Body fluids compositions,

and their measurements

By: DR QAZI IMTIAZ RASOOL
 OBJECTIVES
a)Discuss the distribution of total body
H2O (TWB) in the body

b) List the ionic composition of different

body compartments

c) Explain the principles of measurements

 Body as an open sytem

Body exchanges materials and energy
with its surroundings
 Route Range Regulatory
(l/day) influences

Insensible - 0.3-0.4 Atmospheric

lungs vapor
pressure
(temperature)

Insensible - 0.35-0.4 10x increase

skin in burn
victims

Sweat 0.1-2 (per Temperature,

hour) exercise

Feces 0.1-0.2 Diarrheal

disease

Urine 0.5-1.4-20 Body fluid

composition
FACTORS AFFECTING
Total Body H2O

varies depending on body fat:

1. Infant: 73-80%

2. Male adult: 60%

3. Female adult: 40-50%

4. Effects of obesity

5. Old age 45%

6. Climate Level of physical activity

PERCENTAGE OF H2O IN TISSUES
 FLUID COMPARTMENTS

EXTRA CELLUAR INTRA

CELLULAR
FLUID (cytosol)FLUID

PLASMA INTERSTITIAL TRANSCELLULAR

FLUID FLUID

1. CSF
2. Intra ocular
3. Pleural
4. Peritoneal
5. Synovial
 PERCENTAGE OF WATER IN TISSUES

Average 70 kg person total body weight

42 litres total H2O 60%
28 l. Intracellular fluid (ICF) 40%
14 l. Extracellular fluid (ECF) 20%
% is important in fluid therapy
divided into ISF and plasma water
10.5 l. Interstitial fluid (ISF) 15%
3.5 l. Plasma water 5%
 Regulation of H2O Intake

The hypothalamic thirst center is stimulated:

1.By a decline in plasma volume of 10%15%

2.By increases in plasma osmolality of 12%

3.Via baroreceptor input, angiotensin II, and

other stimuli
1. Semipermeable membrane

2. Movement some solute obstructed

3. H2O (solvent) crosses freely

4. End point:

1. H2O moves until solute concentration on

both sides of the membrane is equal
2. OR, an opposing force prevents further
movement
Solutes dissolved particles

1. Electrolytes charged particles

1. Cations positively charged ions
Na+, K+ , Ca++, H+
2. Anions negatively charged ions
Cl-, HCO3- , PO43-

2. Non-electrolytes - Uncharged
1. Proteins, urea, glucose, O2, CO2

12
APPROXIMATE IONIC COMPOSITION OF THE
BODY H2O COMPARTMENTS
Plasma Interstitial Cell
H2O H2O
H2O
Balance of Starling Forces acting across the capillary
membrane
1. osmotic forces
2. hydrostatic forces

Plasma vs Interstitial Space

-Balance between Hydrostatic and Colloid Osmotic
forces across the capillary membranes

Intracellular vs Extracellular
1. Osmotic effect (e.g. electrolytes)
2. ICFV is NOT altered by: iso-osmotic changes in
extracellular fluid volume.
 Plasma is clinically accessible
Dominated by [Na+] and the associated
anions
Under normal conditions, ECF osmolarity
can be roughly estimated as:

POSM = 2 [Na+]p 270-290 mOSM

 Net Osmotic Force
Ionic compositionDevelopment
very different
-Total ionic concentration very similar
-Total osmotic concentrations virtually identical

1. Semipermeable membrane.
2. Movement some solute obstructed.
3. H2O (solvent) crosses freely.
4. End point:
H2O moves until solute concentration on both sides of
the membrane is equal.
OR, an opposing force prevents further movement.
 Disorders of H2O Balance: Dehydration

Cells lose H2O

1 Excessive loss of H2O from 2 ECF osmotic 3 to ECF by
ECF pressure rises osmosis; cells
shrink

(a) Mechanism of dehydration

 ECF Osmolarity? ECF Osmolarity ?
1. H2O moves out of 1. H2O moves into the
cells cells
2. ICF Volume decreases 2. ICF Volume increases
(Cells shrink) (Cells swell)
3. ICF Osmolarity increases 3. ICF Osmolarity
decreases
4. Total body osmolarity
remains higher than 4. Total body osmolari
normal remains lower than
normal
 CRITERIA FOR A SUITABEL DYE.
BODY FLUID MARKER

1. Must mix evenly throughout the compartment

2. Non toxic, no physiological activity

3. Even mixing

4. Must have no effect of its own on the distribution of H2O or other

substances in the body

5. Either it must be unchanged during the experiment or if it changes

, the amount changed must be known.

