamata et al. 248.



Figure 13.

Human sweating responses during exercise as a function of internal body temperature at varying levels of dehydration. From Sawka et al. 215.



Figure 14.

Relationship between changes in plasma volume (ΔPV), expressed as % change from control, and PRA following thermally induced dehydration (2.3% body weight loss) and following 3 h of rehydration with either water (H2O‐R) or 0.45% saline (Na‐R). From Nose et al. 175.

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Article Title: Body Fluid Balance During Heat Stress in Humans
 

How to Cite

Gary W. Mack, Ethan R. Nadel. Body Fluid Balance During Heat Stress in Humans. Compr Physiol 2011, Supplement 14: Handbook of Physiology, Environmental Physiology: 187-214. First published in print 1996. doi: 10.1002/cphy.cp040110