Hemodilution, vasopressin suppression, and diuresis during water immersion in man

We hypothesize that hemodilution in the early stages of water immersion plays an important role in vasopressin (AVP) suppression and subsequent diuresis. Ten men (19-24 years) were immersed to the neck in a semireclining position for 8 h in 34.6 degree C tap water. After 8 h of immersion there were decreases (p less than 0.05) in plasma volume (PV) of 15.6%, extracellular volume (ECV) of 18.8%, interstitial volume (ISV) of 19.6%, and red cell volume of 10.7%. Hemodilution (hyposmotem years) were immersed to the neck in a semireclining position for 8 h in 34.6 degree C tap water. After 8 h of immersion there were decreases (p less than 0.05) in plasma volume (PV) of 15.6%, extracellular volume (ECV) of 18.8%, interstitial volume (ISV) of 19.6%, and red cell volume of 10.7%. Hemodilution (hyposmotem years) were immersed to the neck in a semireclining position for 8 h in 34.6 degree C tap water. After 8 h of immersion there were decreases (p less than 0.05) in plasma volume (PV) of 15.6%, extracellular volume (ECV) of 18.8%, interstitial volume (ISV) of 19.6%, and red cell volume of 10.7%. Hemodilution (hyposmotem of 4 mosmol/kg H2O) and near maximal suppression of AVP (to 0.5 pg/ml) and plasma renin activity (to 0.4 ng Ang 1 .ml-1.h-1) were evident by hour 2 of immersion. The early hemodilution (2-2 h) was due to a slight increase in PV with no change in plasma Na+ or osmotic content, even though urine volume and UosmV increased significantly. The hyposmotemia and PRA suppression continued throughout immersion in spite of the progressively increasing diuresis and decreasing PV. These findings suggest the transfer of hypotonic fluid into the vascular system; this fluid does not appear to come from the intracellular volume. We conclude that hyposmotemia is an important part of the mechanism contributing to AVP suppression during water immersion.