Clinical Biochemistry of Domestic Animals (Sixth Edition) - UMK ...

Chapter 17
Fluid, Electrolyte, and Acid-Base
Balance
Gary P. Carlson
Department of Medicine and Epidemiology
School of Veterinary Medicine
University of California, Davis
Davis, California
I. INTRODUCTION
II. PHYSIOLOGY OF FLUID AND ELECTROLYTE
BALANCE
III. BODY FLUID COMPARTMENTS
A. Total Body Water
B. Extracellular Fluid Volume
C. Intracellular Fluid Volume
IV. REGULATION OF BODY FLUIDS AND
ELECTROLYTES
A. Effective Circulating Volume
B. Antidiuretic Hormone
C. Renin-Angiotensin
D. Aldosterone
E. Atrial Natriuretic Factor
V. PHYSIOLOGY OF ACID-BASE BALANCE
A. De finition of pH
B. Buffers
C. Acidosis
D. Alkalosis
E. Mixed Acid-Base Imbalances
F. Anion Gap
G. Bicarbonate and Total CO 2
H. Buffer Base, Standard Bicarbonate, and Base Excess
or Base Deficit
I. Nontraditional or Strong Ion Approach to Acid-Base
Balance
J. Dietary Factors in Acid-Base Balance
VI. EVALUATION OF IMBALANCES
A. Water
B. Sodium
C. Potassium
D. Chloride
VII. CLINICAL FEATURES OF FLUID AND ELECTROLYTE
BALANCE
A. History
B. Clinical Signs
Michael Bruss
Department of Anatomy, Physiology, and Cell Biology
School of Veterinary Medicine
University of California, Davis
Davis, California
VIII. CLINICOPATHOLOGICAL INDICATORS OF FLUID
AND ELECTROLYTE IMBALANCE
A. Packed Cell Volume and Total Plasma Protein
B. Serum Sodium
C. Serum Potassium
D. Serum Chloride
E. Osmolality
REFERENCES
I . INTRODUCTION
The body fluids are arranged in dynamic, but orderly, functional
compartments. Maintenance of these compartments in
terms of volume and composition is essential for sustaining
normal physiological and biochemical events. The electrolytes
dissolved in body fluids fulfill vital roles in virtually
all of life’s processes. Transmembrane movements of electrolytes
are responsible for the electrical events that result in
nerve conduction and muscular contraction, and the electrical
stability of membranes is highly dependent on the concentration
of electrolytes on both sides. Electrolytes also
serve as essential cofactors in many enzymatically mediated
metabolic reactions. The pH of body fluids is maintained
within narrow limits. This fine control is necessary to maintain
the structure and function of proteins essential for normal
progression of metabolic events. Virtually every organ
system participates in the maintenance of fluid and electrolyte
balance or is adversely affected by imbalances. In many
disease states, impaired fluid intake, excessive fluid losses,
or organ damage and dysfunction will lead to a state of
altered fluid and electrolyte balance. Regardless of whether
fluid and electrolyte alterations are the primary problem or
simply represent secondary manifestations of some other
disease process, successful patient management depends on
correct evaluation and appropriate therapy. To achieve this
goal, one must have a clear understanding of the anatomy
Clinical Biochemistry of Domestic Animals, 6th Edition 529
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