Dehydration Hypertonic Clinical Trial
Official title:
Thirst-guided Subject-controlled Rehydration in Healthy Volunteers
Water is largest single component to the human body and is requisite for numerous essential
metabolic processes. Dehydration refers to deficient body water content and is prevalent in
healthcare. It has been repeatedly shown that dehydration is associated with increased
mortality and morbidity. Despite its prevalence and deleterious sequelae, there is
substantial deficiency in the knowledge, assessment and management of this pathological
state: there is no internationally-recognised definition, clinical signs can be subtle and
unreliable, and there is no objective marker with everyday clinical utility. As a
consequence, diagnosis of dehydration and prompt rehydration strategies are often poorly
delivered in healthcare environments.
Thirst plays an integral part in body water homeostasis. Plasma osmolality will increase with
uncompensated water loss and is considered the most reliable surrogate objective marker of
dehydration. Increased osmolality is sensed by hypothalamic osmoreceptors stimulating thirst
and pituitary secretion of antidiuretic hormone (ADH). Thirst has been shown to be sensitive
to small changes in plasma osmolality and shows little intra-individual variation. In view of
this, it is rational to propose tendering control of intravenous rehydration to patients,
enabling them to use the finely-honed intrinsic thirst mechanism to guide their own fluid
therapy. A recent pilot study demonstrated that healthy subjects, when allowed to regulate
their own intravenous fluid therapy in response to thirst intensity, rehydrated themselves
more efficiently than subjects receiving a guideline-based, clinician-delivered fluid
regimen. What is unclear is the extent of the reliability of thirst in guiding intravenous
fluid rehydration therapy.
The investigators propose a double-blinded, repeated measures study in which healthy
volunteers are dehydrated using exercise-heat stress in a climatic chamber. Once dehydrated
by 3-5% of their body weight, subjects will receive intravenous fluid rehydration which they
can demand in response to their sensation of thirst. In one arm of the study they will
receive low volume fluid bolus on demand, and in the other arm they will receive a higher
volume fluid bolus. Thirst scores and surrogate markers of dehydration will be measured
throughout this process. The investigators can then assess whether the demand for additional
fluid in response to thirst reduces in frequency in proportion to the degree of correction of
fluid deficit.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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N/A | |
| Recruiting |
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