6. The material should be relatively easy to measure.

 DILUTION PRINCIPLE
Principle of mass conservation
Based on using a marker whose concentration can be
measured.

Inject x gm of marker into compartment

measure concentration at equilibrium (y gm/L)
Since concentration = mass/ volume
Volume = mass / concentration
= x/y L

C1V1=C2V2
 Measuring Compartment Size
Indirect METHOD INDICATOR (DYE) DILUTION TECHNI
TECHN
(Law of Mass Conservation)
Based on concentration in a well-mixed substance that distributes
itself only in the compartment of interest.
Compartment

Volume (V) Amount of

Tracer Lost
Amount of
Tracer Concentration (C) From
Tracer Added
Compartment
(A)
(E)

Concentration = Amount Injected

Volume of Distribution
Amount of Tracer Remained in Compartment = A - E
Compartment Volume = (A E)/C
 Indicators used for measuring plasma
volume, ECF volume and total body H2O
Compartmen Criterion Indicators
t
1. Plasma Substance 1. Evans blue dye;
should not cross 2. radioiodinated fibrinogen;
capillaries 3. radioiodinated albumin

1. ECF Substance Isotonic solutions of sucrose,

volume should cross inulin, mannitol, NaCl
capillaries but
not cross cell
membranes
1. Total Substance Heavy H2O, tritiated H2O,
body H2O distributes aminopyrine, antipyrine
(TBW) evenly in ICF &
ECF
 Total Body H2O (TBW)

1. Deuterated H2O (D2O)

2. Tritiated H2O (THO)

3. Antipyrine
 Blood volume /Markers used
1. Obtained from plasma volume and hematocrit
2. Total blood volume = Plasma volume/1-
Hematocrit
3. Example: If the plasma volume is 4 liters and the
hematocrit is 0.45, total blood volume is ?
4. =PLASME VOL X 100
100 -HCT

1.T-1824 (Evans blue dye) attaches to plasma proteins and is

removed by the liver. Measures plasma volume
2. Radioactive labeled 125 i albumin
3. Cr51 (radioactive chromium) is incubated with red
blood cells then injected
 Take this problem:
100 mg of sucrose is injected into a 70
kg man. The plasma sucrose level
after mixing is 0.01 mg/ml. If 5 mg
has been metabolized during this
period, then, what is the ECF volume?
9.5 L
14 L
17.5 L If 1mL of solution (10mg/mL) of
10 L dye is dispersed in chamber B
and final concentration is the
chamber is 0.01mg/mL. What is
the volume in chamber B?
1000ml or 1L
 Compartments with
no Compartment-Specific
Substance
1. Determine by subtraction:
2. How would you measure ICF volume?
3. Cannot be measured; it is calculated
(estimated)..
4. ICF volume = Total body H2O ECF volume

5. Interstitial volume
1. Can not be measured directly
6. Interstitial Fluid Volume (ISFV).
ISFV = ECFV - PV
 Measurement of other spaces
Extracellular volume
Na24
Cl35
Inulin
Sucrose
Mannitol
Sulfate
I125 iothalamate
Disperse in plasma and interstitial fluid, but
not permeable to cell membrane
30-60 min for dispersion to extracellular fluid
 Determining body fat:
Technique: bioelectric impedance
technique

Principle:
1. Body fluids conduct electricity well;
2. But fat is anhydrous and therefore is a
poor conductor of electricity;
3. The resistance to flow of a small
current between points on the body is
proportional to fat mass.
 Lean body mass (LBM)

Definition: LBM is fat free mass

Total body mass = fat mass + fat free mass
Note: fat is relatively anhydrous
Note: the H2O content of LBM is constant
H2O content of LBM is constant - 70 ml /100 g
tissue
 Take this problem:
In a healthy adult male weighing 70 kg, total
body H2O (TBW) was measured to be 42 L.
What is his lean body mass (LBM)? What is
his fat mass?
1. Given TBW = 42 L
2. Assume all this H2O is in LBM & that fat is H2O
free
3. We know that H2O content of LBM is 70
ml/100 g
4. Thus, if TBW is 42 L, LBM = 60 kg
5. Since he weights 70 kg, his fat mass is 70-60
= 10 kg