Rapid plasma volume decline upon quiet standing reflects large filtration capacity in dependent limbs

The plasma volume (PV) decline upon 1.5, 3, 5, 8, 10, 15 and 35 min periods of quiet standing was studied (Hb/Hct) in male volunteers (n = 7). This approach permitted detailed definition of the time-course of the volume change. PV decreased by as much as 8.5 +/- 0.4% (328 +/- 15 mL) after 3 min standing and by no less than 11.7 +/- 0.4% (466 +/- 22 mL) after 5 min. The reduction was 14.3 +/- 0.7, 16.8 +/- 0.8, 17.7 +/- 0.8 and 17.4 +/- 0.9% after 8, 10, 15 and 35 min, or 568 +/- 30, 671 +/- 39, 707 +/- 41 and 691 +/- 44 mL. These data, in conjunction with the 1.5 min experiments, indicated a very rapid approximately 125 mL min-1 fluid loss initially on standing. However, the PV loss showed marked decline with time and was virtually completed within 10 min. Finally, the observation was made that the rate of PV recovery after standing was inversely related to the duration of standing. It is suggested that (a) the transcapillary hydraulic conductivity in the dependent limbs, the predominant targets for fluid filtration on standing, is about 0.010 mL min-1 100 mL-1 mmHg-1 and much greater than indicated previously. However, protective mechanisms restrict rapid fluid loss to early phases of standing. (b) Decrease in PV may contribute importantly to haemodynamic stress and to orthostatic, fainting reactions during short quiet standing. Apparently, PV loss may be equally important as pooling of blood, traditionally regarded as a dominant cause of adverse orthostatic reactions. (c) The duration of standing, as such, may be critical for the rate of PV recovery after standing.