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DETERMINATION OF THE VOLUME OF THE EXTRACELLULAR FLUID OF THE BODY WITH RADIOACTIVE SODIUM.

N L Kaltreider1, G R Meneely, J R Allen

  • 1Departments of Medicine and Radiology, School of Medicine and Dentistry, University of Rochester, and the Medical Clinics of the Strong Memorial and Rochester Municipal Hospital, Rochester, New York.

The Journal of Experimental Medicine
|October 30, 2009
PubMed
Summary
This summary is machine-generated.

This study introduces a radiosodium (Na-24) method to measure sodium space, finding it exceeds extracellular fluid volume due to bone sodium. The thiocyanate method is preferred for clinical use.

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Area of Science:

  • Physiology
  • Nuclear Medicine
  • Biochemistry

Background:

  • Accurate measurement of body fluid compartments is crucial for understanding physiological states and diagnosing diseases.
  • The sodium space, representing fluid available for sodium distribution, includes extracellular fluid and intracellular sodium.
  • Existing methods for measuring extracellular fluid, like thiocyanate, have limitations in precision and speed.

Purpose of the Study:

  • To describe and validate a method for measuring sodium space using radiosodium (Na-24).
  • To compare the radiosodium method with established techniques for plasma volume (T-1824 dye) and extracellular fluid (thiocyanate).
  • To investigate the distribution kinetics of radiosodium and its equilibration with various body fluid compartments, including effusions and bone.

Main Methods:

  • Intravenous administration of radiosodium (Na-24) to normal subjects and dogs.
  • Simultaneous measurements of plasma volume using T-1824 dye.
  • Simultaneous measurements of extracellular fluid using radiosodium and sodium thiocyanate.
  • Analysis of tissue and plasma concentrations of radiosodium and chloride to determine excess sodium in bone.
  • Collection of serum and transudate samples at varying intervals post-injection to assess diffusion equilibrium.

Main Results:

  • Radiosodium rapidly distributes into approximately 25% of body weight within 3 hours, with slower diffusion into CNS and skeleton.
  • Plasma and interstitial fluid constitute 15% and 85% of the sodium space, respectively.
  • Diffusion equilibrium between serum and transudates is delayed (9-12 hours) for both radiosodium and thiocyanate.
  • Excess sodium in bone was quantified in both dogs and humans, representing a significant portion of total body radiosodium.
  • Correcting the sodium space for excess bone sodium reduced the average volume by 18.9% in humans.
  • The radiosodium method provides a measure of sodium space exceeding extracellular fluid by the non-extracellular sodium component.

Conclusions:

  • The radiosodium method accurately measures the sodium space, which is larger than the extracellular fluid volume due to bone sodium.
  • Diffusion equilibrium in edematous effusions is slow, impacting the timing of accurate measurements.
  • While both radiosodium and thiocyanate methods have limitations for precise extracellular fluid estimation, thiocyanate is more practical for clinical settings due to substance availability and simpler apparatus.